2017 was tough. Even setting aside the obvious travesty of Trump’s presidency, the past twelve months have battered me. My closest friend was killed in a freak sledding accident. My family’s cat of nearly twenty years died of renal failure. My parents, married for 30+ years, separated. My health suffered after months of working 100 hours a week; I developed a crippling viral pneumonia that left me wan and exhausted. The sable talons of depression have sunk into my flesh once again. And yet, I’m here. Bruised, thin, quieter. Wiser, kinder, more empathetic, more spontaneous, more appreciative of life’s precious tenuousness. On net, a more complete person, but the transaction has been hell. 2017, I won’t miss you.
I have not written much lately. I have not done much of anything except work.
As part of my emergency medicine residency, I am required to complete two months of training at the University of Maryland Shock Trauma Center in Baltimore. I enjoy being back in the city of my graduate school days, but the schedule at Shock is absurd: 80+ hours per week and call shifts in which I remain awake at the hospital–making critical life or death decisions about patient care–for 30 hours straight. It is brutal. It is unhealthy for residents. It is unsafe for patients. Yet, the culture is one of “It has always been this way.” That doesn’t mean it should stay this way.
I tell every patient, and am now telling you, that I have often been awake for more than 24 hours when I am trying to figure out how to save a person’s life. My brain is so tired, I frequently have trouble speaking clearly. Patients are universally, and justifiably, appalled by this information. I hope the reader need not require hospitalization, but if you do, ask your doctor for how long she or he has been working on shift. The answer may not be a comforting one.
Upwards of 250,000 Americans die every year from medical errors. The medieval, ridiculous, dangerous culture surrounding physician work hours surely is a part of the problem. Physicians apparently refuse to heal themselves, so it’s up to readers and patients to demand change, to demand well-rested doctors, and to demand oversight and penalties for renegade providers and institutions that push physicians beyond all reason and margins of safety.