Loathing the Lag
by Vasudeva Iyer, MD
Most people that I know despise the concept and the whole process of daylight-saving time. That nightmare came much earlier in March of 2026. I hated dealing with the various problems that accompany the time change, especially the prospect of losing an hour of sleep. Trying to correct the time in the“ elderly clocks” high on the wall has always been another challenge; that became my chore once my children left home. While driving to work early morning on the Monday after the time change, plagued by brain fog due to the“ social jet lag” my thoughts wandered and as usual ended up reminiscing the contextual story of a patient.
65-year-old Jack was experiencing“ painful numbness” of his left hand, which often disrupted his sleep and affected his activities; his wife was much annoyed with his habit of waking up at night several times and shaking his hand repeatedly. She was also quite critical of his tendency to accidentally drop stuff he holds in his hands, and it reached crisis level after he dropped a gallon of milk on the kitchen floor. She forced him to see the family doctor pronto, who referred him to me for a nerve conduction study to confirm carpal tunnel syndrome. When asked about the onset of his symptoms, he smiled and said it started on Nov. 2, 2025, the day after the time change. He then proudly declared that he was a“ horologist” and asked if I knew what his work involved. I deliberately kept silent for 15 seconds to let him bask in epistemic arrogance, followed by my query: how many clocks he repaired in a day. He appeared piqued but went on to narrate his story. Apparently, he has several clocks high up on the wall and must use a ladder to correct the time in each, on the day after the time change. He accidentally fell off the ladder and landed supporting his weight on the left hand. He experienced pain and swelling of the wrist, and X-rays did not show any fractures; soon painful paresthesia started and continued to worsen. The referring physician suspected median nerve stretch injury at the carpal tunnel due to the forcible hyperextension of the wrist during the fall from the ladder, while changing the time on the clock at the end of daylight-saving time. The nerve study did confirm significant left median nerve neuropathy at the carpal tunnel.
Ever since I specialized in sleep medicine in the‘ 80s, I have always been interested in chronobiology. It is a broad field, but in clinical sleep medicine, it involves the study of normal and abnormal circadian rhythms in the human. As Kentuckians, we should take pride in the fact that the state of Kentucky played a major role in the study of circadian rhythm; groundbreaking sleep research done at the Mammoth Cave 88 years ago virtually laid the foundation for the science of chronobiology.
10 LOUISVILLE MEDICINE