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Crunchy, Crispy, Crusty, Cooked

December 09, 2017
by Mark David Siegel

Hi everyone,

When our girls were young, they’d get so cranky sometimes there was no way to console them. I’m trying to remember the word we used to describe them—something like “crunchy,” “crispy,” “crusty,” or “cooked”—but whatever it was, they were brittle, and bed was the sole solution.

We all get cranky sometimes, even as adults. Over the past few days, I’ve noticed a few people haven’t seemed like themselves—edgy or tearful, or uncharacteristically defensive or impatient. For many, the most obviously precipitant was long days, compounded by insufficient sleep.

As a parent, I know fatigue makes all problems worse. A tough day at school, an unanswered text, or a disappointing grade- all seem cataclysmic at first, but they inevitably become manageable or forgotten after a good night’s sleep.

The same is true for grownups. Otherwise cheerful, idealistic physicians can get fried after long stretches at work, particularly this time of year when the only sunlight we see may be through a hospital window.

Wellness includes at least four special ingredients: nutrition, self-care, community, and sleep. We need to try our best to eat well, care for our bodies, nurture friendships, and get enough sleep. It can be especially hard for residents to stay well, and I’ll be the first to acknowledge that 80-hour work weeks, long stretches without a break, and overnight calls pose challenges lacking easy solutions. But these challenges should make our commitment to wellness that much more vital.

Some of the problems we face are daunting and complex, but many more are not. Whether it makes us crunchy, crispy, crusty, or cooked, we must recognize the impact of fatigue. As winter approaches, let’s be sure to care for ourselves and for each other. If a colleague seems sad or irritable or short-tempered, please look past the outward behaviors and consider what may be wrong. The answers aren’t always complicated, and we need to remember that a good meal, a trip to the gym, an evening with friends, and a good night’s sleep can work wonders.

Take care,


A pre-winter scene outside my bedroom window at 3AM (when I should have been asleep):

Submitted by Mark David Siegel on December 10, 2017