My opinion

By Dr. Deepak Gupta
Corresponding Author Dr. Deepak Gupta
Self, - United States of America
Submitting Author Dr. Deepak Gupta

healthcare, sleepless, worker, society

Gupta D. LOSING SLEEP OVER SLEEP: Is it auto-cannibalism when, while providing healthcare to sleepless society, healthcare of sleepless sweaters gets disrupted?. WebmedCentral SLEEP MEDICINE 2021;12(9):WMC005738

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submitted on: 29 Aug 2021 12:29:20 AM GMT
Published on: 15 Sep 2021 07:30:56 AM GMT

My opinion

After reading the article about our evolution into zombie nation [1-3], I was reflecting how humanity may have gotten to this stage. I may have some insight so I will start by pondering on my personal story. My day used to begin at 0900 hours. That lasted for three years. Then my day started to begin at 0830 hours. That lasted for three months. Then my day settled to begin at 0800 hours. That persisted for fifty-four months. Then I moved across the hemisphere and my day moved to begin early at 0730 hours. This has been my life for over thirteen years with earlier start times always knocking at the door. Will it finally settle down to start at 0700 hours? 0630 hours? 0600 hours? 0530 hours? 0500 hours? 0430 hours? Irrespective of whatever early start times healthcare industry decides to finally settle down, I am already waking up way before 0430 hours for last so many years for various reasons [4]. Sometimes it is so that I do not end up oversleeping. Sometimes it was so that I did not reach so late that I did not have enough time to evaluate the patients or prepare the workstations or attend the didactics. Sometimes it is so that I can avoid the morning rush hours especially during winters/snowstorms. The bottom-line is that in terms of due importance accrued, our personal health ranks behind our paying jobs especially when personal physiology conflicts with boisterous bottom-line of healthcare industry that directly and indirectly supports the livelihood of up to a fifth of whole population, at least in terms of gross domestic product. Does it mean that the bottom-line of healthcare industry may evolve the sick as economic assets for society’s livelihood forcing the overbearing healthcare industry to turn society sicker (some more than others) as well as poorer (some more than others)? Does it mean that the bottom-line of healthcare industry will accrue those getting sicker a freedom to quit [5] either the healthcare industry permanently or just the job temporarily or even the life itself [6-8] which may not be rare unlike other industries? Although rather than toughing it out modern humans may be evolving into over-demanding big babies as compared to ancient humans riding it out for millenniums while living and surviving out in the wild, the bygone eras can not be revived even though those bygone eras’ imprints on the human genes interfere with modern humans shaking off the shackles like circadian rhythms which were borne out of their ancient ancestors’ experiences. Some may even make the case that no economy, ancient or modern, can exist, survive, function and excel without its share of and reliance on sweaters with sleepless sweaters being modern versions of ancient sweaters [9-13]. The major irony in all of this is that the very existence of healthcare sweaters may be inducing invention and persistence of unnecessary healthcare procedures [14-16] to sustain the current numbers of healthcare sweaters while paradoxically believing often misinterpreted impending shortages of healthcare sweaters. Even though public health measures enforced during COVID-19 pandemic quashed not only unnecessary but also necessary healthcare interventions as judged by their gradation per pre-pandemic times, both necessary and unnecessary healthcare interventions may bounce back with extraordinary vigor and resurgence as soon as pandemic is declared to have ended because pandemic era lessons may soon be forgotten when healthcare economy does not learn to reflect and self-evaluate [17-18].

Interestingly, as similar to the fear of dinosaurs, the fear of humans has forced many animals to become nocturnal [19-23] so that they can avoid interaction and conflict with better armed humans. Similarly, modern humans may be forced to become diurnal or sleepless so as to survive in the world managed by overbearing digital systems and legal fiction entities which do NOT sleep at all and can restart right away when they are shut down [24]. This will allow inorganic systems to become the evolutionary force driving humans to “adapt or die” just like humans have been the driving force forcing animals to “adapt or die” [25-26]. Are these inorganic systems and their accelerating complexities essential for sustenance of modern humanity? Or is the complexity of systems the only viable product of natural selection [27] that evolved the earliest simplest life form from inorganic complexes to eventually give birth to complex dominant dinosaurs who eventually went extinct long before the passage of time allowed evolution of complex human brain to rule the world which has ultimately created its own nemesis as the complex inorganic singularity of artificial intelligence that is beyond comprehension and control of modern humanity? Therefore, whatever appears unnecessary to the simple soul-searching minds may not be unnecessary after all because simplicity searching souls may always find themselves just a tag behind and just a level outdated in the terms of rapidly evolving organic and inorganic life on the earth [28-35]. It may be evolutionary pressure to demonstrate resiliency that has evolved humans just like any other species to perform unnecessary, costly and even wasteful exercises to demonstrate to other species that humanity can afford to be wasteful and still outlive other species [36]. This is not very hard to imagine and comprehend when the leading nations demonstrate to the rest of the world that they can afford to do unnecessary, costly and even wasteful deeds and still rule over the rest of the world because the exorbitant markups charged by leaders over the actual value of products demonstrate to followers that leaders can afford to charge exorbitant and still force “free will” on followers to shell out unnecessary, costly and even wasteful markups.

The irony of this evolutional complexity is that when complexity serves its purpose to advance species’ survival, those species seemingly embrace the evolving complexities but then eventually denounce the uncontrollably advanced complex systems once those systems become existential threat for those who have been historically advocating the systems when those systems were still in their infancy and had not demonstrated the scale and reach of their complexities yet. It may be worth asking and pondering. Do proceduralists allow procedures on themselves [37-40]? Do litigators allow litigations against themselves [41]? Do regulators embrace regulations for themselves? Simply stating, the complex systems seem only appropriate when they seem to benefit self and weaken opponents so that us do not lose the race for survival to them. Interestingly, guideline/rule/law developing experts/rulers/legislators are those who will eventually benefit from the developed guidelines/rules/laws and will always hide behind the colloquial “It’s complicated” while forgetting that it is complicated because natural selection among the current breed of experts/rulers/legislators is evolving increasingly complex systems, whether organic or inorganic, to benefit the future breed of experts/rulers/legislators, whether organic or inorganic.

The questions which seem worth exploring have not been explored yet [42]. What does a sleep diary among physicians look like? What does daily wakeup time among physicians look like? Is circadian rhythm among physicians changing? Do physicians visit their physicians as frequently as they and their expert societies’ guidelines are expecting their patients to visit physicians? What percentage of 55-to-80-year-old physicians gets low dose computed tomography scan for lung cancer screening if they are current smokers or have recently quit smoking within last 15 years or had at least 30-pack-year smoking history? What percentage of female physicians starts getting their annual mammograms once they turn 40? What percentage of physicians gets their colonoscopies every 10 years once they turn 45? What percentage of physicians gets themselves checked with Cologuard [43]? What percentage of female physicians gets their Pap tests every three years since they turned 21? What percentage of 30-to-65-year-old female physicians gets their Pap tests plus human papillomavirus detection tests every five years?

Summarily, I should not abhor but accept that modern humans are being forced to adapt their circadian rhythm [44-51] to survive the world run and ruled by the evolving complex inorganic systems just like modern era has forced animals to become nocturnal to coexist, if not outlast, modern humans. The right to simplicity was lost at the origin of everything from nothing because the simplest thing is nothing and its nothingness from which everything originates and then evolves at accelerating rate towards the infinitely possible complexity. Therefore, past always appears simpler to the present while future always appears scarier to the present and modern humans like modern animals can just adapt to the present unless they choose and decide to die rather than overcoming their fear of scarier future by ingeniously preparing for its possibility or eventuality.


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