Econo/politco blogger Megan McArdle explains her rationale for why we need medical resident work reform (which I’ve posted on here and here):
I am a gold medalist in the macho Sleepless Working Olympics. I once worked a 60-hour shift without sleep. (Yes, that’s 2.5 days without any shuteye.) One stormy February, I put in 468 hours, almost 120 hours a week for four weeks straight, sleeping an average of less than 4 hours a night. I have enjoyed all the exciting side effects of prolonged sleep deprivation, like uncontrollable “microsleep” which once almost caused me to walk into the path of a cab, or the hallucinations that set in after 48 hours or so–not fun hallucinations, either, just long conversations with co-workers who turned out to have left the building hours or even days before. I was essentially dreaming with my eyes open.
So I know whereof I speak when I think about interns training on gruelling regimens. And you know what I learned on all those sleepless nights?
Well, actually, not much. It turns out that adequate sleep is crucial to memory formation. But I did manage to process and retain one fact: when you have not had enough sleep, you. are. stupid.
Your attention span shortens. Your decision making process slows down to a crawl. Your emotions fray–towards the end of that fateful February, I burst out crying when I learned that the delivery of a hot-swappable backup drive had been delayed.
And, what I think is the most telling argument:
I understand that against this, you have to set the benefits of continuity of care. But there’s a funny thing: if continuity of care were really that great, attendings would only have four days off a month, instead of the sybaritic five or more that McNamee is deploring. Most doctors I know work really hard. But they don’t work a lot of 36 hour shifts, and they don’t think that two weekends a month off is the height of decadence.
Let me propose something a little different for all those attending physicians who think that residents should be hazed work in 36 hour shifts. Why don’t you work 36 hour shifts with only 4 days off per month? I mean, don’t you care about your patients and their continuity of care?