12 ms·

Side note... The tech/startup world has realized relatively quickly that 100 hour workweeks are detrimental to productivity, retention, and overall success. S

Side note... The tech/startup world has realized relatively quickly that 100 hour workweeks are detrimental to productivity, retention, and overall success. Seems like articles such as this come out on a weekly basis, along with other articles on 'progressive' practices such as unlimited vacation, flex working hours, mandatory time off, half-day Fridays, etc... and it's only taken a dozen or so years. The medical profession, on the other hand, has struggled with this for almost a hundred years. The norm was for residents to work 100+ hour weeks, for 3-5 years. Non-stop. Only recently have they given themselves a pat on the back for achieving a '[mandatory 80 hour workweek](https://en.wikipedia.org/wiki/Medical_resident_work_hours#Towards_an_80-hour_work_week)' https://en.wikipedia.org/wiki/Medical_resident_work_hours#To.... Seems odd that people building apps and games have figured out that working insane hours is bad, but the people responsible for treating the sick and wounded are still chugging along, bleary eyed and overworked.

munificent 10y ago
The work is very different. If I'm coding and I'm tired, I can go home and get some sleep. When I get in the next day, the code is exactly how I left it. A doctor can't put their patients in suspended animation while they get some shut-eye. The patient's condition may worse or improve. They may make vague complaints that are clues that can only be pieced together if you were around to pick up all of them. Likewise, it's very very difficult for a doctor to serialize every bit of data they've gleaned from a patient to pass on to the next doctor to come on rotation. Because of that "continuity of care"—having one doctor around to continuously interact with the same patient—is really important. It would definitely be great for doctors to work shorter hours, but it does have some real costs. Patients aren't text files.
- rqebmm 10y ago
  This is all very true, but on the other hand: if you're coding and you're tired it's exceedingly unlikely that your mistake would kill someone.
  - pixl97 10y ago
    Unless you're coding medical devices.
    - andyjdavis 10y ago
      You are presumably not writing the code and immediately patching some device that is hooked up to a patient.
  - Rylinks 10y ago
    It cuts both ways. If you're coding and you decide to go home early, it is also exceedingly unlikely that your absence will kill someone.
- Retric 10y ago
  4*12 = 48 hours a week and 2 people a day, 4 per week. Long hours is mostly a staffing issue. 24/7/365 is very hard when you don't have a lot of people. Note, staggered hand-offs also work best. You really don't want everyone to leave at the same time.
- st3v3r 10y ago
  At the same time, a tired doctor is going to miss things, and is going to make shitty decisions.
- brazzledazzle 10y ago
  My understanding from friends in the medical field is that doctors also nap during their shift. Obviously not as beneficial as a good night's sleep and probably depends on what's going on during their shift but it does alter the comparison a bit.
  - w-ll 10y ago
    Yea, but naps really boost productivity even for just a short nap. I wish the start-up culture was more cool with naps. Spoken from someone who has worked at large and small startups that sometimes after lunch just really needs a nap.
    - saeranv 10y ago
      Occasionally after lunch, I'll get hit with this intense wave of sleepiness, which no amount of caffeine seems to be able to fix. The best I can do is stare at my screen blankly through half-closed eyes while my brain is more or less shut off. It can last up to an hour. It's horrible, I've literally looked up motels in the area to see if I can nap during my lunch break but no luck :(
      - harryjo 10y ago
        Are you eating large heavy meals? Try more, smaller, lighter meals.
        saeranv 10y ago
        Good point, this is probably a contributing factor that I've overlooked.
      - ajmurmann 10y ago
        I sometimes will nap in a conference room for twenty minutes just testing my head on my arms which I have crossed on the table. Helps tremendously.
      - ojbyrne 10y ago
- xapata 10y ago
  But patients can and should be more similar to text files. It's a real tragedy that patients die simply because a doctor failed to write accurate notes for the next shift.
- jacalata 10y ago
  Do you have any evidence that's a relevant favor in the practice? Eg: how many times does a doctor see the same patient again in a shift? Is that really relevant across all medical positions/specialties?
dragonwriter 10y ago
> The medical profession, on the other hand, has struggled with this for almost a hundred years. IMO, this is all about money. For residents to work shorter hours, either the cost of care would have to go way up or each residents total pay would have to go way down. Payers won't accept the former, current and prospective residents won't accept the latter (largely, because the cost of medical education is driven by expectations set by the status quo -- they literally can't afford a cut.)
- eterpstra 10y ago
  This may be partially true, but my anecdotal evidence points elsewhere. I live in a very poor city in the US, and most of the private hospitals here run a surplus. The problem (like in tech) is finding adequate talent. Doctors and nurse practitioners (the people that are licensed to actually provide medical care) are in extremely short supply. The money problem is at the University level. Medical programs are so rigorous and expensive, that schools cannot expand and graduate enough students to meet the demand. Hospitals and clinics are expanding, but medical schools are not. So the students that do graduate and move on to residency are overworked due to lack of adequate staff for the facility (rather than lack of money). Residents are extremely cheap compared to boarded physicians and nurse practitioners. I know personally if the hospitals I work for could hire more residents, they would in a snap, but the local University won't fund the programs. The only solutions are to either get more money into schools to graduate more practitioners, or hope that new technology and innovation can somehow alleviate the burden of work on the existing care providers.
  - msabalau 10y ago
    Or we could open medical credentialing to foreign talent. But that would mean that our trade policy would have disadvantage elites rather simply leaving the working class open to global competition while protecting doctors, lawyers, and content conglomerates.
    - eru 10y ago
      That could be part of a solution. Another one is to be very careful about how much training to require for which function. Eg lots of routine work in hospitals could be done by people with less training than a full doctor. Some places around the world are moving in that direction.
underwires 10y ago
From what my doctor friends have told me, it is all about information hand-off, or lack thereof. When you have been on duty for 8 hours you have all the details of all the situations that are happening currently, but it is very difficult to hand off all that information to the next person, so it is just 'easier' to keep working and to be there when that info is needed. It seems like that could be remedied with overlapping shifts, but that costs more money. I wonder how medical malpractice factors in.
- cmdrfred 10y ago
  Why can't everything be in the patent's chart? I do healthcare IT and doctors seem to do their digital 'paperwork' sometimes weeks after the visit. I know because we get calls to unlock the records so they can modify them. If all this data was in the chart, problem solved.
  - ansible 10y ago
    Sounds like we need to make data capture going into the charts much more slick and smooth. I'm thinking of a voice-driven personal assistant using the latest in AI. So you can just tell it what you're doing, and what you're thinking about the patient's problems, and it organizes it automatically, and makes it easy for others to retrieve (via voice). Adding in some kind of unobtrusive HUD would be awesome too.
    - bawana 10y ago
      As a physician I can tell you it's not about data entry and data retrieval. It takes time to abstract into words the cognitive model in a physician's brain that represents the patient's condition and progress. Words are static and the format we are forced into documenting is also arthritic and linear. It does not convey the fluid and fuzzy nature of a patient's condition and progress. Treating a sick patient is a little like reverse engineering a binary. Disassembly into blocks takes some guesswork. Pattern recognition plays a role- therefore you already need to know design patterns before you even approach a binary. Properly codifying your guesses can be helped by using something like IDA but sometimes that slows you down and you can go just as fast using ollydbg/gdb/whatever. This is because the construct is in your brain and you are using these software tools to gather data points, not construct some model on paper that stands like a sculpture or perhaps a Rube-Goldberg device that is a rough approximation of the original source code. Treating patients begins with such a puzzle. You need to know what diseases look like, what the key distinguishing features of look-alike diseases are. Then you also need to have a feel for the time course of these processes. On this mental scaffold you pin data points gleaned from the tests you order. Trying to communicate this whole mental structure along with the relevant data points and also pointing out the confusing chaff can be a tremendous waste of time. Verbal communication is a lot faster. The abstraction/deabstraction bottleneck is avoided. Instead, approximations are presented so the model is quickly understood by the next physician. The next level of detail is then overlaid. Then another level of detail is overlaid and so on, like building a fractal image. The advantage of this approach is that the big picture is conveyed first without a lot of detail that could be misleading if it receives the wrong emphasis. Also, the receiving physician can interrogate the process early in the big picture phase to verify major diagnostic and treatment decisions. Writing text is a linear process- it is a serial data stream. However, puzzle solving requires a constant zooming and zooming out as well as non linear jumping around, Puzzle solving is not well suited to a linear data stream. But writing and reading text is all that we are taught since grade school. Even the attempt to structure knowledge into an 'outline' is too restrictive. Interestingly, when we teach children how to use the this linear tool of text writing, we do not use linear methods. Rather, a sentence is approached as a whole entity and then broken down until the meaning is understood. We use this game of 'diagramming sentences' to break down, analyze and communicate the parts of our sentences. The most meaningful parts are the subject and verb. Then we sometimes add an object. Adjectives and adverbs are modifiers. Prepositions are key fulcrums as well. The similarity to medicine is that a patient's condition is analogous to a sentence in English. When we discuss a patient's condition, there is a similar pattern-the principal parts are presented first. Additional levels of detail are then added to embellish and refine the picture. The model morphs and morphs again as certain facts are emphasized and others de-emphasized. Finally it locks into one of the 'disease patterns' we recognize. Electronic medical records are not any different than the notes we used to write. They are a skeumorphic sham that do not permit better or faster comprehension. Computers have permitted an amazing use of graphics and improved design patterns that have changed the content on the net. If you saw a web site designed in 1990 you would recognize it immediately. Today's sites are much more dynamic. Font choices, formatting, parallax page movement, drop downs, animation and sound focus our attention to communicate information quickly. Hyperlinks permit non linear navigation. Electronic medical records make no use of that. Graphic primitives, hyperlinks or audio cues are not built in to these programs. Instead we are forced to use relics from a previous era. Why? That's a WHOLE 'NOTHER can 'o worms. There are over 450 electronic medical record systems most of which do not talk to each other. It feels like I am using wordstar. Remember that program?? Improving patient care needs to begin with the patient. We need to be able to give a person an iPad with a picture of a body on it. As they point and click and expand relevant body parts, they need to be given choices of typical symptoms. The whole patient centered part can be in any language- it would be mostly pictures with a few words. As they continue to point and click, the iPad is generating the text that represents their choices. The text could be in the physician's language. A person could do this while waiting for the physician. So when the physician gets to the patient, you just saved half an hour. and maybe avoided some unnecessary tests. and maybe gotten them the care they they needed. faster.
nugget 10y ago
This varies greatly by specialty. Surgeons (and anesthesiologists) are working 80 hours/week or more. Most non surgical specialties are well under 80. Pediatricians, dermatologists, psychiatrists and a handful of others probably average around 50 hours/week over the entire residency, with another 10 hours/week of home study (equivalent to a developer reading technical articles from hacker news & stackoverflow).
mikekchar 10y ago
> The tech/startup world has realized relatively quickly that 100 hour workweeks are detrimental to productivity, retention, and overall success. Not that quickly ;-) My first job at a start up was 1992, I think. I didn't take a single day off (even national holidays) for 18 months. 12 hour days during the week, 8 on the weekend. After that, I took a year off to pretend to do a master's degree (but really just hung out in the gym and lifted weights). And then I went straight into a job where I became much more sensible and only worked 90 hour weeks. I remember reading Jamie Zawinksi's writing at the time. There are some remnants of it around the internet, but because of this: https://www.jwz.org/blog/2011/11/watch-a-vc-use-my-name-to-sell-a-con/ https://www.jwz.org/blog/2011/11/watch-a-vc-use-my-name-to-s... he's not keen for people to link to it. I still remember with great fondness the post about trying to answer a survey of how many hours a week he worked. He said something like 120, but the computer field only had 2 digits. JWZ was incredulous that this could happen given that the guy who wrote the code surely worked more than 100 hours a week. Back in those days, this was the way we thought you were supposed to do it. Even though Peopleware was written in 1987, we all read it and promptly ignored its advice (BTW, when was the last time you saw a programmer's desk of the recommended size? ahem....) Even today (getting pretty darn close to the 30th anniversary of Peopleware) how many teams believe that crunch is not just necessary, but desirable? Hey, the fact that we don't crunch is one of the biggest selling points of the group I work with. Lot's of great programmers are willing to give up salary in exchange for a no-crunch life. Lately there is general acceptance amongst programmers that a 40 hour week is a good idea (this is not always shared by entrepreneurs). However, my experience is that before about the year 2010, the concept was ludicrous -- even ridiculed. I'm really happy to see the tide turn, but this is a fairly recent phenomenon.
- toomanybeersies 10y ago
  He seems to have set his website so that when referred by HN it goes to this imgur image: http://i.imgur.com/32R3qLv.png http://i.imgur.com/32R3qLv.png Seems he doesn't have a high opinion of HN.
  - vitd 10y ago
    Oddly, I don't get that image when I click on the parent article's link.
lasfter 10y ago
A humorous (albeit terrifying) anecdote: My girlfriend's brother is a doctor, and falls asleep very easily. He told us that during his residency, he once fell asleep during heart surgery while holding open the patient's chest (with some kind of crowbar-like medical instrument whose name I forget). Fortunately he maintained muscle tension so nothing bad happened. The surgeon noticed he was sleeping and told him to take a walk. He also falls asleep driving, standing on the bus, at the dinner table, etc.
- lutorm 10y ago
  Falling asleep like that is likely a symptom of severe sleep deprivation, not a personal characteristic.
- harryjo 10y ago
  > The surgeon noticed he was sleeping and told him to take a walk. Pardon me?! The surgeon didn't say "take a nap" ? Your girlfriend's brother should see a doctor about possible apnea or other sleep disorder.
- gambiting 10y ago
  "He also falls asleep driving" - I don't know where you are, but in EU this would prohibit you from ever having a licence, just like being a diagnosed alcoholic would(unless you get a note from a doctor saying that you are fine to drive).
gavingmiller 10y ago
> 'progressive' practices such as unlimited vacation Unlimited vacation is not progressive and it is also unhealthy. It causes feelings of guilt while on vacation. Often there's an unspoken obligated to check-in (email & chat) when on vacation. And leads to taking fewer vacation days not more. When leaving a company, they have no obligation to pay out accrued vacation days since there is none defined (this may be a Canadian thing). Additionally, it can also come with the unspoken culture of overtime, since it can easily be made up with "more time off". Having worked with unlimited vacation, if I am ever offered it again, I will decline and negotiate defined vacation into my employment agreement.
- nfriedly 10y ago
  I had unlimited vacation on my last job, and I think I personally did great with it (4-5 weeks per year, very little email checking and such). But on average, I'd say you're right. Many of my coworkers took almost zero vacation. At one point, the CTO just started scheduling a week off at a time for people who hadn't taken one in a year+.
  - harryjo 10y ago
    4-5 weeks vacation per year, tracked, and an option for unpaid longer leave, sounds great.
    - gambiting 10y ago
      That's what you get by law in EU, standard, no matter what you do. Plus unlimited sick time off that doesn't come out of your holiday allowance.
      - mkesper 10y ago
        After six weeks, you'll get paid by your health insurance, though (german standard). Definitely less cash but still. :)
- eru 10y ago

munificent 10y ago

The work is very different. If I'm coding and I'm tired, I can go home and get some sleep. When I get in the next day, the code is exactly how I left it. A doctor can't put their patients in suspended animation while they get some shut-eye. The patient's condition may worse or improve. They may make vague complaints that are clues that can only be pieced together if you were around to pick up all of them. Likewise, it's very very difficult for a doctor to serialize every bit of data they've gleaned from a patient to pass on to the next doctor to come on rotation. Because of that "continuity of care"—having one doctor around to continuously interact with the same patient—is really important. It would definitely be great for doctors to work shorter hours, but it does have some real costs. Patients aren't text files.

rqebmm 10y ago
This is all very true, but on the other hand: if you're coding and you're tired it's exceedingly unlikely that your mistake would kill someone.
- pixl97 10y ago
  Unless you're coding medical devices.
  - andyjdavis 10y ago
    You are presumably not writing the code and immediately patching some device that is hooked up to a patient.
- Rylinks 10y ago
  It cuts both ways. If you're coding and you decide to go home early, it is also exceedingly unlikely that your absence will kill someone.
Retric 10y ago
4*12 = 48 hours a week and 2 people a day, 4 per week. Long hours is mostly a staffing issue. 24/7/365 is very hard when you don't have a lot of people. Note, staggered hand-offs also work best. You really don't want everyone to leave at the same time.
st3v3r 10y ago
At the same time, a tired doctor is going to miss things, and is going to make shitty decisions.
brazzledazzle 10y ago
My understanding from friends in the medical field is that doctors also nap during their shift. Obviously not as beneficial as a good night's sleep and probably depends on what's going on during their shift but it does alter the comparison a bit.
- w-ll 10y ago
  Yea, but naps really boost productivity even for just a short nap. I wish the start-up culture was more cool with naps. Spoken from someone who has worked at large and small startups that sometimes after lunch just really needs a nap.
  - saeranv 10y ago
    Occasionally after lunch, I'll get hit with this intense wave of sleepiness, which no amount of caffeine seems to be able to fix. The best I can do is stare at my screen blankly through half-closed eyes while my brain is more or less shut off. It can last up to an hour. It's horrible, I've literally looked up motels in the area to see if I can nap during my lunch break but no luck :(
    - harryjo 10y ago
      Are you eating large heavy meals? Try more, smaller, lighter meals.
      - saeranv 10y ago
        Good point, this is probably a contributing factor that I've overlooked.
    - ajmurmann 10y ago
      I sometimes will nap in a conference room for twenty minutes just testing my head on my arms which I have crossed on the table. Helps tremendously.
    - ojbyrne 10y ago
xapata 10y ago
But patients can and should be more similar to text files. It's a real tragedy that patients die simply because a doctor failed to write accurate notes for the next shift.
jacalata 10y ago
Do you have any evidence that's a relevant favor in the practice? Eg: how many times does a doctor see the same patient again in a shift? Is that really relevant across all medical positions/specialties?

dragonwriter 10y ago

> The medical profession, on the other hand, has struggled with this for almost a hundred years. IMO, this is all about money. For residents to work shorter hours, either the cost of care would have to go way up or each residents total pay would have to go way down. Payers won't accept the former, current and prospective residents won't accept the latter (largely, because the cost of medical education is driven by expectations set by the status quo -- they literally can't afford a cut.)

eterpstra 10y ago
This may be partially true, but my anecdotal evidence points elsewhere. I live in a very poor city in the US, and most of the private hospitals here run a surplus. The problem (like in tech) is finding adequate talent. Doctors and nurse practitioners (the people that are licensed to actually provide medical care) are in extremely short supply. The money problem is at the University level. Medical programs are so rigorous and expensive, that schools cannot expand and graduate enough students to meet the demand. Hospitals and clinics are expanding, but medical schools are not. So the students that do graduate and move on to residency are overworked due to lack of adequate staff for the facility (rather than lack of money). Residents are extremely cheap compared to boarded physicians and nurse practitioners. I know personally if the hospitals I work for could hire more residents, they would in a snap, but the local University won't fund the programs. The only solutions are to either get more money into schools to graduate more practitioners, or hope that new technology and innovation can somehow alleviate the burden of work on the existing care providers.
- msabalau 10y ago
  Or we could open medical credentialing to foreign talent. But that would mean that our trade policy would have disadvantage elites rather simply leaving the working class open to global competition while protecting doctors, lawyers, and content conglomerates.
  - eru 10y ago
    That could be part of a solution. Another one is to be very careful about how much training to require for which function. Eg lots of routine work in hospitals could be done by people with less training than a full doctor. Some places around the world are moving in that direction.

underwires 10y ago

From what my doctor friends have told me, it is all about information hand-off, or lack thereof. When you have been on duty for 8 hours you have all the details of all the situations that are happening currently, but it is very difficult to hand off all that information to the next person, so it is just 'easier' to keep working and to be there when that info is needed. It seems like that could be remedied with overlapping shifts, but that costs more money. I wonder how medical malpractice factors in.

cmdrfred 10y ago
Why can't everything be in the patent's chart? I do healthcare IT and doctors seem to do their digital 'paperwork' sometimes weeks after the visit. I know because we get calls to unlock the records so they can modify them. If all this data was in the chart, problem solved.
- ansible 10y ago
  Sounds like we need to make data capture going into the charts much more slick and smooth. I'm thinking of a voice-driven personal assistant using the latest in AI. So you can just tell it what you're doing, and what you're thinking about the patient's problems, and it organizes it automatically, and makes it easy for others to retrieve (via voice). Adding in some kind of unobtrusive HUD would be awesome too.
  - bawana 10y ago
    As a physician I can tell you it's not about data entry and data retrieval. It takes time to abstract into words the cognitive model in a physician's brain that represents the patient's condition and progress. Words are static and the format we are forced into documenting is also arthritic and linear. It does not convey the fluid and fuzzy nature of a patient's condition and progress. Treating a sick patient is a little like reverse engineering a binary. Disassembly into blocks takes some guesswork. Pattern recognition plays a role- therefore you already need to know design patterns before you even approach a binary. Properly codifying your guesses can be helped by using something like IDA but sometimes that slows you down and you can go just as fast using ollydbg/gdb/whatever. This is because the construct is in your brain and you are using these software tools to gather data points, not construct some model on paper that stands like a sculpture or perhaps a Rube-Goldberg device that is a rough approximation of the original source code. Treating patients begins with such a puzzle. You need to know what diseases look like, what the key distinguishing features of look-alike diseases are. Then you also need to have a feel for the time course of these processes. On this mental scaffold you pin data points gleaned from the tests you order. Trying to communicate this whole mental structure along with the relevant data points and also pointing out the confusing chaff can be a tremendous waste of time. Verbal communication is a lot faster. The abstraction/deabstraction bottleneck is avoided. Instead, approximations are presented so the model is quickly understood by the next physician. The next level of detail is then overlaid. Then another level of detail is overlaid and so on, like building a fractal image. The advantage of this approach is that the big picture is conveyed first without a lot of detail that could be misleading if it receives the wrong emphasis. Also, the receiving physician can interrogate the process early in the big picture phase to verify major diagnostic and treatment decisions. Writing text is a linear process- it is a serial data stream. However, puzzle solving requires a constant zooming and zooming out as well as non linear jumping around, Puzzle solving is not well suited to a linear data stream. But writing and reading text is all that we are taught since grade school. Even the attempt to structure knowledge into an 'outline' is too restrictive. Interestingly, when we teach children how to use the this linear tool of text writing, we do not use linear methods. Rather, a sentence is approached as a whole entity and then broken down until the meaning is understood. We use this game of 'diagramming sentences' to break down, analyze and communicate the parts of our sentences. The most meaningful parts are the subject and verb. Then we sometimes add an object. Adjectives and adverbs are modifiers. Prepositions are key fulcrums as well. The similarity to medicine is that a patient's condition is analogous to a sentence in English. When we discuss a patient's condition, there is a similar pattern-the principal parts are presented first. Additional levels of detail are then added to embellish and refine the picture. The model morphs and morphs again as certain facts are emphasized and others de-emphasized. Finally it locks into one of the 'disease patterns' we recognize. Electronic medical records are not any different than the notes we used to write. They are a skeumorphic sham that do not permit better or faster comprehension. Computers have permitted an amazing use of graphics and improved design patterns that have changed the content on the net. If you saw a web site designed in 1990 you would recognize it immediately. Today's sites are much more dynamic. Font choices, formatting, parallax page movement, drop downs, animation and sound focus our attention to communicate information quickly. Hyperlinks permit non linear navigation. Electronic medical records make no use of that. Graphic primitives, hyperlinks or audio cues are not built in to these programs. Instead we are forced to use relics from a previous era. Why? That's a WHOLE 'NOTHER can 'o worms. There are over 450 electronic medical record systems most of which do not talk to each other. It feels like I am using wordstar. Remember that program?? Improving patient care needs to begin with the patient. We need to be able to give a person an iPad with a picture of a body on it. As they point and click and expand relevant body parts, they need to be given choices of typical symptoms. The whole patient centered part can be in any language- it would be mostly pictures with a few words. As they continue to point and click, the iPad is generating the text that represents their choices. The text could be in the physician's language. A person could do this while waiting for the physician. So when the physician gets to the patient, you just saved half an hour. and maybe avoided some unnecessary tests. and maybe gotten them the care they they needed. faster.

nugget 10y ago

This varies greatly by specialty. Surgeons (and anesthesiologists) are working 80 hours/week or more. Most non surgical specialties are well under 80. Pediatricians, dermatologists, psychiatrists and a handful of others probably average around 50 hours/week over the entire residency, with another 10 hours/week of home study (equivalent to a developer reading technical articles from hacker news & stackoverflow).

mikekchar 10y ago

> The tech/startup world has realized relatively quickly that 100 hour workweeks are detrimental to productivity, retention, and overall success. Not that quickly ;-) My first job at a start up was 1992, I think. I didn't take a single day off (even national holidays) for 18 months. 12 hour days during the week, 8 on the weekend. After that, I took a year off to pretend to do a master's degree (but really just hung out in the gym and lifted weights). And then I went straight into a job where I became much more sensible and only worked 90 hour weeks. I remember reading Jamie Zawinksi's writing at the time. There are some remnants of it around the internet, but because of this: https://www.jwz.org/blog/2011/11/watch-a-vc-use-my-name-to-sell-a-con/ https://www.jwz.org/blog/2011/11/watch-a-vc-use-my-name-to-s... he's not keen for people to link to it. I still remember with great fondness the post about trying to answer a survey of how many hours a week he worked. He said something like 120, but the computer field only had 2 digits. JWZ was incredulous that this could happen given that the guy who wrote the code surely worked more than 100 hours a week. Back in those days, this was the way we thought you were supposed to do it. Even though Peopleware was written in 1987, we all read it and promptly ignored its advice (BTW, when was the last time you saw a programmer's desk of the recommended size? ahem....) Even today (getting pretty darn close to the 30th anniversary of Peopleware) how many teams believe that crunch is not just necessary, but desirable? Hey, the fact that we don't crunch is one of the biggest selling points of the group I work with. Lot's of great programmers are willing to give up salary in exchange for a no-crunch life. Lately there is general acceptance amongst programmers that a 40 hour week is a good idea (this is not always shared by entrepreneurs). However, my experience is that before about the year 2010, the concept was ludicrous -- even ridiculed. I'm really happy to see the tide turn, but this is a fairly recent phenomenon.

toomanybeersies 10y ago
He seems to have set his website so that when referred by HN it goes to this imgur image: http://i.imgur.com/32R3qLv.png http://i.imgur.com/32R3qLv.png Seems he doesn't have a high opinion of HN.
- vitd 10y ago
  Oddly, I don't get that image when I click on the parent article's link.

lasfter 10y ago

A humorous (albeit terrifying) anecdote: My girlfriend's brother is a doctor, and falls asleep very easily. He told us that during his residency, he once fell asleep during heart surgery while holding open the patient's chest (with some kind of crowbar-like medical instrument whose name I forget). Fortunately he maintained muscle tension so nothing bad happened. The surgeon noticed he was sleeping and told him to take a walk. He also falls asleep driving, standing on the bus, at the dinner table, etc.

lutorm 10y ago
Falling asleep like that is likely a symptom of severe sleep deprivation, not a personal characteristic.
harryjo 10y ago
> The surgeon noticed he was sleeping and told him to take a walk. Pardon me?! The surgeon didn't say "take a nap" ? Your girlfriend's brother should see a doctor about possible apnea or other sleep disorder.
gambiting 10y ago
"He also falls asleep driving" - I don't know where you are, but in EU this would prohibit you from ever having a licence, just like being a diagnosed alcoholic would(unless you get a note from a doctor saying that you are fine to drive).

gavingmiller 10y ago

> 'progressive' practices such as unlimited vacation Unlimited vacation is not progressive and it is also unhealthy. It causes feelings of guilt while on vacation. Often there's an unspoken obligated to check-in (email & chat) when on vacation. And leads to taking fewer vacation days not more. When leaving a company, they have no obligation to pay out accrued vacation days since there is none defined (this may be a Canadian thing). Additionally, it can also come with the unspoken culture of overtime, since it can easily be made up with "more time off". Having worked with unlimited vacation, if I am ever offered it again, I will decline and negotiate defined vacation into my employment agreement.

nfriedly 10y ago
I had unlimited vacation on my last job, and I think I personally did great with it (4-5 weeks per year, very little email checking and such). But on average, I'd say you're right. Many of my coworkers took almost zero vacation. At one point, the CTO just started scheduling a week off at a time for people who hadn't taken one in a year+.
- harryjo 10y ago
  4-5 weeks vacation per year, tracked, and an option for unpaid longer leave, sounds great.
  - gambiting 10y ago
    That's what you get by law in EU, standard, no matter what you do. Plus unlimited sick time off that doesn't come out of your holiday allowance.
    - mkesper 10y ago
      After six weeks, you'll get paid by your health insurance, though (german standard). Definitely less cash but still. :)
eru 10y ago