I love silence. If you listen closely enough, you can almost hear the earth humming its own tune.I also love the vibrant soundtrack of a buzzing city, the shouts of construction workers, the distant traffic, or the persistent hiss of a coffee maker proudly announcing that something delicious is about to happen. But silence has a different quality. It soothes the soul.Which got me wondering: does silence sound different in different parts of the world?Before you shake your head and conclude that I have finally lost my marbles, consider this. I studied in Canada, a country blessed with spectacular wilderness.I have sat beside remote lakes where there was not a human being in sight, surrounded by the beautiful, almost intoxicating sound of nothing. And yet, somehow, you half expected a Canadian to emerge from behind a tall tree carrying pancakes and maple syrup.Africa is different. Standing on the desert sands at my nephew Mohammed’s Mighty’s Ranch game farm, watching the sky turn crimson as the sun offered its final salutation before retiring for the night, silence does not merely surround you.It inhabits you. You feel as though you are the last person on Earth. Having considered the matter carefully, I have decided that Africa’s silence is the most golden of all.But I digress. Let us return to the present. Where was I, standing beneath those distorted circles of white light?I was in the hallway of the Medical and Dental Sciences building at the University of Western Ontario. The silence had now been punctuated by gentle conversation and, as usual, laughter.My roommate, Dave Jasey, and close friend Dan Ceccacci were sipping coffee during a brief respite from studying for final examinations. The clock read 2:30 a.m. And we still had a long way to go.Looking back, we had 16 examinations crammed into two weeks. During that fortnight, we probably averaged three hours of sleep a night, supplemented by the occasional all-nighter for those moments when apparently three hours was considered excessive.This was the life of a healthcare student. By the end of examination period, the combination of exhaustion and stress had reduced us to something resembling human beings, although the resemblance was becoming increasingly debatable.At the time, however, we had little idea what all that sleep deprivation might actually be doing to our bodies. Sleep, it turns out, is not simply the biological equivalent of putting your feet up after a long day.It is when the brain conducts its nightly maintenance programme. Memories are consolidated, metabolic waste is cleared, hormones recalibrated and the immune system given an opportunity to repair and recharge.In other words, while we sleep, our bodies are doing overtime while we are doing absolutely nothing. As it turns out, an essential service.Chronic sleep deprivation, however, turns that elegant system into something resembling a badly managed government department.Concentration and reaction time deteriorate, memory becomes unreliable and emotional control starts to fray. Cortisol, the body’s principal stress hormone, can rise, while glucose regulation and immune function become impaired.Over time, insufficient sleep is associated with increased risks of obesity, diabetes, cardiovascular disease and depression.We knew none of this at 2:30 in the morning. We simply knew that another examination awaited us, another textbook needed conquering and another cup of coffee seemed like a perfectly rational medical intervention.Looking back, perhaps the most remarkable thing was not that we survived those two weeks, but that we willingly repeated the experiment.We were studying medicine and dentistry, after all. We were learning how to preserve human health while simultaneously demonstrating, with considerable enthusiasm, precisely how not to do it.And perhaps that is the first lesson of healthcare: before you can understand the patient, you occasionally have to survive being one.
