Neurosurgeons fail to fix a wayward night owl


My tribe consists of competitive overachievers. We used to call them “gunners” in medical school, and Gunners tend to be morning people, or “larks.” Let’s be honest; people are impressed by those who are up at 4 a.m., training for their next ultramarathon before heading to their noble jobs. A typical conversation among neurosurgeons at a morning conference might go something like this:

Ned: “How are you this morning, Rena?”

Rena: “Great, Ned! I had a terrific 10-mile run before the sunrise session.”

Ned: “Wasn’t it an amazing sunrise? I was up at 3:45 composing a new piece for my violin before tennis drills with my eight-year-old.”

I struggle to come up with a story about my morning achievements and settle on painful honesty.

Me: “I hit the snooze button desperately for an hour, and then I barely made it here, five minutes late. I spilled coffee on my sweater on the way in. Is there any food here?”

Rena and Ned exchange horrified stares.

I like my peers; I just have to be a little deaf to their embellishments. If I believed that everyone was up before the sun, joyfully enriching themselves and their children before I angrily hit the first snooze button, I might have already expired from hyposelfesteemia or imposteroma. I imagine that some of them are closeted night owls, eager to appear normal among the larks. But instead of calling them out on it, I just say, “You’re so amazing!” That’s what they were fishing for, anyway.

I didn’t mention that I was up until midnight, happily working on an article. I booked some flights for my family vacation and bought myself some kick-ass boots. I answered a few emails and reviewed some MRIs for upcoming surgeries. Nobody bothered me; they were all sleeping. People assume that if you are up late doing something, it’s one of two things: self-indulgence or procrastination.

“Barbara, you’re quiet this morning.”

“Yeah, I was up late last night.”

“Ha ha! I’ve been binge-watching that show with the dragons too.”

OR

“A couple of after-dinner cocktails, eh? Wink, wink.”

OR

“Oof! Deadlines! I feel ya, Procrastinicia!”

I looked up some synonyms for “night owl,” and even the thesaurus is judgmental: debauched, degenerate, depraved, lecherous, loose, oddball, rebel, unprincipled, wanton, wayward. WTF, Merriam-Webster! My pineal gland just likes night darkness better than morning darkness. It’s biological, not pathological. There’s no need to owl-shame. While you were up defining words and making sweeping generalizations, I was tending to some blissful sleep hygiene.

I may be an oddball night owl among a flock of larks, but after being forced into the morning person ritual by my profession, I wonder if I’ve been enrolled in a sort of reparative chronotherapy for night owls. “Look how much I got done before work!” they say. “The early bird catches the worm,” they say. Could it be that my people saw the error of my lifestyle and have been working against my nature to mold me into something more socially acceptable? Less depraved?

Larks like to write a lot of articles about their superiority. An article titled “Late to Bed, Early to Die” talks about health risks related to the night owl chronotype. “Many of these effects may be attributable to a misalignment between a person’s internal clock, or circadian rhythm, and the socially imposed timing of work.” They go on to suggest that more studies are needed on how to adjust night owls’ biology so they can become morning people. This is what I’m talking about! Why not study how to adapt work schedules for different chronotypes? Sugarcoat it as protecting our health, but this is starting to sound like conversion therapy!

Like other night owls, I was born this way. There is evidence that chronotypes are genetic. As a kid, I slept until after sunrise and stayed up late looking at the stars. In college, I might have been in the crowd that knew where to get seasoned fries after midnight, but it was also after midnight, when the air was crisp, that I was mastering the logic of organic chemistry.

By the time I was in medical school, I had to curtail my late-night socializing or suffer social jet lag. Class was an all-day grind, and coffee was no match for kidney physiology. I still did my best studying at night. The only reason to study in the morning was if I had to cram the last few gangliosides of lipid storage disease into my brain on exam day. When I entered the clinical years, we were expected to pre-round at 5 a.m. or earlier. I never understood this. A medical student wakes the patient up at 5 a.m. to see how they are doing.

“How are you feeling today, sir?”

“I’m tired because I am not getting any rest here.”

Then the student reports to the residents when they make rounds together at 6, waking the patient again. Later, they round with the attending doctor to wake the patient a third time after they finally fall back asleep. The gunners sometimes would even pre-pre-round to try to look extra sharp. If I wanted to shine, I needed to be on it. I needed to be a lark.

I suspect my husband, Matt, born a lark, was secretly working with the medical school to steer me toward the surgical specialties that rounded so early, hoping they could correct my biological tendencies. One might guess that being a night owl might be an asset going into residency in a surgical field. Being alert to operate at night is good, no? The problem is that the prevailing religion of the morning people in medicine dictates that elective surgery starts at 7:30 a.m., and meetings are at 6:30 so as not to interfere with the sacred operating start time. So after properly tending to a patient’s near-death experience in the dark hours, I am expected to pop in and animatedly talk about (insert boring medical topic here). In the dark conference room, with the MRI projected on the screen, I can hide my resting night owl bitch face in the shadows and talk radionecrosis with the best of them.

It has taken years, but my well-meaning lark counselors may see me as a success. I suggest the 6:30 a.m. meeting. I get on the indoor rowing ergometer before work. I go to bed before 11. I answer an email at 5 a.m.

It’s an act, though. Of course, I am sleepy by 10 p.m. I have been robbed of my biological need for morning sleep. Before that killer erg session this morning, there was 45 minutes of negotiating with my alarm clock. There was complex mental math to determine how much time I really needed to work out, shower, and round before my 8:30 clinic patient. I can mold my true owl into a lark facade with coffee, makeup, and happy light therapy, but deep down, I am still an owl. Accept me for who I am.

Barbara Lazio is a neurosurgeon.






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