(and to Other Physicians, Division Chiefs, Hospital Administrators and Everyone Else With Responsibilities for Other Humans):


Yesterday I started but didn’t complete a post on the interesting concept of the Decline Effect. I got caught up with several extra-ML responsibilities that kept me busy until very late last night, which became morning before I knew it. I sensed my tiredness, and delayed that short essay for fear of writing something erroneous on the Internet.

Today I had to get up extra early for a meeting. My mind wandered, and I contemplated my fatigue.

I realized that I used to feel like this often when I was practicing, and especially when I returned to work after my cancer treatments and major back surgery. On nights and weekends, working as an attending hematologist and oncologist and caring for patients who were critically sick, I would get called constantly and, not infrequently, have to go to the hospital at odd hours. The work was exhausting.

Residents’ and fellows’ hours are regulated now, and they were then in New York State. But for senior physicians, including many older and frailer than I am, there’s no limit on the consecutive hours they might be responsible for patients’ lives.

Reminder: Without sufficient rest, you can’t think as clearly as you might or should.

No one should be staying up late or all night and then be performing surgery, calibrating humans’ heart rhythms or even just ordering labs. It’s not worth it.

All the physicians I know are real people. Many excellent doctors are too old to pull all-nighters. Our health care system needs evolve so they can take better care of themselves and keep caring for others.

That’s it for today.


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