Call Karma...Or Not

I'm on home call this week, so you might say I'm tempting fate by typing this post out. That is, if you believe in call karma -- and I for one don't.

Pager-carrying people like to talk about call karma, tongue-in-cheek for the most part. It's the notion that some unlucky people seem to have consistently hectic call shifts while others sail through hassle-free.

Now assuming random assignment of call shifts, there's no logical explanation for call karma. But the busy sleep-deprived nights leave a more lasting impression than the quiet ones, so we're all susceptible to on occasion convincing ourselves that call karma exists.

And that's fine. A throw-a-way comment about your call karma isn't going to hurt anyone. It's common ground in hospital chit-chat, not unlike how the "q word" (quiet) is invariably met with a knock on wood. We've all said these things.

But is joking about call karma as innocuous as we might think? I'm not so sure.

If something challenging comes up early in your shift and someone ascribes it to call karma, you subconsciously brace yourself for a busy night. Really though, you're using an inaccurate idea to reinforce negative thinking. In that sense, call karma is a cognitive distortion -- a way that our mind convinces us of something that isn't really true.

Call karma aside, your perception of your workload can shape your reality. If you go into home call building it up in your head to be a big task, your pager weighs on your mind and disrupts your evenings. A more laissez-faire approach, where you keep your social plans, work out, and don't make home call out to be more than it has to, might require more adaptability, but probably promotes a healthier mindset.

I decided in med school that when someone asks how I'm doing, I'd never respond with tired. No one wants to hear that. Everyone's tired. There's no need to reinforce it. Similarly, when someone asks how your weekend was, "I was on call" isn't the answer they're looking for. And even if it's true, don't let call define your weekend (or medicine define your life!).

The pages we receive are beyond our control, yet to some extent we all have the power to control our call experience -- dare I say, control our call karma -- by challenging those creeping negative thoughts that shape our outlook on the work.