Simple elements of life can be a challenge for those pursuing training as a surgeon.  Getting home from work, for example.  In the days when the trainee was expected to take call in a busy hospital every two or three nights, the resident often was trying to drive home in a state of profound sleep deprivation.  This led to significant difficulties.  One of my fellow residents seriously injured her knee by crashing her car driving home after call.  She was on crutches for months, making standing at the OR table a bit of pain.  I can’t even count the number of times I was awakened by angry honking from the car behind me because I had fallen asleep at the wheel while waiting for a traffic light to turn green. I quickly learned to take the car out of gear whenever I stopped at a red light.  Once, I woke up to the sound of my car driving through an abandoned field–had no idea where I was or how I got there.  Most exciting was the time I fell asleep while driving down the merge ramp to the expressway, in the driving rain in the middle of the night–woowee, that was a hoot. You really snap awake when you realize that you are looking at headlights instead of taillights in front of you at sixty miles per hour.

I found that the only reliable way to get home without falling asleep was to drive as fast as physically possible.  This not only generated the adrenaline necessary to keep my eyelids up, it also shortened the critical period of vulnerability.  Stop signs became optional after one in the morning.  Red lights became optional after three.  You get the idea.

Unfortunately, the police forces of the various localities I drove through were not amused by my technique.  Soon after I adopted my Steve McQueen attitude toward commuting, I began to accumulate significant expenses in the form of moving violations.  While many cops are sympathetic to physicians in training, very few are willing to forego writing the ticket when you just blew through a red light at eighty in a thirty mile per hour zone.  It got to be way too expensive.  I think I was making somewhere in the range of $25,000 a year at the time, and traffic tickets (my kind at least) were over a hundred bucks a pop; they were popping at the rate of one or two a month.  You do the math.

As a result, I had to slow down again.  This worked for a bit, but then one spring evening I fell asleep at a red light and rolled back into the car behind me.  No real damage, but unfortunately the car was driven by a state trooper.  Troopers never let you off without a ticket.  It’s because they have to wear that ridiculous hat, I think.

So driving slow wasn’t working, either.  I needed a solution, as I was facing a problem that would continue for another four years.  At the time of my encounter with the state trooper’s bumper, I was on the transplant service.  One morning, as I was trying to stay awake during attending rounds, I saw my salvation.  It was a styrofoam box just outside the OR, waiting to be tossed in the trash; one of the containers used to hold a kidney being transported between hospitals for transplantation.  The box is about the size you’d expect to hold a St. Bernard, because it needs to hold the ice to keep the kidney cold.  It is impressively marked with multiple labels proclaiming in large, authoritative fonts:  RUSH:  HUMAN TISSUE FOR TRANSPLANT.  I excused myself from rounds (fake page gambit, always handy) and took possession of the box, promising the janitor I’d toss it for him.

From that day on, I never drove anywhere without my HUMAN TISSUE box in the trunk.  Back in Steve McQueen mode, I was again getting pulled over with fair regularity.  Now, however, I greeted the officer with the explanation that I had no time for him, I was driving like this because I had to get a kidney to the hospital for transplant.  This usually elicited quite a bit of skepticism, requiring me to pop the trunk.  Which I would do with profound irritation, pointing at the box and saying, “Okay, believe me now?  Because I gotta get this to {insert name of hospital in general direction I was heading at time I was pulled over) so a little girl will live to see another birthday.  Or is making your ticket quota on my ass more important?  Your call, officer.”  I admit, I usually laid it on a little thick.  What can I say, I was tired. Always tired.

This worked without fail.  I never got another ticket for the rest of my residency.  Only problem was the one time I really gave the cop such a hard time (I was really, really tired) he insisted on giving me an escort all the way to the hospital.  I had to thank him and actually carry the box into the ER as he watched.  I couldn’t leave until he pulled away.

Still better than another hundred bucks down the drain.  Besides, that little girl needed that kidney.