Look over the shoulder of an ED doctor on the evening train. They aren't scrolling Instagram. They are watching a 15-second video of a fish bone being pulled out of a tonsil, set to Yakety Sax . This is their equivalent of a cat video. The collective snort-laugh that echoes through the carriage usually means someone just watched a Foley catheter get inflated in the wrong spot.
Note: If by "ED" you meant treatment teams or Executive Directors , the lifestyle applies similarly to high-stress, sleep-deprived professionals. However, this article focuses on Emergency Department staff, who are famous for their dark humor and chaotic schedules. The Iron Horse and the Siren’s Call: Life, Laughter, and Sleep-Deprived Chaos on the ED Commuter Train By J. Vance, R.N.
Tomorrow, they will do it again. And the 6:17 AM express will be waiting. molested on train
Twenty minutes later, they return to their seats. The ambulance is waiting at the next station. The adrenaline wears off, leaving only exhaustion.
Between 7:00 AM and 9:00 AM, the train is filled with two distinct species of ED staff: The Night Shift (leaving) and The Day Shift (arriving). They pass each other like ghosts. The night crew has the "thousand-yard stare"—the result of having spent eight hours holding a laceration together while a patient screamed about the Wi-Fi. The day crew has the "pre-shift anxiety tremble"—fueled by the knowledge that the night shift left them three critical patients and a missing crash cart. Look over the shoulder of an ED doctor on the evening train
This is the premier ED train game. It requires two or more exhausted clinicians. “Would you rather deal with a weekend drunk who claims he’s the King of England, or a hypochondriac who has Googled ‘exploding head syndrome’?” “The King. At least he stays still for the IV.” The game escalates until someone mentions "rectal foreign body removal," at which point everyone groans and the game ends.
The 6:17 AM express out of Westhaven doesn’t look like a nightclub. It smells of stale coffee, wet wool, and regret. But to the cluster of people slumped in the rear carriage—wearing hospital scrubs under puffer jackets and sipping energy drinks like wine—it is home base . This is their equivalent of a cat video
But as they step onto the platform, there is a quiet solidarity. The train gave them 45 minutes of laughter, dark jokes, and silent commiseration. It prepared them to go home, kiss their bewildered spouses, and try to explain why a story about a lawnmower accident made them laugh so hard.