Wildflowers at Long Ridge OSP, heralding the long-awaited arrival of spring in the Bay AreaToday, the New York Times website posted an opinion piece that scurries around the belabored topic of resident physicians, work hours during training, and sleep deprivation. If you scroll through the hundreds of comments, you can see that it's still quite a touchy subject for many.
Including me. Although my plastic surgical residency now seems like a lifetime ago (there's nothing like rediscovering the pleasures of a "normal" life), it really wasn't. I'm not sure what the popular conception of the training required for plastic surgery is, but I assure you, it's not a bunch of folks sitting around sipping lattes, taking occasional breaks to inject Botox or do a quick boob job.
I started residency when talk of the mythical 80-hour work week was swirling about; but that's all it was, the stuff of dreams and fantasy, especially to a bunch of overworked, underslept surgical interns and residents who thought it was more of a cruel joke. One hundred- or 120-hour work weeks were not uncommon. I was routinely on call every other night or every third night - these became thirty, thirty-six hour stints in the hospital - do the math, and you realize you've hit 80 hours before mid-week.
I remember one of my general surgery chief residents dispensing advice to the newbies. Doug told us the three things key to surviving internship. When you finally make it home, eat first, then shower. If you go to sleep first, that just means you will go back to work hungry and stinky. And always put the car in park when you come to a red light.
Was it miserable? Well, yes - you're tired, you're hungry, you're working hard, you're not working hard enough, you're on your feet, you're getting yelled at - you're in survival mode. But there's a degree of martyrdom that colors your thoughts (it's 9 am, the time when normal people are just trickling in to work, and I've been at it for 5 hours already, and so many more to go), your spirits are lifted by the joy of actually helping people, and your awesome colleagues in the trenches with you are funny, encouraging, and ultimately save you.
And by the time I finished my training, the 80-hour work week was in full force. Did that mean that when the clock hit 80, the scalpel was removed from my hand and I was sent home? Perhaps for some of the newer trainees, yes, something like that. But some weeks I worked a more humane 60 hour week, and others clocked closer to 100 - but I had already learned to stop counting at 80.
A lot of my peers had the same mathematical dysfunction. Maybe we were the last of the old school, maybe we were already inured to the pain of the endless workday as it quietly merged into night. As surgeons, you just can't quit mid-case. As physicians, you just can't leave your patients. As professionals, you have pride; you want to follow through, you want to make sure that your patients get the best care possible, you want to see what happens.
It's hard to say what is right for the future of medical training, having been on both sides of the work hour debate. And as wonderful and impossibly precious as time and life seem now, outside of residency, I still get to experience medical training, but from another perspective - as the ever-waiting spouse.
My husband is still in the thick of his surgical training. Somehow he too has developed the inability to count beyond 80. It's tough to watch someone you love endure this. Maybe in some ways a resident's life is a little better these days; most months I do get to see my husband every day, if sometimes only for an hour as he shovels some food in and gets his exhausted body ready for another woefully inadequate amount of sleep.
But that's what we tolerate, because we aspire to be the greatest surgeons we can become and because we love what we do.
