I am a good sleeper. I suppose I should qualify that statement. Once I decide to go to sleep, I am a good sleeper. It is the going to sleep part I do poorly. I don’t think Ambien or Valium will get my ass out of my chair and direct me to brush my teeth and go to bed. When I counsel patients on proper sleep hygiene, we discuss no watching TV from bed or reading or eating. I have none of those problems. It is the actual getting into bed that I have problems with. I can stay up all night simply by not going to bed. But once I get up and get into bed, I am OUT in seconds. And I mean OUT. Wake me in 15 minutes and I am already in REM sleep, dreaming. And once I am asleep, I want to stay asleep.
I can wake and THINK in a split second.If I get an emergency call in the middle of the night, I am awake and alert and fully cognitive. I can assess a patient’s emergency, have a discussion with the emergency room attending and talk to the pharmacist at the 24 hour Walgreens. Waking and thinking is never difficult.
Don’t ask me to wake and FEEL. Or if you do, realize, my normal daytime filters are off line. At 3 am if you call me and ask me why I was upset with you, expect an unadulterated, unfiltered, unsulfured answer. You will get the RAW, unmitigated respond. I am not diplomatic. And why should I have to be? There is no emergency in the universe that requires me to FEEL on demand. It you wake me at 3 am and want to know what I am “thinking”…what you really want to know is how I am feeling. If you want to know the definition of entropy or the anatomy of the rotator cuff muscles…I can give those answers in a way that you could record me and post the audio on Youtube. That part of my brain never goes offline. The mind of a geek. Any other geek can verify this. Even alcohol doesn’t knock the cognitive offline. If anything, it can hyperfocus it. Ever been around a bunch of us geeky types at a cocktail party? We may fail a roadside sobriety test…but we can drink and think. But I cannot sleep and feel any better than I can drink and feel. Want to know how I really feel about something? Serve me a cocktail (2 serving MAXIMUM) and you can get a rant worthy of open mic night at the Improv. Waking me at 3 am is equally provocative.
The problem with the provoked waking for an emotional demand is that it often ends with me being unable to go back to sleep. And so, here I sit, at my computer, wishing they made an Ambien that prompted me to get up out of this chair and go back to my bed.
[Note to self: when not on call do not leave phone on nightstand.]