Would You Trust A Sleepy Surgeon?

If someone is going to cut on me, I want to make sure they are full of vim and vigor. Sharp as a fresh scalpel. And that they had a perfectly, wonderful, full night's sleep before they go to work on me. And I don't care if it's for a hangnail or clogged artery. I want a full level of alertness.

Yet a new study out of Canada in the New England Journal of Medicine says sleep deprivation among cutters isn't that big a deal. Lots of sleep. Little sleep. It really makes no difference.

Researchers took a look at more than 38,000 surgeries and divided surgeons who did those surgeries into two groups -- those that worked the night before (from midnight to 7 a.m.) and those who supposedly were tucked into bed at an early hour.

They found complication rates were small and equal for the two groups. And it didn't matter if the surgeons were doing hard stuff or easy stuff. Nor did the age of the scalpel wielder.

But let's hold the surgery for a second. The study has a few holes that need stitching. First off, the study did not actually look at the actual number of hours of sleep any of the surgeons got. Yet a previous study on this very topic in JAMA a few years ago showed surgeons who slept less than 6 hours had a complication rate more than triple the surgeons who had 6 hours or more.

Plus this study assumed if you worked before 7 a.m. you were automatically sleep deprived. Yet many of us start our cases at 6:45 a.m. -- after a full night's rest. So the study assumed we had to be drowsy docs when, in fact, we were not.

The idea of a sleepy surgeon scares me to death, as does a stressed surgeon, or an angry surgeon, or a surgeon who just had a fight with a spouse. No pun intended, but you need to be sharp at all times you're using that scalpel.

What's the answer? I wish I knew. Canada is actually considering a law making it mandatory for a surgeon to disclose if he or she has been awake for more than "X" number of hours, and could use some shuteye. Hence, the study.

Here in the States, it's a different story. It's voluntary. An honor system. Don't cut unless you're at your best. Fortunately, the surgeons I know are excellent at self-policing. But you always worry about the one somewhere who pushes the envelope, and cuts corners.

By the way, if you look at the picture on this page, it's me doing surgery at 2:15 a.m. in need of some serious sleep after working an endless day to that point. But that picture was taken in Iraq during a war. There simply was no choice but to work fast and with a full tank of adrenaline. And with a crackerjack staff that made sure we did things perfectly, or else we were told something wasn't right.

Now back home, it's a not a war. But sleep deprivation can be. We simply need to do things the right way.

Dr. Dave Hnida is CBS4's Medical Editor. He blogs about the latest studies and trends in the health world. Read his latest blog entries, check out his bio or follow him on Twitter @drdavehnida