Watch out for exhaustion before you fluff your living lines!
On an unremarkable evening in 2021, Patrick Charnley sat down with his family to eat sausage and chips. He was thirty-nine years old, an ultra-fit partner at a London law firm, a man who viewed downtime as wasted time and weekends as inefficiency. His wife sat beside him. His daughter and son, then nine and seven, were nearby. It was an ordinary scene in an ordinary home, the kind of evening he had lived through hundreds of times before, always with his mind already racing toward the next deadline, the next case, the next measure of success he had not yet secured.
Within the hour, his heart stopped.
What followed was forty minutes of clinical death. His wife performed CPR on the living room floor while their children ran desperately through the house seeking help. Paramedics arrived and deployed defibrillators once, twice, repeatedly. Nothing. The machines could not persuade his heart to remember its purpose. His wife, kneeling beside the body of the man she had married, began to accept that he was gone. It was only when the medical team administered adrenaline, a final roll of the dice with no guarantee, a gesture that was almost ritualistic in its desperation, that his heart, against every probability, shuddered back into rhythm.
Patrick awoke from a week-long coma blind, hallucinating, and permanently altered. His eyes functioned, but his brain could no longer translate light into meaning. In the absence of visual input, his mind began to generate its own images, a phenomenon called Charles Bonnet Syndrome. He saw frightening things: an American nurse trying to murder him, shadowy figures lurking at the edges of his perception. But he also saw beauty. One hallucination transported him to a sanatorium in the Alps. He stood before vast windows, gazing at snow-covered peaks while nurses conversed quietly in an adjacent room. The experience, he recalls, was blissful, a profound sense of safety and calm that his waking life, for all its achievements, had never been able to deliver.
Here is the part of this story that disturbs me more than the cardiac arrest itself. Patrick Charnley, reflecting on everything he has lost, his career, his eyesight, his cognitive sharpness, his ability to play chase with his children, his place in the world of high-functioning professionals who measure their worth in billable hours, says he would not go back. Given the choice between the life he lived before and the life he inhabits now, diminished and difficult and constrained, he chooses the latter. “I live a richer existence now,” he told the BBC’s Ready to Talk podcast.
Its a common cliche in many work circles that 24 hours is no longer enough, but it seems a man can self-destruct guarding his own work principles!
A man who died and returned believes his life is better on the other side of tragedy. This is not, as we might prefer to frame it, a story about resilience and the triumph of the human spirit. It is an indictment. It is a verdict. It is the body’s final, devastating veto on a way of living that has become, across the developed world, not merely common but compulsory.
We have constructed a world that requires us to burn ourselves to the ground to prove we are worthy of occupying space within it. The message is delivered early and reinforced constantly through every channel of modern life: productivity is morality. Rest is laziness. Leisure is for those who have stopped striving, who have conceded defeat in the race that defines our era. Your value is measured in output, your output measured in hours, and those hours must be extracted from your finite, irreplaceable body until the body refuses to cooperate. Patrick Charnley did not invent his work ethic. He absorbed it from the culture he inhabited, a culture that celebrates the 4am email, the skipped lunch, the weekend catch-up session disguised as personal discipline, the vacation days that accumulate unused until they expire. He viewed downtime as wasted time because that is precisely what we have taught ambitious people to believe. The body, however, does not read the culture. It reads its own biology. And when pushed past its limits, it does not negotiate. It collapses.
The aftermath of Patrick’s cardiac arrest was not a tidy redemption arc. He returned home to find that severe fatigue governed every aspect of his existence. He never wakes refreshed. Every day begins in deficit and accumulates exhaustion as it progresses. His cognitive processing speed, initially measured in the bottom two percent of the population, remains significantly impaired despite months of rehabilitation. He cannot spontaneously join family activities. He cannot keep pace with peers whose lives continue unaffected, who have not been forced to confront the fragility of the neurological architecture that underpins everything we call intelligence and competence and success. And for a period, he did not care. This was not depression, he clarifies, but something psychologists term pathological apathy, a complete detachment from motivation and desire, a state of floating through time without solid ground beneath his feet. His psychologist eventually helped him understand what was required: grief. Not the overcoming of loss, but the acknowledgment of it. He had to mourn the lawyer he would never again be, the father who could run and chase and wrestle, the man who moved through the world with unthinking competence and expected it to continue indefinitely. We do not speak enough about the grief embedded in survival. We celebrate the comeback, the triumph over adversity, the inspirational narrative of beating the odds. We are less comfortable with the slow, unglamorous work of accepting that some losses are permanent and must be carried, not transcended.
Most of us will not suffer cardiac arrest on our living room floors. Most of us will not spend forty minutes clinically dead or wake to find our brains permanently reconfigured. But the mechanism that broke him operates within all of us, and it operates at reduced intensity every single day. The body does not issue warnings arbitrarily. Fatigue is not a design flaw. Exhaustion is not weakness. These are communications, the body’s attempt to negotiate with a consciousness that has stopped listening. When you wake unrefreshed, your body is speaking. When you yawn through afternoon meetings and struggle to maintain concentration, your body is speaking. When your internal batteries deplete before lunch and no quantity of caffeine restores them, your body is speaking.
Dr. Foldvary-Schaefer, a neurologist specialising in sleep disorders at the Cleveland Clinic, states it plainly: insufficient sleep cannot be compensated by any amount of late-day coffee. The debt accumulates. The interest compounds. Eventually, the account is called due.
We define ourselves by our work because our culture offers few alternative frameworks for self-worth. The first question at dinner parties, networking events, and family gatherings is almost invariably occupational. What do you do? It is code for a more fundamental inquiry: What are you worth? How should I calibrate my estimation of you? How much status do you carry? We have internalised this equation so completely that we no longer recognise it as contingent, as a specific historical arrangement rather than a universal truth. But consider how strange it is that a human life should be summarised by its economic function. Consider how impoverished our self-conceptions have become when a lawyer who can no longer practice law must relearn how to value himself outside the framework of billable hours and professional achievement. Patrick’s wife, interviewed alongside him, noted that before the cardiac arrest, her husband was always present physically but frequently absent mentally, his body at the dinner table, his mind still at the office, still negotiating, still strategising, still performing the relentless cognitive labour that his profession demanded. It took a brain injury to teach him to inhabit his own life.
Why you should take your rest seriously?
Dr. Foldvary-Schaefer’s diagnostic criteria for insufficient sleep are straightforward: waking unrefreshed, excessive daytime yawning, difficulty maintaining attention, the creeping sense that your cognitive resources are depleted long before your responsibilities are.
By these measures, a significant portion of the adult population is chronically sleep-deprived and functioning far below optimal capacity. We treat this as normal. We treat exhaustion as the price of ambition. We treat the body’s protests as obstacles to be overcome rather than messages to be heeded. And then we express surprise when the body, having exhausted every other avenue of communication, resorts to emergency measures.
