Marathon runner

As part of our resident education program, there is an hourlong noontime conference at the hospital five days a week. The subject is usually something medical, like "Diagnosis and treatment of urinary tract infection in the elderly." Although you might expect us to resent these conferences, we usually don't: for some of us, it's the only didactic teaching we get during busy rotations, and when it's good teaching, it's really useful.

The other day, however, the subject was "Surviving Medical Residency." Apparently, it featured some guy nattering about how in residency, you have to make time for hobbies and family and going to the bank. I don't know for sure, because instead of going to some dumb lecture on surviving medical residency, I went to the freaking bank. And then I sat down among the birds and the trees, and I ate my freaking sandwich outside of the goddamn hospital.

My program is not that bad. Our graduate medical education office is so on board with the work hours thing that it's a little embarrassing. Still, it's a little bit funny, and not in the ha-ha way, to sit among a group of stressed-out people listening to someone tell you how to function as an adult, when you all know that if you just had the hour off, you wouldn't seem so dysfunctional in the first place.

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When I first met my fellow interns at the beginning of the academic year, I was struck by how many of them had run marathons. A full 3/4 of my class had trained for or run at least a half-marathon, and it was not just coincidence-the proportion was similar in classes ahead of us.

I guess it shouldn't have surprised me so much. The kind of people who run marathons are the kind of people who are completely OK with being told to work 27 hours in a row without sleep. And it's odd-most of us really are OK with it, even though we can give only weak reasons ("It promotes continuity of care/provides a view of acute disease evolution/builds character") why.

Lawyers, software engineers, and beat journalists all over the country pull all-nighters all the time, both in training and on the job. It's almost a point of pride to work so hard every now and then that you don't sleep, because it's fun to have a war story to tell, and it's pretty satisfying to lay your head on a pillow after having pushed through fatigue to complete a job.

But how many of these professionals have all-nighters every three nights for a month built into their apprenticeships? How many consider thinking while tired to be a critical skill of the job? How many have to put systems into place to prevent the errors that occur as a result of the routine fatigue of its trainees?

Theoretically, the point of working so hard during internship is to make sure we're able to handle the demands of the rest of residency. And the point of working hard during the rest of residency is to make sure we're able to handle the demands of functioning as an independent physician in the most understaffed, underresourced hospitals.

What if we were to instead hire more doctors, and pay them less? What if you didn't ever need the skill of thinking while tired, because instead of working until the work was done, you worked until the end of your shift?

Demonstrating, perhaps, a touch of Stockholm syndrome, I feel that a little something might be lost. Maybe I've just let The Man convince me that the way things are are the truth and the light. After all, I plan to use my skills in understaffed, underresourced places, and I've already translated those thinking-while-tired skills into terrific midnight tuna sandwiches.

Or maybe I just like having good war stories. I guess I'm a marathon runner, too.