I’ve gone back and forth for days about whether to write this.
Not because I don’t have an opinion, but because social media doesn’t leave space for nuance, and this topic deserves more than soundbites and outrage.
What follows isn’t about excusing behaviour. It’s about asking better questions. Questions we are very good at avoiding.
The case of Dr Helen Eisenhauer has sparked intense debate. Much of it has focused on rules, probity, professional standards and personal responsibility. Those things matter. I am not disputing that.
But when I read the tribunal findings, something else stood out. Something that many people seem keen to brush past.
Sleep deprivation.
It is referenced clearly in the tribunal notes. Long nights awake with a child. Ongoing exhaustion. An acknowledgement, in her own words, that her judgement was impaired.
I want to be very clear here. I am not saying sleep deprivation was the sole cause of what happened. I have not spoken to Dr Eisenhauer and I would never claim to know how much she was struggling.
What I am saying is that sleep deprivation is not neutral. It is not just “being tired”. And it is not something we can keep pretending sits outside workplace risk.
We know, beyond reasonable doubt, that chronic sleep deprivation impairs judgement, decision making, emotional regulation and risk assessment. This isn’t opinion. It’s decades of research and thousands of lived experiences.
People don’t suddenly become dishonest, reckless or careless out of nowhere. When sleep deprived, they become desperate. Fearful. Less able to see clear options. More likely to make snap decisions that they would never make when rested.
That context matters.
What has troubled me most in the commentary around this case is how quickly responsibility has been individualised.
She should have planned better.
She should have had better childcare.
She should have spoken up.
She should have coped.
Those statements assume something very dangerous. That the system is fine, and the individual failed.
In reality, many systems are built on silent exhaustion.
I know this because I have lived it.
Years ago, I worked in a sales role where I had been one of the top performers for a long time. People knew what I was capable of when well rested. Then my sleep collapsed.
I was still doing the job. Still turning up. Still trying. But I didn’t have the physical energy to perform in the same way, or the mental capacity to think clearly under pressure.
I spoke up. I told my manager I was struggling and didn’t feel safe on the roads. I asked, temporarily, for a different way of working.
He didn’t know what to do with that request.
Not because he didn’t care, but because the system gave him no tools. He had targets, pressure from above, and no framework to fall back on. The response was simple. Crack on, or go home.
So I cracked on.
And when you’re exhausted and afraid of being seen as failing, you start making decisions that don’t look like you. Little lies. Half truths. Avoidance. Anything to buy time and survive.
This is not a character flaw. It is a predictable human response to sustained pressure and impaired cognition.
The tribunal described Dr Eisenhauer’s situation as predictable.
It was.
And that’s the point.
If something is predictable, we should be designing systems to prevent it, not waiting to punish it after the fact.
Many employers genuinely believe they are supportive. Often, they are, for what they know how to support.
But sleep deprivation rarely sits neatly in HR policies.
It isn’t a diagnosis.
It isn’t a protected characteristic.
It doesn’t appear in return to work risk assessments.
And crucially, it is not something people feel safe admitting.
Parents. Carers. People managing health conditions. People going through menopause. People dealing with grief or financial stress.
They don’t raise their hand and say, “I’m cognitively impaired through lack of sleep.” They tell themselves this is normal. That everyone is coping. That they just need to try harder.
January makes this worse.
Dark mornings. Dark evenings. Broken sleep. Reduced resilience. A quiet acceptance that functioning on fumes is just part of life.
Until it isn’t.
This is why good intentions are not enough.
Support has to be visible, understood and genuinely usable. Managers need permission, training and clear pathways. Employees need to know that speaking up will lead to support, not judgement or career damage.
And employers need to start treating sleep as what it actually is.
A safety issue.
We already accept this in transport, aviation and high risk industries. We understand that fatigue impairs performance and increases risk.
Yet in offices, hospitals, schools and workplaces filled with parents and carers, we pretend it is a personal issue to be managed quietly at home.
That disconnect is costing people their health, their confidence, and sometimes their careers.
I am not writing this to point fingers. I am writing it because silence helps no one.
If we want fewer mistakes, fewer crises and fewer people reaching breaking point, we have to stop asking only “who is responsible?” and start asking “what made this predictable?”
Because sleep is not a personal failing.
It is a workplace risk.
And it deserves to be treated as one.
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