Serious question: how are these surgeons still awake after one month without resorting to stimulants and other medications? That would be 20h a day, with weekends, or 14h+ a day, every day with no break.
If you drive more than about 9h in one go, at least around here, you're considered a threat for others on the street and unfit to drive. But US surgeons are considered high quality after working 14h?
“50 years ago … physicians had rates of narcotic addiction 30 to 100 times higher than the general population, and about 100 doctors a year in the US died by suicide.”
“They are taught, throughout a decade of grueling training, to dissociate themselves from their body’s natural cues, telling them that it is time to rest, eat or urinate.”
I’ve done a lot of long hours before in engineering work. I found that at 13 hours I am significantly impaired.
I’ve done 16-24hr days and caffeine stops working the same way around 16 hours. Ephedrine can get you some more time or the adrenaline of a stressful situation.
80-100 hour work weeks for years is crazy for residents. Work is their life. They may not even go home in between shifts. They can do some key drop power naps or navy seal power naps. My cousins are in the field and Maslow’s pyramid is a constant conversation topic.
I’m sure there are some military manuals or doctor support forums you could research further.
“This is going to hurt” is a good window into the field. Book/tv series.
I had similar questions for him just last month. He pointed out that working so much keeps his critical skills really sharp which is what you want when you're doing surgery/emergency.
I suppose when you get woken up to intubate someone, you want it to be second nature rather than a faded skill you practice every couple months because you dropped down to saner hours. But he's also paid hundreds of thousands of dollars to do that.
Fun fact: he said one of the most preventable deaths he sees in the ER is people choking on food alone in their home. I think about that every time I almost choke to death on some gooey cheese. Make sure to chew well, folks.
My electrician career averaged less than 40 hours per week, and four-day workweeks were our norm. Life is nothing but sacrifices for an acceptable level of self-decided laziness/relaxation.
I normally advocate not living alone (slip-and-falls are also a concern; only god can help you if you have a stroke), but if you insist, take the Red Cross CPR class.
It's cheap/free, a few hours long, will teach you how to resuscitate anything, and most importantly...how to perform the Heimlich on yourself.
Has anyone tested this? When I teach for long hours (much less than a medical doctor), I make more mistakes. It's a mimus sign in a matrix in the blacboard that I'm solving using the Gauss method.
If none of the studens see the error, I'd notice when I verify the solution. It's not a big deal. My error can't kill anyone.
Airplane pilots and truck drivers have mandatory rests. Because when they make an error people may die. You don't want a super sharp pilot that has worked 100 hours last week.
Can that really be learned or is that a sign of a serious circadian rhythm dysfunction? A healthy human body doesn't just sleep at a moment's notice, that only works when the clock is broken.
You get into a weird mental space where you are halfway auto pilot and halfway conscious, and your brain has a really hard time staying focused without being forced to. Hard to explain, but if you’ve been there it makes sense.
Note that this was working, among other places, on nuclear reactors and on flight decks in the US Navy. This is absolutely normal there, and those are fairly dangerous places to be.
These are smart people, they do not want it to change. Their income would decrease if more people were trained/brought in. Have a lot of physician friends, it's awful and they complain, but are worried about wages. They do not want to make less.
A big part is the expense of undergrad+med school+low residency wages+most grew up upper-middle class and have big expectations. They're very worried about losing ground wage-wise. which is fair in my opinion...they have a de facto union/guild (like most smart people who earn a wage try to do).
Somewhat undercut by the rampant suicide rate.
> A big part is the expense of undergrad+med school+low residency wages+most grew up upper-middle class and have big expectations.
Oh so when you say "they don't want things to change" what you mean is "they know the path to success and if they try to take care of themselves or demand decent working conditions there's a good chance they'll be fired and end up bankrupt and in a debt trap for life." Got it. That kind of explains the suicides.
- Doctors in training usually want to work as much as possible to finish their training as fast as possible, especially if they want to work in surgery. For instance, if you train for "general surgery", you need to do about 25 appendectomies, about 35 cholecystectomies, and so on. So in a perverse way, you need a bit of "luck" that you are working while these cases come in. More time in the hospital simply increases your luck.
- Young doctors without kids often want to work a lot to earn more money and accelerate their career.
- Older doctors with kids usually want to work less and more flexibility for choosing shifts.
However, I still keep up with three people whom completed grad school; two physicians, and one dentist (all practice medicine, now, except me).
Remembering their almost-simultaneous relief as each paid off their final $xxx,xxx student loan... the dentist still has to pay off his "Practice" financing (office), but all texted me upon the first deposits of their "first big-boy paychecks" — proud to finally be tackling this debt.
Two of the three have confided to me that "I am smarter than all three of them, having left medicine early [enough to pay off only $109k of student loans]."
I always thank medical staff, whatever the rank, for having to deal with the public. My dentist friend admits to never having-considered that his stubby fingers would have to work in tinier mouths (relative to normal hands).
C'est la vi.
Sounds like a great way to incentivize tons of unnecessary surgeries as well.