Johns Hopkins Magazine -- February 2001
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A Hard Day's Night
Author's Note


Do the marathon hours required of residents impair patient care and the well-being of residents themselves? That was the driving question of my story on residents' work hours, and one that is still subject to debate.

However, another question interests me. It is not as intellectual or perhaps even as significant as the first, but I find it intriguing nonetheless. How do residents and other doctors, particularly surgeons (the focus of my story), stay awake and alert during their lengthy work days? Do they resort to mega-doses of caffeine? Some other "crutch"?

In my non-scientific survey of a score of surgeons, I was surprised to find that few used much caffeine. Chief surgical resident Nita Ahuja told me she avoids the stuff prior to going into the operating room so she can maintain a steady hand.

Cardiac surgeon Levi Watkins drinks coffee, but caffeine does not appear to be the reason he rarely sleeps more than a few hours. Even when he is on vacation, he says, he'll get up at four or five in the morning. Overall, the surgeons with whom I spoke seemed to be inherently driven and exhilarated by their jobs, and endowed with a tremendous capacity to focus.

Putting off the need to sleep was only part of it. One young surgeon told me that she never leaves the operating room to take a bathroom break, even during a 10-hour operation. She simply doesn't think about the need to go, she said. The day I shadowed Ahuja around Sinai Hospital starting in the wee hours of the morning, she explained that she hadn't really had any breakfast and might grab a salad later in the afternoon if she had time. By 10 a.m., I, meanwhile, had begun thinking about where I might find a cup of coffee and a snack.


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