Night Shift: The Dark Ages

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Almost two decades ago, our oldest son was entering the United States Naval Academy for “plebe summer,” the first time the new students are put to the rigorous tests of academy life. The chaplain met with all the anxious parents in the cavernous Alumni Hall.

He started off by stating solemnly that every one of our precious sons and daughters, even if they had never been religious in their entire lives, would “meet God” that summer.  He went on to explain there was probably one experience that most, if not all of our high performing progeny had never experienced.  And that was abject, fall on your face, failure.  He said that the detailers, the upperclassmen in charge of their indoctrination, would, in fact, delight in making sure that they had that experience.  It wasn’t just hazing.  There was sound training behind it.  They wanted to see what they did afterward.  Would they quit?  Would they blame someone else for their failure?  Or would they pick themselves up, shake off the dust … and try again?

I suspect we’ve all been through our own version of plebe summer at some time.  I know I thought I was quite a hot shot in college, graduating near the top of my class.  But I found myself in the middle of a medical school class who were all at the top of their respective classes.  The first time I failed a test was a real shocker.  But after I got over the hyperventilation, I had a long talk with the man in the mirror, doubled down on my study time, and started the long trudge to graduation.  It would have been all ‘happily ever after,’ but life isn’t a fairy tale.  Like the students at the end of Plebe Summer, I learned that this was but the first of many trials.


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When the brigade of midshipmen, the rest of the 4,000+ students at the academy, return to the ‘yard’ after summer cruises they see the plebes being returned to the academy by the weepy eyed adoring parents.  They enjoy poking the scared plebes in the eyes by playing Christmas music from the upper decks, especially the melancholy “I’ll be Home for Christmas.”  It’s then that the students realize that the hell of plebe summer was just the beginning.  More, a lot more, will come.  But somehow most of them survive to the holidays.  The real test is when they return this time to silence.  There is no fanfare.  Just the prospect of grinding out the cold, gray, lonely months of winter.  Over the years, the epithet used to describe these months became “the Dark Ages.”   Their only hope was that they could hang on until summer, when the next group of starry eyed dopes arrived to start their beatings.

We, too, have learned that getting up after a knock down is actually not the hardest thing to accomplish.  It’s getting up the second, the third and the fourth.  And that’s not said to whine or worse, to sound like a bunch of losers.  But life has its moments for everyone, even the most successful.  It even seems like life has cycles.  We can have long periods of success.  But we can also have long periods where nothing seems to be going right.  And we just seem to be hanging on for dear life.

My wonderful wife (no tongue in cheek) and I have been married for over 45 years. So we are asked from time to time to give marital advice to young couples.  She once shocked a group of newlyweds, all cuddled close to one another, who were asking for our secret to ‘keeping love alive.’   She smiled somewhat sheepishly and casually explained “You know, you’ll have some good days and some back days …some good decades and some back decades.”


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As you read this, you may be on one of those upswings.  Life might be the best you’ve ever had it.  The cases you’re seeing may be sharpening your mind and making your adrenaline pump.  Your schedule may have finally stabilized to allow you to get to the gym and find that body that wasted during medical school.  Or you might finally have the time to do a few of the things you dreamed about.  You’re probably making more money that you ever thought possible.  Maybe you’re enjoying the respect and maybe even the adoration of your family and your community.  If you are… enjoy it.  Share it.  And most of all, be grateful to God for your blessings.

You may not be there.  Or you may have been there and lost it.  Maybe you’re in a group that doesn’t appreciate you or worse uses you.  This is for all you young night guys who are being used and abused by the older partners in the group. Your life may have been going well, but then you got sued for something unavoidable.  Your professional life might be going well, but your personal life has taken a hit. You may be in a long down cycle.  You may be in the Dark Ages.  And if you are, I’ve got a little advice for you, because I’ve been there too.

First, shorten your focus.  Some will tell you to keep your eyes on the prize.  But I’ve found that to be an exercise in frustration.  On my multiple tours overseas with the Marines, I came to understand that I had volunteered to enter a miserable, filthy, medium security prison where I could, if I didn’t pay attention, get killed.  I dreamed of good meals, hot baths, home and family.  But I found that I couldn’t just live for the day I came home.  I had to make it work every day.   Sure it’s OK to lift your eyes to the goal from time to time, but then focus on the goals and successes of today.  Knock out part of that long list of requirements and responsibilities.  Check them off.  Take a deep breath and then get in there for the next round.  If there is any possible way, enjoy the moment.  But be grateful for the little things of today.

Next, look for the opportunities that only show themselves only to the desperate.  You may find the courage do that thing you’ve always dreamed about.  Or you might find the hunger to do that thing you knew you needed to do, but lacked the will power.  They say that hunger is the best spice.  But desperation also makes the vision sharper.  Look hard.  What you find might make you grateful for the fires through which you have passed.


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And most of all, understand that you are not alone.  A few years back EPM ran a poll of emergency physicians asking if they had ever felt depressed.  We were shocked at the responses of those who not only revealed their depression, but in some cases, thoughts of suicide.  And of those whose minds went to self destruction, the common thought was that they felt that they were alone in their predicaments.  Many felt that if they broke the silence and reached out for help they would lose the careers they loved and the ability to provide for themselves and their families.  So they stewed in a toxic brew of helpless, frustration and self-directed anger.

Night shifts can bring that out in some of us.  The fatigue, the loneliness, of long strings of nights can be really harmful to some.  First reach out to the ones nearest to you, your crew.  Get to know them better.  You are their leader.  They need you and you need them.  Years ago one of the highest compliments I ever received from a reader was when he told me that “on a long night shift, when all I have is a stale doughnut and a cold cup of coffee, I read your stories, and I realize that I am not alone.”

Life can be hard, even when you have a great job that really helps people and earns you a great living.  And sometimes these down times may seem like they are not going to get better any time soon.  But things somehow have a way of working themselves out when we stay focused on tasks before us, stay alert for opportunities that present themselves, reach out to those around us, and know deep within our being that someone has our back.

The days are getting longer.  Summer will be here soon.  The Dark Ages won’t last forever.

ABOUT THE AUTHOR

FOUNDER / EXECUTIVE EDITOR Dr. Plaster has been an emergency physician for more than thirty years, working exclusively night shifts for the past twenty years in emergency departments across the country. During that period he joined the U.S. Navy and served two tours in Iraq. Dr. Plaster is the founder and executive editor of Emergency Physicians Monthly and the founder of Plaster Publishing.

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