Popular Science

Your schedule could be killing you

Modern lifestyles are at war with the way our bodies evolved to function.

It is 7 p.m. on a spring Friday, and the Highland Hospital emergency room in Oakland, one of the busiest trauma centers in northern California, is expecting. When the patient—a young bicyclist hit by a car—arrives, blood is streaming down his temples.

From a warren of care rooms, a team of nearly a dozen doctors and nurses materializes and buzzes around the patient. Amelia Breyre, a first-year resident who looks not much older than a college sophomore, immediately takes charge. As soon as the team finishes immobilizing the victim, Breyre must begin making split-second decisions: X-ray? Intubate? Transfusion? She quickly determines there is no internal bleeding or need for surgery and orders up neck X-rays after bandaging the patient’s head.

Breyre will make a half-dozen similar critical choices tonight. Highland, a teaching hospital, is perhaps the most selective emergency-medical residency in the nation. To be here, she must be outstanding. To succeed, though, she must stay sharp.

That quality of focus—amid the chaos and battered ­humanity that comes through Highland’s doors—is itself in need of urgent care. Andrew Herring, an emergency-room doctor who supervises Breyre and 40 other residents, is worried about the team. ER doctors are shift workers, and their hours are spread over a dizzying, ever-changing schedule of mornings, afternoons, and nights that total 20 ­different shifts a month. That’s meant to equally distribute the burden of nocturnal work across an entire

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