Another piece of advice that you won’t get from many attendings: invest in some good shoes. It will make your life much more bearable.

There’s a reason Danskos are so popular. They really do feel much better than any other shoes I’ve tried. Back for the first several months, I had “nurses’ shoes,” which did absolutely no good. My feet used to be so bad, by the end of a 14-hr day, that it hurt more to sit down in the car to drive home, than to keep standing up. When I finally decided to pony up ~$100 for some Danskos in January, this improved dramatically.

As any surgeon will tell you, the problem with sitting down is that you fall asleep much faster sitting down than standing up. So when you’re going to be tired a lot, you have to be able to keep standing up.

Speaking of being tired, I have to share our chairman’s take on fatigue, in the context of the ACGME’s mandate to teach residents how to deal with (or avoid) fatigue (and bear in mind this is one of the nicest guys you could meet, completely not fitting the surgical stereotype): “If you’re tired, you’re tired. Deal with it. What’s this fatigue nonsense?” I think some people think the surgeons are the ones who were born with less need for sleep than other people. While that may be true of the neurosurgeons, whom I have literally calculated to sleep no more than 4 hours every night, I don’t think it’s the case with most of us. We just have something we consider more important than sleeping. (Ask my family: when I was on vacation recently, I spent more than half the day sleeping. But when I’m at the hospital, as long as I’m not sitting down in a dark room for conference or radiology sessions, I’m usually fine. I’m scared enough of failing to do something important that it keeps me alert.) So I think most of us agreed with the chairman: of course we’re tired. It’s a fact of life. We just don’t spend much time thinking about it.

Anyway, get some good shoes; as long as your feet aren’t killing you, it’s easier to keep moving.