When I started my residency in the city that never sleeps, the emergency department was unbelievably quiet at 3am. For us residents, it was our time to get extra learning, chat with senior residents, discuss topics with attending physicians. We had cleaned up the evening rush of patients and we were waiting on a few results and dealing with a very slow trickle of patients. Sometimes I would just spend hours sowing a large complicated laceration. Other times, the toxicologists would give us mini lectures and these were the nights I learned all about treating Digoxin toxicity (which I have cared for maybe 3 times in my 11 year career). And even other times, we would practice using the nasopharyngeal scopes on each other.
And yet, by the time I finished residency, the place was a ZOO at 3am, but we could get through the patients by 7am to leave a nice clean board for the morning team. By the time I was a 3rd year attending in another urban setting, I was lucky if I was able to see everyone by 7am.
We have always worked nights. But we were never the norm. Why have our patients become so nocturnal? Why has our society become so nocturnal?
My family and I went camping a few weeks ago. We grilled out, made a fire at dusk and cooked some s’mores. As the fire dwindled, my husband and I put the kids to bed. By 8:30, I was in bed. I read for 15 minutes. I did not bother looking at my phone… I had not a lick of reception. I had a glorious night of sleep. In some ways, I wish this simplicity was imposed on me regularly. It is much more difficult to self-impose tech free restrictions when I am in control of them.
I got my first cell phone in college. It was a cool flip phone I knew how to text on only using the keypad with 12 buttons. I was super cool. I finished my residency with an iPhone. Over the last 20 years we have been upgrading our handheld technology constantly. With the upgrades there is also more information accessible around the clock. Social media has become its own industry, Amazon and other marketplaces have made shopping a 24 hour endeavor, and overall the availability of technology has made communication instant and nonstop. There is an expectation that communication will occur rapidly and responses are expected. Whatever happened to writing nice letters in the mail in your best script? (Kids don’t even learn script anymore… coding classes at a young age have replaced that!)
By transitioning to a 24 hour society, we have displaced and short changed one of the most important pieces of health: our sleep. Our understanding of the neurobiology and physiology of sleep is still so basic. With this basic knowledge and our inability to fully appreciate its importance, we have decided that we do not need it. Our lack of knowledge has been our detriment in prioritizing sleep.
Without sleep we turn into drunk-like uncoordinated people unable to reason and regulate our emotions. That’s what we know. Think about all the things we don’t know.
Technology has given us the opportunity to say, I can do something other than sleep. So please consider: Just because you can, does not mean you should! Create a sleep zone (both in physical space and in time) that is technology free. Eliminating tech from your bedroom and also creating a time every day that is void of technology can be easy ways to start securing a healthier sleep pattern.
Challenge yourself: Can you go from 10p-7am without the use of tech?