How 2 Train Heroes?

Diving off the pier into the cold water at sunrise, we are truly alive. Good mornings and good lucks exchanged, bikes racked, equipment triple checked.  A brief calm develops in stark contrast to the effort ahead. Treading water waiting for the horn - We're off. Board is full at 6AM. Sigh of relief from the overnight doc. Careless bartending puts my kids through college, but chest pain, stroke, pneumonia,  cancer, and trauma surround me too.  "Hey Doc! Fat tongue and difficulty breathing just walked in...". Game on. Coach Wooden used the word Intentness to describe courage and resolve. Today we refer to this strength of character as Grit. In both sport and medicine, success always requires grit. There are no shortcuts. Show up prepared or stay in bed. Talented athletes and the topic experts make it look easy, only by completing ten thousand hours of deliberate practice before the big day. Cold water creates sensory overload - total immersion achieved insta...

Thought provoking podcast on Technology, Authenticity and Learning from Kevin Kelly on the Tim Ferriss Show : Creativity and Intentness (i.e. Grit). My current podcast line up: 1,  EMRap 2,  KeyLIME 3.  Tim Ferriss Show What's on your device?

Coach Woodenism for the Week: " Intentness, the willingness to persevere when hardship is forced upon you and those you lead." In this series, we're applying Coach John Wooden's Pyramid of Success to medical education. We began by discussing the foundation of Attitude, Effort, Friendship, Loyalty, and Cooperation. The second focuses on the mind, beginning with Self Control, followed by Alertness, Initiative, and now Intentness. The coach defined Intentness as 'a relentless pursuit of excellence'.  Whether this fire burns or build depends on a coach's and clinician's focus. Focus only on self, then you are finished. Focus on helping others, then you build everyone. In today's technology driven world, Intentness is more important then ever. Clinically, we are often tempted to cut to the bottomline by focusing only on the chief complaint in our busy ED's. If we just get the CT and get 'em out, we may miss the abuse that is real life threa...

We see that guy every morning when we walk into, or out of the hospital. The clinician who looks 20 years older then he really is, shuffling about, staring straight ahead, almost grimacing. When you say "Good Morning", he just looks the other way. He's the guys who has been here way too long, falling way too far down the rabbit hole of burn out. Let's face it, none of us ever want to become that guy. But on our worst days, many of us already have been. Myself for sure. Medicine is a tough game of paradoxes - exhilarating, exhausting, rewarding, and always demanding. So how do we instead become the guy? The clinician people gravitate towards at the start of the day, when help is needed to meet a new challenge, and at the end to review the day's success. In Academic Medicine Slavin describes Positive Psychology's PERMA model to preventing burnout in Medical Education. Positive emotions: Foster positive emotions by reducing unnecessary stressors and promoti...

So live your life that the fear of death can never enter your heart.  Trouble no one about their religion;respect others in their view, and demand that they respect yours. Love your life, perfect your life,  beautify all things in your life.  Seek to make your life long and its purpose in the service of your people.  Prepare a noble death song for the day when you go over the great divide. Always give a word or a sign of salute when meeting or passing a friend,  even a stranger, when in a lonely place.  Show respect to all people and grovel to none. When you arise in the morning give thanks for the food and for the joy of living.  If you see no reason for giving thanks, the fault lies only in yourself.  Abuse no one and no thing,  for abuse turns the wise ones to fools and robs the spirit of its vision. When it comes your time to die,  be not like those whose hearts are filled with the fear of death,  so tha...

We learn our most effective strategies for helping others to achieve success from our favorite coaches. My long time coach and colleague, Dr. Mark Kling, recently reminded all of us at County to always see the Forest through the Trees. When Mark first started at Cook County nearly three decades ago, the busiest ED in the city was literally a hallway. When I was a resident fifteen year ago, we worked together in an 30 bed ED with one computer that never worked, on the first floor of a third world hospital, ironically in the middle of a magnificent city. Today, we are privileged to practice medicine in a state of the art hospital for the underserved, that easily rivals any other healthcare institution in the county. In many ways, the evolution of our department parallels the development of Emergency Medicine. So when we become frustrated by a computer locking up, an overworked colleague, or a long wait for an inpatient bed, let's pause for a moment, an...

Coach Woodenism for the Week: "Stay the course. When thwarted, try again - harder, smarter. Persevere Relentlessly." In this series, we're applying Coach John Wooden's Pyramid of Success to medical education and leadership. We began by discussing the foundation of Attitude, Effort, Friendship, Loyalty, and Cooperation. The second focuses on the mind, beginning with Self Control, followed by Alertness, and this week Initiative. Initiative is defined as the ability to begin and follow through energetically with a plan. In the clinical arena, the teacher first demonstrates Initiative by arriving on time, always jumping to help, and staying to finish each day's work. As a coach, we need to expect this same level of professionalism from our trainees.  Beyond the bedside, we model Initiative by becoming a solution tester, instead of just another whining problem identifier. Is your nurse backed up on discharges? Avoid the fundamental attribution error by asking him w...