Sleep : It puts even the most powerful men on their back : Dr Prerna Motwani

Sleep HealthlyWhether a person is a daily wage labourer or CEO of a multinational company, sleep doesn’t differentiate. Everyone needs to clock a set number of hours on bed.
But in today’s fast paced life, where everyone wants get ahead of time, somewhere sleep is being compromised. To achieve a certain standard of living we are working for inhuman hours and sacrifice our health.
When sleep fails, health declines,in turn poor sleep and bad health decreases the quality of life and take happiness away.
Doctors all over the world are known to work for long and odd hours. On an average a physician works for over 60 hrs a week,added a residents shift can easily stretch to 36 or 48 hours. Under these circumstances, a doctor is supposed to make sound and major decisions pertaining to his/her patient’s life. What if there is some error of judgement? Who is to be held responsible?
Something like this happened in New York, USA years ago, and it changed the way Americans treated their doctors.
The Incident:
In 1984, 18 year old Libby Zion, died within 24 hours of hospitalization. Her father, Sidney Zion, a columnist in New York Times, did what everyone of us would want to do. Avenge his daughter’s death.
Libby a college freshman, fighting depression with prescription anti-depressants and a dubious history of cocaine use was brought in on the night of 4th october 1984, with fever, jerking body and disorientation.
She was admitted and evaluated by two residents, Luise Weistein, a freshly graduated intern and Greg stone, who was one year senior to Weistein. Unable to diagnose, the residents termed it as,”Viral syndrome with hysterical symptoms.”, which just means hyper reaction to mild infection. Meperidine was prescribed, a sedative, to control her agitations. From there the two residents left to attend to the 40 other patients they were covering.
Once left unattended, Libby became more agitated. When the residents were contacted ,they asked the nurse to put her under medical restrains, so that she doesn’t harm herself and another sedative haloperidol was prescribed.
Around 6:30 in the morning, her temperature hit 107 degrees. Weistein was called again and quick measures were taken to reduce her temperature. However, before this could happen, Libby suffered a cardiac arrest and passed away.
For the hospital it was just another case with a bad outcome, but it shattered Sidney Zion and his family.
The aftermath:
Grieving the loss of their child, Zion’s parents became convinced their daughter’s death was due to inadequate staffing at the teaching hospital.In a New York Times op-ed piece, Sidney Zion wrote: “You don’t need kindergarten to know that a resident working a 36-hour shift is in no condition to make any kind of judgment call—forget about life-and-death.”
The case eventually became a protracted high-profile legal battle, with multiple abrupt reversals; case reports about it appeared in major medical journals.
In May 1986 Manhattan District Attorney Robert Morgenthau agreed to let a grand jury consider murder charges. Although it declined to indict, the jury issued a report strongly criticizing “the supervision of interns and junior residents at a hospital in New York County.”
In response, New York State Health Commissioner David Axelrod established a blue-ribbon panel of experts headed by Bertrand M. Bell, an outspoken primary care physician at the Albert Einstein College of Medicine in the Bronx, to evaluate the training and supervision of doctors in the state.
In 1989, New York state adopted the Bell Commission’s recommendations that residents could not work more than 80 hours a week or more than 24 consecutive hours and that senior physicians needed to be physically present in the hospital at all times.
This commision brought forward the human side of doctors. People saw them as being capable of error and their working conditions were improved significantly.
In India doctors are still made to do 36-48 hours shift, and any error on doctors part is met with violence. Are we waiting for our own Libby Zion case to happen? Do we need an enraged and aggrieved family of an innocent victim to fight for the human treatment of doctors?
It’s high time Indian system got up and gave doctors their right to sleep and sound health, if not for them then at least for their patients.
Is India ready for it’s own Bell’s Commission?

 Dr Prerna Motwani is a dentist and writes about the health issues in India. Currently she works with Curofy as a Content Manager

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