Diagnosis: Old Age

“I think insomnia is a sign that a person is interesting.
Aver Sawyer, Notes to Self

I learned in medical school that geriatric patients sleep less than youngsters. Even though this is a HIPPA (Government privacy) violation I would like to publicly announce I have diagnosed myself with old age.

When my time on Royal Pains finished, going back to just being a full time doctor had no appeal. I still had a wife, kids, and dogs, which meant bills to pay, so I would continue to be a doctor, but I also wanted an artistic life. As I raised my kids I knew three out of four would become artists of various kinds. I had told each of them to go out into the world and create beauty to stop some of the ugliness that we witnessed everyday on the news. I decided I wanted to do the same and needed to regulate and regiment my time towards this end. I wanted my mornings free to write on a consistent basis.

Fortunately, I am in a business that is 24/7. The general rule I had learned working in emergency departments was if you wanted to be the guy that worked the shit shifts you could generally get perks. Volunteering to be the group’s nocturnist got you deferential treatment for most of your wants and needs. I could now choose pretty much what days of the week I wanted to work the dreaded night shifts.

While training in Emergency Medicine you realize most of your workdays will be between the hours of 3 p.m. to 2 a.m. The morning shifts are the cake for a family man (yes honey, I will be home for dinner with you and the kids). Even if you are out of the house in the dark, you will be home for din-din and family time. The graveyard shift is the curse of most ER folk. For the vast majority of those family men or women it’s not just an eight-hour absence, it’s 24 hours of dread. You wake up in the morning, have breakfast, get the kids to school, do some shopping, maybe grab a sandwich for lunch, and then… well in the 30 years of my career you tried to go to sleep. My wife trained the kids to keep it down or stay out of the house in the afternoon. “Daddy is asleep. Yeah Daddy, the guy with the beard that provides the love that buys toys, food, the roof over your head…yeah that guy…” In most of my years in Emergency Medicine I had between three and four of these graveyard shifts a month. Sleep in the afternoon, get up, have dinner (anxiety building), watch some TV (anxiety more intense), and, finally drive to the hospital where I’d usually find my anxiety justified. An overcrowded, loud, and smelly ER. To keep my anxiety down in the old, really unhealthy days, I’d smoke a big, malodorous cigar (an hours drive equaling an hours worth of smoke) on the way to the hospital. The joke was that for many years I owned a soft-topped jeep and in the winter smoking those cigars would keep the smoke in and not ventilate it out into nature. In the spring I’d literally have to scrape the hardened smoke residue off the plastic windows. If this weren’t bad enough, I’d smoke another smelly one on the ride home to “come down” from the night.

Sleep in the old days came easy. Anytime of the day I wasn’t working you could find me on a couch, chair, sofa, or table – asleep. I was always tired but at least I could sleep.

Today I have the curse of an old man and a night worker. “What time is it?” Don’t ask me because half the time I can’t tell without looking at a 24-hour clock. There are months in winter where I venture out of the house in the dark and return in the dark, never seeing the sun for days at a time.

No, I seem to have skipped the sleep step in my life. My axis is different than most of yours. My awake time is between 9 p.m. and 5 a.m. If you work the night shift and have a partner in your life you are always in the “on” mode. In my case, wife maintenance daylight, ER work in the dark. The nights you aren’t working you kiss the wife good night and then you go looking for something to do.

For me, I thank the Lord nightly for the invention of a good set of headphones and my iPad. It used to be my laptop and DVDs, but since the invention of Netflix I now have, for the paltry sum of $7.99 a month, every TV show I might be interested in that was filmed in the U.S. and England (thanks for Sherlock, Brits, you filled the 2:30 a.m. to 4:00 a.m. hours nicely). There are other diversions besides brainless TV. The New York Times gets my thanks for their so obviously liberal and stupid editorials. I always have to be careful not to laugh or scream out loud for fear of waking up the house. Thank you Huffington Post, I now understand why women shave their mons pubis and how to give women (now a woman) multiple orgasms like a porno star. (Hey Ron Jeremy has my body type and he did pretty well). Thank you Google News, you are up to date and when I fear for the sanity or survival of the world (especially on the other side of the world) you give me minute-by-minute new terrors as to how the world might possibly end.

Finally, I’d like to thank you most on-line medical journals. As the hour passes 4:30 a.m. and I crave shut-eye, you provide articles that are better than overdosing on Ambien or Lunesta, both of which provided funding for the boredom.