We fight these forces at our peril. In February 2009 a commuter jet en route from Newark to Buffalo crashed, killing all 49 aboard and one on the ground. The copilot, and probably the pilot, had only sporadic amounts of sleep the day leading up to the crash, leading the National Transportation Safety Board to conclude that their performance “was likely impaired because of fatigue.” This sort of news enrages Harvard’s Charles Czeisler. He notes that going without sleep for 24 hours or getting only five hours of sleep a night for a week is the equivalent of a blood alcohol level of 0.1 percent. Yet modern business ethic celebrates such feats. “We would never say, ‘This person is a great worker! He’s drunk all the time!’ ” Czeisler wrote in a 2006 Harvard Business Review article.
Starting in 2004, Czeisler published a series of reports in medical journals based on a study his group had conducted of 2,700 first-year medical residents. These young men and women work shifts that are as long as 30 hours twice a week. Czeisler’s research revealed the remarkable public health risk that this sleep debt entailed. “We know that one out of five first-year residents admits to making a fatigue-related mistake that resulted in injury to a patient,” he told me in the spring of 2009. “One in 20 admits to making a fatigue-related mistake that resulted in the death of a patient.” When Czeisler came out with this information, he expected hospitals to thank him. Instead many “circled the wagons.” He despairs of anything being done until U.S. employers get serious about insomnia and sleepiness. “My conviction is that one day people will look back on what will be viewed as a barbarous practice.”