So, to stay with the night theme, I only slept an hour yesterday after my Sunday night shift.  Then, I had to be up and about, teaching a c lass, running some errands.  I used to do that all the time.  Sleep briefly, then spend the day with Jan and the kids.  When they were very small, we’d take off and go shopping, eat lunch out, maybe do a movie, just spend the entire day together as a family.  When we had trips to take, I would come home from nights and simply pass out in the front or back of our car, and sleep while we traveled.  Then, after I had overcome the worst of the fatigue, I’d get up and drive.

I remember the way it felt.  (Because I felt that way yesterday.)  For those poor souls who have never worked all night, for those who have always slept their comfy eight hours in a warm bed, and risen to coffee and bagels, to those who could never consider sleeplessness an option, all I can say is ‘congratulations!’

But I learned to appreciate it.  Fatigue is a narcotic.  It leaves me feeling a little fuzzy, a little euphoric.  I have known exhaustion enough that I can plow through almost any activity.  It’s the gift of medical school and residency.  There’s a bleary-eyed feeling, a sense of floating, even though my arms and legs feel heavy and tired.  Extreme fatigue is rather like the sense of warmth before freezing to death.

Sometimes, when fatigued, I wander through stores looking for some small item we need, but I just take my time.  The noise of people and commerce, the colors, the music, all add to the sense of unreality.  It’s not hallucinatory, but it is intriguing.  (The danger, of course, is that the next day after sleeping, you’ll wake and realize you bought a life-sized dancing Santa, because it looked cool and you wanted to reward yourself for your job well done.)

I feel for everyone who works nights.  Every factory worker and police officer, every pilot and paramedic, every social worker and retail clerk; they all know what I’m talking about, and most of them do it for much less than physicians, and with much less scheduling flexibility.

But we all know the gifts of fatigue, and the gifts of the night.  I don’t recommend them if they can be avoided; but if you have to walk with the raccoons and possums, if you have to be one with the truck-drivers and night watchmen, the drug dealers, drunks and strippers, at least learn to embrace the unique delights of the night, the glories of exhaustion and the final victory of falling into the bed to irresistible, well deserved sleep.

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