My last call night, I realized how important it is to be on my toes, even at 4am. I did a c-section at 4am and it went fine, except for some excess bleeding secondary to uterine atony. We had controlled the bleeding, but she had lost a good amount of blood during the operation. As I was in the recovery room, dictating the case, the nurse called me over.
Nurse: "Her blood pressure has dropped."
Me: "How low is it?"
Nurse: "Right now, it's 70/40."
Me: [Right now, I'm thinking, "Crap!"] "Ok, bolus 1 liter normal saline, get another large bore IV, draw labs, and let me examine her."
[I then proceed to see if she's bleeding and get a fist-sized clot out, but otherwise it's ok.]
"Ok, let me get the attending."
Yeah, that's me on my toes. They may be short little toes and it may have been 5am, but yeah, I did things right. Of course, that was my first time where a patient needed my immediate attention. And I was alone, at least in the room. It was scary, exhilarating, and pretty awesome all at the same time. In the end, it helped me have faith in my own abilities and, yeah, I really am a doctor.