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Blog: Nap time
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“Oh, so you attended the thyroid symposium in Orlando?” Dr. Duick asked.
“Yes," I answered and began to brag about it!
“So, you remember me?” Dr. Duick asked.
“No,” I answered, with utmost honesty, but clearly with unheeded naivety. That could have been the end of the interview.
That was part of the dialogue that I had with Daniel S. Duick, MD, FACE, FACP, a practicing endocrinologist with Endocrinology Associates PA in Scottsdale, Arizona, and my prospective employer, during an interview for my first job. That was in late March of 1996, in Cape Girardeau, Missouri, and the position was for a junior associate of Dr. Duick.
This was the only job interview that I had, toward the end of my fellowship. I miraculously heard about this job opportunity via a recruitment letter that came by mail, to our fellowship office, as I was in the last months of my endocrinology fellowship at Indiana University (IU), in Indianapolis, Indiana. At that point, I had lost all hopes to secure a job in the U.S., being a foreign medical graduate on a J-1 study visa. I had explored hundreds of jobs in underserved U.S. communities, but it was so competitive, as thousands of foreign medical graduates were competing for these limited jobs (about 30 positions in each state, on average). I was literally preparing to pack up and leave the country, to go back home.
Cape Girardeau, Missouri, and its surrounding large rural area, was considered an underserved area, and I was invited for a job interview.
Earlier in the preceding winter, I was asked by one of my research mentors at IU, Professor Charles Clark, to attend a meeting on his behalf in Miami, Florida. Dr. Clark was the principal investigator for a multicenter clinical trial investigating a new insulin product, and I was a senior fellow and member of the clinical trial’s research team. The meeting was one day before the thyroid symposium in Orlando, which I had already registered to attend.
After attending the clinical trial meeting in Miami, I flew late Friday to Orlando to attend the thyroid symposium the following Saturday. To impress Dr. Duick at the interview, I was bragging about how “famous” I was as a senior fellow, attending two important back-to-back national meetings. I meant to brag about the fact that I was a senior fellow of Dr. Clark, a nationally renowned diabetes expert, having been a past president of the American Diabetes Association and the editor-in-chief of the ADA’s official journal, Diabetes Care.
As I was bragging about all of that, Dr. Duick surprised me when he asked about the Orlando meeting in particular, and I thought he was pleased to know that I attended the Orlando meeting.
When I answered “no” to his question, he was surprised, for a reason that I did not understand at the moment.
“You do not remember me?” he asked.
I then asked him with curiosity, “Oh, you mean you, too, attended the meeting?”
“I was one of the speakers,” he said.
“Really?” I asked in both disbelief and embarrassment.
“You must have been sleeping through my lecture,” he added.
“I must have,” I said, with utmost embarrassment.
The rest of the interview went OK, though, at the time, I did not know what an “OK” interview would be like, as it was my first interview.
When I returned home, I told my wife that I did not think that I would get the job because of that “nap.”
Well, I got the job.
I am sharing this story to discuss the issue of napping during lectures.
Now, 20-plus years later, as I have become a teacher who gave numerous lectures at the medical school, as well as in regional and international conferences — I can relate very intimately to this issue. In addition to being a regular speaker, I have also organized or co-organized numerous regional and international medical symposia and conferences, serving as a moderator in lecture sessions. As a moderator, sitting on the stage with other moderators, one can watch both speaker and audience during a lecture.
I can say that the worst thing a lecturer may experience (once he or she escapes the not uncommon glitches in audio-visual equipment) is seeing nappers in his or her audience. The more the nappers spotted, the worse the lecture would feel because he or she would get the impression that the lecture is boring or not well-presented.
When I go back in my memory, to the days of medical school and training, I recall having napped through many lectures. It is true that some lecturers have unique skills to keep the audience awake (such as quality of slides or the use of animations), but napping in lectures is almost inevitable to at least few attendants in any audience. This is especially true during afternoon lectures.
The etiology of napping during lectures is multifactorial. Besides a speaker’s lecturing skills and the lecture content, attendants’ factors are also important. The relevance or importance of the lecture to an attendant is important. Also, the context of the lecture is so relevant. Major national or international meetings are generally attended by audiences who travel long distances to attend such lectures, questing to further their knowledge and can listen to famous speakers.
Let’s look at grand rounds in teaching institutions. In general, grand rounds are usually full of residents, for whom it is mandatory to attend these grand rounds. If you look at the audience in any given grand round, you will find a good number of residents not paying much attention to the ongoing lecture, with some staring at their cellphones or tablets, finishing patient work, such as an admission note.
Some of these residents may have not had enough sleep the night before, which is another important factor. In fact, adequate sleep at night is prudent to keep a human being fully attentive during the day, including being able to focus on a lecture. Recent research has found that about 95% of people need at least 8 hours of sound sleep to recharge for the next day. Other attendants of grand rounds, such as faculty members, may be more attentive to the lecture than residents, at large, but some may doze off now and then.
I can relate to this as I reflect on the old days of training when I was a resident, at which time I would nap through many lectures. After that stage of training, and forward to the present, I can say that I may not have napped in any lecture (or very rarely have I).
Furthermore, the amount of food taken at lunch, especially carbs and sweets, is also important, in view of the well-known effects of heavy lunch on human’s ability to focus during lectures.
A quick search of the internet will return numerous items about the attention and awareness of audiences during lectures. This link is an interesting posting, titled “How do you control sleepy audience in a conference or in a classroom?” at Research Gate: https://www.researchgate.net/post/How_do_you_control_sleepy_audience_in_a_Conference_or_in_a_Class-room.
The author discusses how to engage the audience and keep them awake during a lecture. The associated online comments are quite interesting, furthering the discussion about the topic.
Finally, I recall vividly a series of lectures by Dr. James Davidson, a senior British physician who was one of our teaching faculty of my internal medicine residency program at Hamad General Hospital in Doha, Qatar (1988-1992). Dr. Davidson would always start his lecture with a slide that depicts the course of audience “awakeness” during lectures. The slide was a handwritten graph that Dr. Davidson had adapted from a prior published study. Googling such graphs, one will find several examples in various shapes and illustrations. I still vividly remember Dr. Davidson’s graph, and so I reproduced it herein (Figure) for entertainment of this blog’s readers. I further adapted the graph to add some humor.
Whenever I remember that dialogue with Dr. Duick, I feel embarrassed, again, to have napped during a lecture given by my prospective employer. That could have cost me losing that once-in-a-lifetime job opportunity.
I reminisce on the sweet memory of that interview whenever I notice someone napping during one of my lectures, and I laugh to myself, saying to myself, “Been there, done that!”