Observations BMJ Confidential

Michael Farquhar: Sleep, the best medicine

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k202 (Published 24 January 2018) Cite this as: BMJ 2018;360:k202


Michael Farquhar, 41, would like you to sleep better and is convinced that you can. Consultant in children’s sleep medicine at Evelina London Children’s Hospital, he argues that people have forgotten how crucial sleep is to physical and mental health. He instructs junior doctors that it may be better to rest than to act the hero—putting their own needs last and risking mistakes. He was inspired to become a paediatrician at age 8 after seeing doctors at Raigmore Hospital, Inverness, save the life of his sister from epiglottitis.

What was your earliest ambition?

I watched the Space Shuttle Columbia’s first launch when I was 4, and I was determined to be an astronaut.

What was your best career move?

One that felt like a disaster at the time. I didn’t get a Scottish SpR (specialist registrar) post before Modernising Medical Careers came into effect, so—very reluctantly—I came to England to take up one of the last English paediatric SpR numbers. If I hadn’t I probably wouldn’t have pushed myself to be where I am now.

What was the worst mistake in your career?

Not challenging an aggressive, bullying consultant more strongly, very early in my middle grade career. I was too afraid of the consequences of calling her out. It took me a long while to properly regain my self confidence.

How is your work-life balance?

I’m working on it. (Practise what I preach, not what I do. . .)

How do you keep fit and healthy?

Sensible eating and light exercise helped me lose 20 kg in 2017. Gyms scare me. I should probably get over that.

What single change would you like to see made to the NHS?

Make it truly independent of politics, funded appropriately to its need.

What do you wish that you had known when you were younger?

That coming out wouldn’t end my world: it would start it over again. It gets better.

Do doctors get paid enough?

I don’t think that most people working in the NHS are valued enough at present.

To whom would you most like to apologise?

All of the friends I wasn’t brave enough to be honest with, for far too long.

What do you usually wear to work?

Shirt (often bright/loud) and trousers; and one of an increasing number of quirky watches.

Which living doctor do you most admire, and why?

As a brand new paediatric SHO in Glasgow I worked for Layla Al-Roomi. She was a force of nature, an outstanding paediatrician, and one of the sharpest diagnosticians I’ve ever met, who combined empathy and compassion with frank honesty. She was a role model for the sort of paediatrician I aspired to be.

What is the worst job you have done?

I’ve been very lucky: I’ve taken lots of value even from jobs I disliked. I least enjoyed neonatal intensive care, as I always missed the interaction with kids. And I spent one very boring university summer steam cleaning beds in a basement in Edinburgh.

What single unheralded change has made the most difference in your field in your lifetime?

The iPhone’s arrival in 2007. It instantly transformed how we live—and affected how we sleep. Many of our lives now seem unimaginable without an iPhone or something similar. Persuading people to part with them before bedtime is a regular challenge in our clinic.

What new technology or development are you most looking forward to?

The 2017 Nobel Prize for Medicine was awarded for work on understanding circadian physiology. Over the next decade we will increasingly realise that we have to think much more about our body clocks in understanding health and illness.

What book should every doctor read?

Undying—A Love Story, by Michel Faber (“In late ’88, not knowing how lucky I was, / I met a woman who would die of cancer”). Faber’s poems, written after his wife’s death, are beautiful, honest, insightful, and—ultimately—full of hope.

What is your guiltiest pleasure?

I’m not really guilty about it at all: X-Men comics.

Where are or when were you happiest?

In the Highlands, surrounded by friends. More regularly, at the theatre: I love losing myself in stories being created around an audience.

What television programmes do you like?

The Doctor (in Doctor Who) was one of my earliest heroes and still is. And it’s great that the comics I’ve loved since I was a kid are now mainstream TV series and films—even if Netflix’s CEO did declare his company’s greatest enemy to be sleep!1

What personal ambition do you still have?

There’s still a Space Shuttle seat with my name on it . . .

Summarise your personality in three words

Thrawn,* gallus,† quixotic.

What is your pet hate?

Untempered cynicism. The world isn’t perfect. Sometimes all that we can achieve are small improvements—but small improvements are better than none, and they can be steps on the way to something bigger.

What would be on the menu for your last supper?

Something simple: mince and tatties, a good beer.

What poem, song, or passage of prose would you like mourners at your funeral to hear?

Music: The Dark Island,2 played by the Red Hot Chilli Pipers (“the most famous bagpipe band on the planet”)—slowly, as the coffin moves towards the cremation fires, and then with a wee bit of a jig to get everyone going again. Poem: For Andrew Wood, by James Fenton.

Is the thought of retirement a dream or a nightmare?

It feels more like a fantasy sometimes, but definitely a dream.

If you weren’t in your present position what would you be doing instead?

The day I accepted my present post I turned down a job in Sydney. On some mornings I imagine an alternative me, sunning myself on Bondi instead of shivering in a grey London winter; but I’m confident that I made the right decision.


  • *Thrawn: a Scots adjective meaning perversely stubborn, determined to keep doing something even when people tell you not to.

  • Gallus: wild, unmanageable, bold.


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