To sleep or not to sleep, that is the question

Abstract

The chief of surgery finds a recently boarded vascular surgeon, Dr B.R. Ash, on the couch in the doctor's lounge where a resident is trying to awaken him for permission to start the elective schedule. Dr Ash had finished an arduous all-nighter emergency case less than an hour ago and mumbles for the resident to proceed. The chief surgeon knows that the case about to be started is a type IV thoracoabdominal aneurysm repair to be followed by a carotid endarterectomy.