tag:blogger.com,1999:blog-30499448.post788709606545509847..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: To Sleep, Perchance...Sid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-30499448.post-10754343332045477692008-06-20T16:52:00.000-07:002008-06-20T16:52:00.000-07:00There seems to be a lot of discussion amongst the ...There seems to be a lot of discussion amongst the RRC and ACGME to propose an even shorter work week, somewhere around 56 hrs. While I'm sure that will do plenty in terms of residents getting sleep, I'm a bit more dubious of what will happen to their education. I presume surgical residency will have to be longer.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-35114805085791438232008-06-20T15:39:00.000-07:002008-06-20T15:39:00.000-07:00When I was chief resident one of my attendings was...When I was chief resident one of my attendings was famously hard to wake up, and often gave meaningless instructions on the phone. One morning when he arrived I said to him, "I did what you said, Art, but I'm still not sure the leg needed removing."<BR/>He blanched considerably before he realized I was jerking his chain. <BR/><BR/>(That story and many more are in <A HREF="http://cutting-remarks.blogspot.com/" REL="nofollow">my book</A>.)Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-44649335098304921342008-06-20T15:22:00.000-07:002008-06-20T15:22:00.000-07:00I made it through the pre-hour restriction era of ...I made it through the pre-hour restriction era of residency too, but it took a toll on me. I sometimes gave nurses orders that I had no recollection of the next day (luckily, they were the right orders!) Sometimes after 36+ hours, I was so tired even my teeth hurt. I don't recall being sleepy in the OR but I sure was tired when the surgery was done! I am too old for that stuff any more, I try to make sure I get enough sleep. Sleep deprivation can't be good for anyone.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-55734270472429573742008-06-19T20:18:00.000-07:002008-06-19T20:18:00.000-07:00I really don't know how you did it. It must be th...I really don't know how you did it. It must be the adrenaline in the OR.<BR/><BR/>But do you like the idea of 80 hour weeks and reduced training. Who is right?SeaSprayhttps://www.blogger.com/profile/07906503090688697222noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-70376402324692449102008-06-19T00:21:00.000-07:002008-06-19T00:21:00.000-07:00I have to say that sleep deprivation took it's tol...I have to say that sleep deprivation took it's toll on me during residency. I know that I made mistakes because I was tired. My chairman always said that we would do fine in the OR tired, and I think I did. However, I missed some of the little things because frankly, I just couldn't keep my eyes open and focussed long enough. Some of those little things became big things. <BR/><BR/>I now do in-house trauma call and while the sleep deprivation is somewhat better, I still wonder about the health effects it may have on me. I find myself struggling to lose weight and in general, my mood is worse than when I had slept better. I can't imagine it's healthy to not sleep as much as your body would like to on a regular basis.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-58909243844499403242008-06-18T01:50:00.000-07:002008-06-18T01:50:00.000-07:00I am currently in medical school and I am leaving ...I am currently in medical school and I am leaving after this semester is over. Part of the reason is that I have realized that I function very poorly when deprived of sleep and so the prospect of crazy work hours (I live in Denmark, so it is probably not bad by American standards). I used to work as a programmer before entering medical school, and I have found that it is really true when programmers say that anything written after 12 pm is most certainly crap. I am sure it is different for different individuals, but as another commenter wrote, can the medical profession afford losing potential doctors because of such a thing ?Unknownhttps://www.blogger.com/profile/18318705201268774099noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-21336490696823406532008-06-17T21:05:00.000-07:002008-06-17T21:05:00.000-07:00I saw that 60 minutes episode as well, and thought...I saw that 60 minutes episode as well, and thought about how much I would love to study the sleep of my hospitalized patients, ICU patients and hospice patients. If I had the time.....<BR/><BR/>In finishing a recent important paper, I pulled an all nighter. My wife asked me if I was in residency again.<BR/><BR/>Thanks for the good read.Christian Sinclairhttps://www.blogger.com/profile/14685043408496367587noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-31331036343499418752008-06-17T13:22:00.000-07:002008-06-17T13:22:00.000-07:00Dr. Schwab,Sleep deprivation must be something tha...Dr. Schwab,<BR/>Sleep deprivation must be something that surgeons and mothers have in common!:)Justine Johnston Hemmestadhttps://www.blogger.com/profile/16173113744180112355noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-46441506082827344572008-06-17T12:36:00.000-07:002008-06-17T12:36:00.000-07:00I don't know how big a role sleep deprivation play...I don't know how big a role sleep deprivation plays when I'm taking care of patients. I will say, though that I rarely feel sleepy while operating, but when I was a resident and writing orders for a patient or dictating after having been up for 24 hours, I think that may have been a fertile ground for mistakes.<BR/><BR/>When I work long past 24 hours in a row (28-36), I have near-miss car accidents not uncommonly. I do feel that there is a good justification in limiting trainees hours because working more than (a certain number of hours yet to be determined) poses a real threat to the physician's health, and I wonder why that's so seldom emphasized in talks of work-hours restrictionsMidwife with a Knifehttps://www.blogger.com/profile/04309579302399381913noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-50399464824599189232008-06-16T18:21:00.000-07:002008-06-16T18:21:00.000-07:00It all depends on the individual. Melatonin produc...It all depends on the individual. Melatonin production, biological and circadian rhythms vary across the board. Personally, I can go for about three days with occasional power naps whilst others I know become light headed without their six to eight hours each night.<BR/><BR/>Sleep is for the weak! <BR/><BR/>(Lynched)The Caffeine Ladyhttps://www.blogger.com/profile/17662215834511548631noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-17465034565082106082008-06-16T16:43:00.000-07:002008-06-16T16:43:00.000-07:00mark's: oops. I guess I didn't properly copy the l...mark's: oops. I guess I didn't properly copy the link after using that other one elsewhere. Thanks. Fixed.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-86997177115078869812008-06-16T16:39:00.000-07:002008-06-16T16:39:00.000-07:00I believe that sleep deprivation didn't affect you...I believe that sleep deprivation didn't affect you much. But the 'no-sleep' during training is the main reason I stopped considering a medical career in High School. If I loose too much sleep I get migraines. Will the medical profession always be able to afford driving away potential doctors?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-28339485986154261552008-06-16T15:49:00.000-07:002008-06-16T15:49:00.000-07:00Nice post Sid and I whole heartedly agree. I'm wo...Nice post Sid and I whole heartedly agree. I'm wondering though if the link you have for the "case that led to the 80 hour.." is correct. Wasn't that the Libby Zion case?<BR/><BR/>Right now that is linking to here<BR/>http://www.mcclatchydc.com/detainees/story/38773.html<BR/><BR/>Did you get enough sleep last night?mark's tailshttps://www.blogger.com/profile/08097539019772913051noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-83721503543165603722008-06-16T11:32:00.000-07:002008-06-16T11:32:00.000-07:00Being an MD seems akin to parenting a newborn, exc...Being an MD seems akin to parenting a newborn, except the baby never grows up...Devorrahhttps://www.blogger.com/profile/14542045173559671539noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-81555847666055344462008-06-16T07:57:00.000-07:002008-06-16T07:57:00.000-07:00In my time, I have delivered papers in the middle ...In my time, I have delivered papers in the middle of the night, worked as a nurse, often having to stay another shift, and worked as a police dispatcher in a small town where the phone was in my home. I am here to tell you that sleep deprivation did affect me, badly, and especially after I started to have obstructive sleep apnea. Part of my disability at this time is not being able to sleep, or getting my second wind, drowsing, and then waking entirely, not able to go back to sleep.Silverstarhttps://www.blogger.com/profile/14704947799339747013noreply@blogger.com