In 2009, as a newly minted house officer, I had a point to prove, a goal to achieve and a reputation to uphold. My family was rooting for me. And my mother, who had sacrificed everything to ensure that her daughter became a doctor, was constantly singing in my ear: "Make us proud."
Burdened with that responsibility, I made the mental decision to be the best damned house officer in the Asokoro District Hospital. I went about my job, sometimes taking on extra work along the way without complaining. 'Dr do you want to assist in this surgery or are you tired?' No sir, I can join. 'Dr I know it is time for you to leave, but can you quickly see the patient in bed 12?' 'Doctor, you have not finished taking blood samples for all the babies in the neonatal ward.' 'Doctor, have you left? Please come back, the patient in bed 2 is not making urine'
I tried to be a superhuman - yes, to all the work - after all, I signed up for it. But what I did not sign up for was the almighty 72-hour shift.
The first day I saw the call roster in O&G, I was shocked. As a house officer and the first on call, I would resume Saturday morning, work throughout the day and night, continue to Sunday, work throughout the day (and night) as well, and then somehow appear bright eyed and smiling on Monday at 8am and work again, before finally living for home at 4pm. Therefore, if I came to work on Saturday morning I would leave on Monday evening. At one point, we were only two house officers in the department; and so, I was on call every weekend. This is not to say that I did not take calls during the week; I would do alternate day calls, and the dreaded weekend calls when it was my turn.
By the time I concluded my obstetrics and gynaecology posting, I weighed 44kg and had bags the size of 'Ghana-must-go' under my eyes. I survived on stale biscuits, soft drinks and Indomie noodles. They were days I cried in the bathroom from sheer exhaustion - my feet were swollen, my body ached in places I didn't know existed, and I had a banging headache almost every day. To make matters worse, I was pregnant with my first baby but had to work like a corporal in the army.
I would not wish these working conditions on even my worst enemy.
When news broke that a young doctor in Rivers State, Oluwafemi Rotifa, a resident doctor at the Rivers State University Teaching Hospital (RSUTH), was confirmed dead after reportedly working a gruelling 72-hour shift, my heart sank. In 2023, another Dr Umoh Michael died on Sunday after allegedly working 72 hours non-stop. According to reports, Michael died during a church service at the United Evangelical Church on September 17. He was also said to have worked a 72-hour non-stop shift at the Lagos University Teaching Hospital, Idi-Araba, where he was a resident doctor.
This is not just another tragic headline, it is a grim reflection of a system that has normalised cruelty in the name of service. The Nigerian Medical Association rightly lamented his passing, but beneath the grief lies an uncomfortable truth: This was not an isolated incident. It is the consequence of a deeply defective system that continues to demand the impossible from its doctors.
Doctors are trained to endure sleepless nights, grueling calls and the emotional weight of life-and-death decisions. But endurance has its limits. A 72-hour shift is not just 'tough,' it is a form of institutionalised hazard. Sleep deprivation impairs cognition to the same degree as alcohol intoxication. It slows reflexes, clouds judgement and chips away at empathy. Imagine being asked to insert a central line or resuscitate a newborn after being awake for 48 hours. The risk of error becomes frighteningly high. And unlike machines, our bodies exact a toll: hypertension, arrhythmias, mental burnout; and in this tragic case, sudden death.
Consider the aviation industry. No pilot is ever allowed to fly a plane after such prolonged hours of work. Aviation authorities across the world strictly regulate duty times and enforce mandatory rest periods. Why? Because a fatigued pilot is a danger, not only to himself but every passenger on board. The society recognises this and builds safeguards. Yet in health care, where doctors hold the lives of dozens in their hands each day, such safeguards are glaringly absent.
Are we superhuman? Why do we insist on treating doctors as expendable? Are patients' lives less worthy of protection than airline passengers?
Part of the problem is cultural. We lionise doctors as superhuman beings who can push beyond natural limits. "That's what training is for," some argue, as if medical education is meant to break us rather than equip us. Older doctors say things like "We went through it and did not die, therefore, so must you."
This mythology serves administrators and governments well because it excuses systemic failure. It allows hospitals to stretch thin staffing rosters, avoid hiring more personnel and defer the investment needed to fix health systems.
Doctors are not superhuman. We bleed, we get tired, we mourn. And when we collapse under the weight of impossible demands, the system shrugs and replaces us with the next young graduate in line. This cycle of exploitation is unsustainable and dangerous.
The persistence of 72-hour shifts is not accidental. It is the by-product of chronic underfunding, poor planning and a lack of accountability. Many public hospitals in Nigeria are short-staffed, forcing resident doctors to plug impossible gaps. The doctor-patient ratio in Nigeria stands at an alarming 1:9083, far from the recommended 1:600 ratio.
Government budgets prioritise bricks and mortar - new buildings, new wards - while neglecting the human resource that actually drives health care. In teaching hospitals, the excuse is "training," but in truth, these shifts are a cheap way to provide round-the-clock manpower. Everyone knows it is unsafe. Everyone knows it is exploitative, yet the inertia continues because reform requires political will, financial investment and a reordering of priorities.
Real change starts with admitting the obvious: fatigue kills - not only doctors but also the patients they are meant to serve. That is why certain reforms can no longer be postponed. Just as pilots are protected by strict duty-time limits, doctors too must have legislation that prevents any resident from being worked beyond 24 consecutive hours. At the same time, Nigeria must urgently expand its health workforce by training and retaining more doctors, nurses and physician assistants, so that endless shifts are no longer the default. Hospitals need to abandon the culture of marathon calls and instead redesign duty rosters around structured shifts where safe handovers, not one exhausted individual, guarantee continuity of care.
Wellness must also move from being an afterthought to a policy priority, with mental health support, mandatory rest and even sleep facilities built into the system.
Above all, there must be accountability: hospital administrators and teaching hospital boards should no longer escape responsibility when unsafe schedules cause harm.
The death of this young doctor is a tragedy, but if we only mourn and move on, it would become just another line in the long obituary of Nigeria's health system. True honour lies in ensuring that it never happens again.