Hektoen International

A Journal of Medical Humanities

The sleep of doctors

Barry Meisenberg
Annapolis, Maryland, United States

Anxiety at night
Los Caprichos’: The sleep of reason produces monsters (El sueño de la razon produce monstruos) 1799. Fransisco de Goya. Nelson-Atkins Museum of Art 

The gods who rule 2AM summon the doctor from sleep to the sequestered place where the veneer of unearned pride is bleached away.

You forgot to re-order a sodium level on the whiskered old fisherman with lung cancer. It was low last week and might be lower tomorrow.

He looked OK.

Are looks data? He lives alone. He could seize. He could die.

I will check on him first thing tomorrow

That happened to one of your patients before. Remember?


The nurse with the brain tumor. Remember!

Yes, I remember.

Under your care.

Yes, I remember.

Are you sure the schoolteacher with leukemia and bleeding gums didn’t need platelets? 16,000 isn’t low enough for you?

Guidelines say . . .

Since when do you bend your knees at the altar of guidelines? Where have you misplaced your judgement?

I will check on her first thing tomorrow.

You avoided the prognosis talk with the real estate agent with recurrent ovarian cancer. Now she suffers on a ventilator.

I started the conversation, but she wasn’t ready.

She was ready; you weren’t. You have been her doctor for years, why do you fail her now?

I will check on her first thing tomorrow.

You let that student with the perforated lung mets leave the hospital with bilateral pneumothorax. He nearly died in the parking lot.

That was 30 years ago.

It was yesterday.

I was a resident.

We know not, “resident.” The kid called you, “Doctor.” It was yesterday.

An hour dissolves beneath this pageant of recalled calamities, worn smooth with repeated mental handling. The impending tragedies fall in orderly with the resurrected nightmares.

Still awake, the doctor focuses on the prevailing sounds of the night: home-from-college kids joyously celebrating their youth in the street outside, the whimpering of a dreaming dog, the untroubled rhythmic breathing of a spouse. None can know about the doctor’s summons, it is a private passage, never to be shared.

Sleep now, say the gods of 2 AM, we will call for you again soon.

With a new list of “first things” for 7AM, the doctor pulls up the blanket of humility and seeks, once more, the sweet sanctuary of sleep.

BARRY MEISENBERG, M.D., is a hematologist-oncologist and Chair of Medicine for Luminis Health, in Maryland. He has held leadership positions in both academic and community cancer centers. Ex-officio, he organizes and moderates a humanities-focused program for medical staff and trainees called “Diastole Hour.” Named for the relaxation phase of the heart, Diastole Hour uses fiction and poetry by or about physicians, visual art, and medical history to generate reflection about what it means to be a physician or a patient. Diastole Hour’s goal is to re-awaken the joy and delight of medicine, for we shouldn’t spend our whole lives in systole.

Summer 2021



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