Age and the Trauma Surgeon

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I’m facing another Saturday trauma shift and feeling every bit my age. Trauma on a Saturday usually means no sleep and a steady stream of business. Back in the old days, when I was in my thirties, I could operate for 24 hours straight, catch a few hours of sleep and get up refreshed and do it again. Now it takes me a couple of days to recover from one of those marathon sessions.

My performance in the operating room isn’t affected. A number of studies have confirmed what every surgeon knows from personal experience: fatigue doesn’t significantly affect performance in surgery. And in the operating room, age and cunning always trump youth and enthusiasm. Older surgeons retain their edge over younger ones even when fatigued. There’s tremendous advantage in ‘been there, done that’. When the unexpected happens, the older surgeon spends less time thinking about his next move. He’s learned the hard way how to do things his mentors never taught him.

It’s after the drapes come off and the dressings go on and you have to write orders and notes and talk to the family that there is an advantage to the resiliency of youth. You can feel the energy drain away like someone pulled the plug. Error creeps in when you have to decide on medications and dosages and how to phrase a delicate question.

I tend to get short tempered and cranky. (Those who know me will now ask, “And how is that different from when you’re well rested”, so maybe I should say MORE cranky than usual). I have to think harder to remember names and dates and medications. And the after effects last longer these days.

So, I expect I’ll be up all night tomorrow night and be pretty much a zombie even when I’m awake all day Sunday. It’s hard on those around me. My wife is a surgical nurse practitioner and knows first hand the rigors of the job. She understands. My autistic son is now almost an adult and even he knows that Dad needs to nap, but he only has the weekend to spend time with me and it’s hard for him. And even though I try to be polite to others, my tolerance for stupidity and frustration is low and I’m liable to say things I’ll later regret.

So how much longer will I continue this work? I don’t know. Despite the fatigue and frustration, there’s nothing else like it. Trauma is like combat – often boring, but at times exciting beyond words and above all, addictive.

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