Two Poems for champions of my heart

Equality

 

We are all equal,

There is no sequel,

For we have only this one life.

 

Heaven or strife,

This is our choice,

 

So use your voice,

And your heart,

To rise above the dirt.

 

Make use of your mirth,

That heals up the scars and the pain,

 

Let it flow, let it rain,

 

For perhaps solace lies in the “insane”,

Who can feel the beauty of the life that we live,

Giving of ourselves without a seconds thought.

 

 

16-6-16

 

At the moment my world is inundated with study, work and exams.

As I am progressing through the arduous and challenging joruney of completing specialist training in Emergency medicine, most aspects of my life outside medicine have taken a back seat, to dedicate focus to wards the path of learning the matrix of what is is to be a specialist. I am doing what I feel is effective, and and have learned to possibly be helpful, such as reading widely in books, attending practice exams, studying alone and in groups. I have sometimes been sharing the highs and lows with others on the path, but mostly experiencing them alone, in a solitude that will never be known to the world at large (apart from in daring writings such at this).

Today I learned of the exam results being released for the OSCE (objective, skills and clinical examination), and it is with great joy and simultaneous sadnesss that I heard of the success and failure of friend who are dear and near to me in both my heart, but in terms of the journey that all fellowship candidates are on, past and future.

In the joy of one particular friend I breathed a breath of relief, and for others I shared in a gasp of despair. It seems unfair that some individuals who have such a heart, such skill, and such potential for this profession, have not made it through (this time) final gate of a greater than 10 year training. Whilst this exam processess is well intentioned, and designed to empower these very qualities, it can arguabley, on occasions, be seen to perhaps fall short of what it set out to achieve.

As a researcher in education systems, and someone who has been observing their own progression through various stages of a very diverse journey of education in the arts, sciences, surgery, research and now emergency medicine, I am acutely aware that “assement” and “qualification” are but a prediction tools of relative certaintainty, but are simultanously not gold standards in this objective. In my own endeavours to help improve education and assesment systems, I’ve realised that training, sitting exams, and passing are but steps on a much greater journey, in which the destination can perhaps never fully be realised, for it is ever-evolving.

So then how do we evaluate the concepts of failure, or success?

Is it not an imaginary line (albeit, calculated through a process and mechanism), on a continuum of life-long learning?

Perhaps in specialist training, and many other forms of education for that matter, this line forms a both an psychological, and actual barrier to progression. I wonder how well the impact of examinations correlate to the end product of achieving skilled, well rounded individuals?

These may seem like esoteric questions, but to an educational researcher they questions that could potentially form a life’s work.

 

Coping with Success and Failure – through the relationships we make along the way

As a friend who was studying for his own specialist exam in another field, Anaesthetics, once reminded me “failure is an event, not a person” (taken from a line provided by personal development legend Zig Ziglar). This advice came in incredibly handy when I sat, and failed, my own big exam, the fellowship “written” exam. I have now been studying for a whole year since then, whilst working, getting over the loss of esteem, and building an entirley new strategy. If I pass this time around in August, I have the opportunity and privelidge to sit the same exam, the OSCE, that I am celebrating and mourning the results of with my friends, who are at this next stage.

It seems like a very long and uncertain journey, and perhaps this is why the final result will be so very special.

However, in the meantime there is so much pain, and equivalent joy. The joy partly lies in the hope of achieving what I set out to do, partly in feeling the success of others, but perahps the most guaranteed joy of all, is the wonderful relationships that are forged along the way – irrespective of outcome.

When studying for this exam we are in positions of vulnerability and humilty that most would not actively choose to occupy. Some, perhaps, will quickly forget how uncomfortable it feels to not definitely know if one can make it “there”, whilst others will never forget, no matter how well they perform, for it is in their nature to help others on the path.

Two of these such people, who are always there to help others, ironically did not pass the the OSCE this time around (and I’m sure there will be more good candidates to come, who also didn’t pass, for the OSCE has a pass rate often hovers around the 50%, or less, mark).

Perhaps you also know someone like this, someone who is clearly capable and desrving of such a pass? Perhaps it is even you, the reader.

Whatever the case, the following poem wholeheartedly dedicated to all of you, and all of “us”, life-long learners, who courageously endeavour to live, learn and love.

 

Wisdom, compassion and humility

 

Champions of wisdom, compassion and humility,

Using a pathway to divinity,

That has guided us thus far,

 

Whether we drive a sailboat or in a car,

The vehicle is of no consequence,

If we are not guided by light.

 

Use your sight to look within,

And feel the unity of “Humanity”,

As we once knew and later forgot,

 

We only have this shot,

To get it right,

To live without fright,

For there is really no fight,

 

When we use our energies together at large,

Voyaging in natures communal barge,

That can only be experienced as “Love”.

The rising tide of burnout – a major threat to our healthcare system?

Physician burnout 2

http://catalyst.nejm.org/videos/physician-burnout-stop-blaming-the-individual/

The above is a link to a brilliant talk by the program director for Physician Wellbeing from the Mayo Clinic, Tait Shanafelt, illustrating how physician burnout is a “system issue”.

“We tell physicians to get more sleep, eat more granola, do yoga, and take better care of yourself. These efforts are well intentioned,” says Shanafelt. “The message to physicians, however, is that you are the problem, and you need to toughen up.”

Shanafelt goes on to describe how the six drivers of burnout amongst physicians are largely derived from the characteristics in the work environment.

These drivers are stated as;-

1) Excessive workload

2) Inefficiency and undue clerical burden

3) Loss of flexibility and control over work

4) Problems with work-life integration

5) Loss of meaning in work

6) Organisational objectives that conflict with the altruistic values of the profession

He also states that promoting professional wellbeing is the shared responsibility of individual physicians and healthcare organisations.

Whilst this talk comes from the US setting, I believe the themes that are discussed are becoming increasingly relevant to the Australasian healthcare. My own observations from working in a number of busy tertiary and secondary hospitals across Australia and New Zealand is that we have developed highly efficient systems of delivering essential medical “management”, however, heartfelt “care” appears to have become optional extra.

Hearts in Healthcare

An increasing number of doctors, and doctors in training, have experienced disillusionment the conditions of medical training, and practice, and at the consequential neglected dimension of “care”. I have had countless conversations with caring physicians over the past 5-10 years, at all levels, which has led me to believe that there is a deeply “broken” element to the current healthcare system. Some have felt strongly about the issue of restoring humanity, and the heart, back into medicine that they have also made it their life’s work.

For example, Dr Robin Youngsen, who is a NZ Anaesthetist, has highlighted the importance of creating “time to care” in his first book, which takes on this very title. He also furthered this message his recent TED talk “perfectly broken and ready to heal”, and has set up an organisation dedicating to rehumanising healthcare, called “hearts in healthcare”.

The power of humanity in health care

Looking both forward and backwards in time, isn’t it “humanity” that is at the what is special and important in healthcare?

It seems to me that through a greater understanding, and appreciation, of the benefits of the “human side” of medicine, it is still possible to steer the evolving culture of healthcare in a better direction.

The opening story in Tait Shanfelt’s talk perhaps conveys this better than any, where he recalls how one particular doctor took a deeper interest in his son on a personal level, when he was a patient in hospital. Despite the all round exceptional treatment his son received in hospital, it was this one persons humane interactions that stood out, and also meant so much to him.

Which future shall we steer towards : physician burnout, or, physician wellbeing?

I am a big believer of the notion that often the question is more important than the specific answers.

We now know that burnout exists in high proportions than ever before , but the question remains, how do we respond to this rising tide? Perhaps one strategy can be rather than reacting to the negative effects of burnout, we can proactively create more wellbeing?

But how do we apply this vision in local physician settings settings? Perhaps a start is by asking the question “what can we be doing to improve physcian wellbeing?”.

What am I doing to improve my wellbeing?

What is happening within my hospital or training organisation?

…and

How can I help this ever-growing movement?

What are your reflections on preventing physcian burnout, and promoting a culture of physician wellbeing? I would love to know your views.

I’m just putting this out to further the coversation, between the ever-growing, increasingly diverse network of caring physicians who have a vision of healthcare that values the wellbeing of all, starting with the one who cares.

Physician burnout editorial

Ref: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)30940-6.pdf

#SmaccDUB – critical care and beyond…

I recently returned from a 4 day convention titled “smaccDUB”, the conference otherwise known as “social media in critical care”, this year held in Dublin, Ireland. The conference stayed true to its founding virtues of learning, education and innovation in pursuit of excellence within critical care. Smacc is also the ideological meeting place for all those passionate about promoting “free open access meducation” (a.k.a. #FOAMed) as a means of disseminating and translating knowledge to improve the world of medicine. However, for me this years conference had something a little extra within it, something rather special. The opening laser ceremony touted the themes of exploration, connection, and inspiration and by the end of the conference I couldn’t help but feel this was exactly where we had journeyed. I hope to share some of the reasons why I felt this way through the musings of this blog post.

 

Diversity and creativity

SmaccDUB pushed boundaries, moving beyond the diverse range of resuscitation and education themes that I’ve grown enjoy at the 2 previous Smacc conferences I’ve attended. The talks expand further than ever before on the spectrum of leadership, communication, teamwork, and ethics in the critical care.

Many of the talks showed a progression from pure science to the humanities, and even the philosophy of modern health care and science as we know it was repeatedly challenged during the course of the 4 day convention. To this end the use of the current journal system as a means of knowledge creation and dissemination was questioned in an interesting debate. The panel included former BMJ editor, Richard Smith, and the current editor in chief of the New England Journal of medicine, Jeff Drazen, who argued their differing perspectives on the benefits, or shortcomings, of the current peer review system.

Perhaps exploration of this nature, challenging entire paradigms, is called for at this point in history. For anyone who has witnessed the rapid technological advances that health care has seen over the last 20 years, will be forgiven for wondering just where we are going in the future. With the increasing focus on protocol driven investigations and treatments, it was refreshing to note that the conversation amongst the Smacc speakers seemed to continually  bring the focus of conversation back to the “human aspects” of care.

On the other hand, creativity was an equally important theme embraced by the conference, which itself was a highlight for me. It seemed as if fun and creativity, branded by the use of music, lights and live performance, were like the vessels through which the content was delivered. It was as if “science” and “art” seemed to be inextricably linked at every stage. This was particularly evident for me in the pre-conference sessions which included a workshop on creative writing, design and fine art in order to help make educational content more interesting. But it persisted every step of the way, from the rock-concert style opening ceremony, with laser lights display, right up until the final act of the grand finale.

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The additional daily antics that included choreographed ultrasound displays and competitions, and finally interactive debates, making use of rap and rhyme to argue out positions on issues like thrombolysis in submissive PE, was all part of the mix.

 

Mindfulness, leadership and communication

The conference opened with the “John Hinds” plenary, named as such in honour of the individual whose career long contribution will continue to inspire, as much as his loss will be felt amongst this community of critical care workers, following his relatively recent tragic death. In this section, Victoria Brazil (@SocraticEM) kicked off by entertaining us with a high quality role play. She cleverly illustrated to a captive live audience, the potential negative and positive impacts that our everyday communication can have on the quality of education, trainee self-esteem and ones motivation to learn.

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Scott Weingart (@emcrit), of the EM Crit blog, similarly pushed the boundaries of a traditional talk by discussing Vipassana meditation and the role of this practice in his life. He opened minds and hearts by delivering a plenary session on a topic that perhaps has never before been delivered in a conference of this nature. Speaking from direct experience, his talk endorsed the personal and professional values of meditation when looked at entirely from a scientific perspective. Scott likened this practice to a structured “training”, or exercise for the mind – coining the phrase “kettle bells for the brain” to describe what meditation was analogous to in his mind.

To me this was a groundbreaking talk because here was a leader in our field highlighting a practice that is still relatively unfamiliar amongst our medical community, despite its great potential to improve self-awareness, communication and decrease stress. It was also encouraging to see Scott maintain a completely scientific approach, and alerting the audience of the growing  evidence base for mental health and performance benefits following a meditative practice. The benefits of mindfulness is something that I have experienced in my own life, and I thus my encourage whenever I get the opportunity. The talk even included a short demonstration of the practice meditation, and provided a motivating discussion of how the philosophy of mindfulness could potentially help in stressful settings such those that are commonly encountered in emergency medicine and intensive care.

Multiple talks furthered the leadership theme, including those by TEDMed speakers such as Resa Lewiss (@ultrasoundREL), and visionary talks about the future of medicine, by senior clinics such as Simon Carly (@EMManchester) who blogs at St Emlyn’s virtual hospital. Simon provided an insightful back track into the journey that modern medicine has taken over the last 20, and providing an insight into where it is headed. He also provided a live demonstration of an iPhone ECG trace being delivered through a $100 gadget that is easily accessible already – indeed it appears to be brave new world of health care which we are heading towards at great speed!

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War, fear, and love

Building on the theme of mindfulness and self-awareness the conference also included a talk on “fear”, and heart-felt presentations about working in emergency situations of terrorism and war. A wake up call was delivered to our small room audience when Kass Thomas (@KassThomas4) presented recent real life experience of falling victim to US led gunship attacks on the Kunduz Trauma hospital where she was working during her first MSF mission in Afganistan. Her courageous and chilling talk detailed how she survived the ordeal of seeing so many friends, colleagues and patients die in front of eyes on that frightful October night. Her talk in particular highlighted an urgency to address the plight of hospital aid workers across the globe as there continues to be increasing numbers of hospitals suffering the same fate by being targeted under the hospices of war.

The theme of critical care workers experiencing trauma beyond the realms of normal experience was continued in other talks such as that by Christina Hernon (@emedtox)  who was an immediate responder in the Boston Marathon bombing, and Ashley Liebig (@ashleyliebig), who is a flight nurse who recounts a story fo a heart wrenching paediatric field resuscitation. In a similar vein both these speakers courageously revealed the human behind the professional veil.

Through their captivating stories they took us, the audience, into that vulnerable space of humanity, that nobody voluntarily enjoys.  These talks generated a magnitude of interesting discussion both on the twittersphere and in-person discussions amongst other delegates. Perhaps the common theme that was uncovered was a respectful appreciation of the vulnerability that goes with the human side of the critical care, a side that rarely discussed in fast pace of daily business, and I am grateful to these speakers for creating that space.

In keeping with this gloves off approach, nothing was more “on the mark” than the unplugged presentation by Ross Fisher (@ffolliet), a TEDx speaker and Paediatric surgeons who discussed the inward reaching topic of “what scares me”, “what scares you”. In his day 2 plenary session, he challenged the audience, and guided them through recounts of salient challenges in his own professional career, towards taking a long and hard introspective view at our own personal fears.

One of the most memorable experiences for me in that talk was Ross’s request for the audience to join him in a journey of exploring one’s own worst fear. Despite the vast majority of the audience coming from a critical care background where perhaps the intense nature of the job lends itself to forge patterns of adopting a fearless stride we walk, on this occasion, when asked by Ross, whether we could identify our fear and its debilitating nature, I can’t recall a single person who was left seated. “That was fear”, acknowledge by all, and together we stood.

Many other talks that also provided a compelling discourse about other human factors that are often given secondary importance, were covered with vigor and passion, such as the importance of palliative care, bedside teaching and team training, and the topic of physician and trainee burnout.

However, perhaps one other memorable talk that pushed the boundaries, again,was that by the experienced and entertaining social worker, wellbeing specialist, researcher Liz Crowe (@LizCrowe2) who gave the first talk I’ve heard in a critical care conference whose title and focus centred on “LOVE”. With great passion and enthusiasm, and a large dose of wit, Liz delivered a very serious and important message that “love can revolutionise the way we deliver critical care”.

Liz advocated that there is science that supports what mechanistically makes sense, humans have an improved ability of to make good decisions when they work in an environment where they feel supported and cared for, as opposite to when they feel intimidated and stressed. This talk was laden with culture changing gold and I can’t wait it to come out on the smacc video cast so that we can “share the Love” that Liz speaks of!

Dublin, its surroundings and the Socials

Dublin was a wonderful city, that could provide no better a venue that offered history and culture, as well as fun and frivolity that only a Smacc participatory audience could dream of. Daily #smaccPUB, with rotating venues along the old temple bar, along with the grand finale party at the 5 story Guinness storehouse complex, fully equipped with live bands and DJs ranging from house, to rock to Irish folk – not to mention the highly acclaimed FOAMeoke, and few cats who decided to so some street jamming as part of the after party– who could ask for more?!

From physical reality, back to the twittersphere…

So I will end this post with a handful of crafted tweets by the arguably the biggest component of the conference itself, the delegates, speakers and followers both locally and afar. After all perhaps half the magic of this conference is to do with the emphasis that has been placed on audience participation and interact, that arguably no medium does better than 160 summary of words/photo/or link which the average “tweet” offers as a communication tool.

So congratulations if you made it this far in the entry that I started writing on the plane home, as part of the #smaccdown process. I tried to cut it down but there really was so much happened in such a short period of time, a fact that I’m sure those who also attended will attest. There were many other innovative talks that I attended on resuscitation, hospital systems and medical education that unfortunately couldn’t make it into this post, but hopefully some of them can be covered in the tweets below.

It is clear to see that I thoroughly enjoyed this conference, leaving energised and inspired, but as always I’m keen to hear from you, if you attended or simply were intrigued by what I have shared in these words, and images, so please leave your comments below.

Thank you to the smaccDUB organising team who did a great job, in particular Chris, Roger and Oli, and their team! Also farewell to the other delegates who are part of this friendly ever-growing social media driven med-ed community.

Hope to see you all next year at #DASsmacc!

 

Related posts; 

Scott Weingart: on Vipassana meditation

Andrew Tagg: Don’t forget the bubbles-  smaccDUB summary 

Richard Carden: St Emlyns – A trainee perspective 

Suzie Edge: Primary survey – Speaking out: teams, juniors, leaders and what smaccDUB taught me

 

 

 

Motivational talk on specialist training and Emergency Medicine

Last month I had the pleasure of talking with the UOW 2015 graduating medical at their “welcome to the real world” workshop lecture series. It was a real honour to be invited to speak about Emergency Medicine with this group of future doctors.

I decided to offer some reflections about my own diverse journey which has spanned several countries and a few different disciplines including surgery (which I embarked on many years ago), research (which led to a PhD that was complted this year) and emergency medicine (which I am currently in the process of completing).

2. My journey

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Some of the highlights of the talk for me was to be able to use a bit of simulation and creative to highlight through direct experience what some of the key elements of Emergency Medicine include. To this end I used a bit of shaking and laughter yoga, an audience surprise, and finally a short guided meditaiton to let the group exeprience the calm within the storm. I was lucky this was such a willing audience.

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The actual talk was a good chance to highlight the importance of knowing onself when chosing a medical speciality, as well as knowing what that speciality is about, and understanding what the job entails; both positives and negatives. For me the key reasons to chose a speciality is related to inspiration, and taking a path towards following an inner dream. Mentorship is key for this long journey, and I am every grateful to have had many great mentors along the way.

1. Why we chose a career path

The talk ended with a guitar peformance of a song I wrote whilst doing field work for my PhD titled Peaceful Revolution. It’s an interesting song about some of the wisdom I learned in the villages of rural Sri Lanka. Part of the song is about how there seems to be much more harmony between nature and human existing in the rural areas, and in the cities where I’ve spent most of my life it is easy to have so much in material wealth, but at the same time so easy to forget to touch the hearts of others.

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The gratitude List

There are always so many people to thank for every talk I give. First and foremost I am grateful to my many wonderful mentors – without whom a talk of this nature would not be possible. Then there was the audience, not only for being a kind and generous audience, but also for participating with some of the off-the-beaten-track interactions that I had schemed into this particular talk. Thanks also to the new graduates;- Dr Hayley Dyke who helped me out with being an improptu back up guitarist for the performance, and of course to the lovely Dr Beatrice Dowsett, a member of the class and workshop organiser who invited me to speak. Bea is such amazing person, talented both within and outside the medical arena. I’ve had the pleasure of meeting her at the local hospital acting/film/drama forum created by Dr Tony Chu with the help of other keen artistic doctors at Wollongong Hospital, who meet up monthly for the what we call Fry Day Drama (read more to find out).

I am also very thankful for the clinical team of which I am part of at at the Wollongong hospital, for supporting me to get across to the university campus to deliver the talk during a busy – (Thanks Dr Venita Visvalingam, my supervising Consultant Physician and Dr Annie McKean our hard working Intern!).

Thanks to Dr Nemeshi Fernando who was one of class who gave me some feedback (which I put on my You Tube channel) about the talk. It’s always wondeful to get nice feedback from the audience, and to know that your message is understood.

But finally – Congratulations to the UOW 2015 class – Well done – You made it!!

and… “welcome to the real world!”

Extra web-links

Please leave your “feedback” below:-

I have included the entire talk above, with some additional slides that include a few medical related poems that I once submitted to an Australasian College of Emergency Medicine (ACEM) conference.

If you are reading this and attended the talk, please leave your feedback in the comments section below. I would love to know what was helpful and what resonated most with you as I endeavour to develop this talk further in the future and your feedback is warmly appreciated. 🙂

Angels of the Sea

Whales are creatures of the ocean,
Teachers of gentle motion,
That allow us to see,
The meaning of “being free”,
For they are the angels of the sea.

14-10-15 Another week, another rotation, and a week closer to the final exam of emergency medicine. I usually find starting a new rotation is stressful because at the beginning it’s hard to know all the ‘ins and outs’ of the job. This week was no exception, except I was blessed by being supported by some wonderful colleagues, especially my intern Kate who had such a positive outlook on medicine and life in general!

After feeling so tired from the week just gone, spending extra hours studying for my emeregency medicine fellowship exam which I will sit in February 2016, I decided to catch up on sleep and skip the opportunity of a morning surf. Instead, Sanna and I decided to go to our favourite café in Thirroul to have a coffee and do some study. However, before sitting I felt a strong calling to first go for a ‘nature break’. As far as my logical mind could reconcile, this venture was going to be a walk to the ocean, for the purpose of gaining some inspiration before going back to practicing exam questions.

When walking down to the Thirroul beach I saw that familiar splash in the distant ocean that always makes me think “is that a whale?”. My knee-jerk reaction was to say to Sanna “Hey I think I just saw a whale! Did you see it?”. She usually discounts such suggestions because I forever seem to be saying, “hey I think I just saw a whale!?”. Sanna has grown to be slightly dismissive about these suggesions, but the great majority of times that I’ve suggested this it has turned out to be correct. I keep seeing them and they keep appearing in my life. Today was a case in point.

When we got down to beach front, I went straight to edgy and we could clearly see at least two maginificent playful whales periodically jumping out of the water creating quite a splash. It was an amazing scene to encounter. No matter how far away, or close, one is to a whale in the wild, it is a magnificent thing to be around them. Interestingly the previous night I had a beautiful dream where I saw a humpback whale jumping out of the ocean in full breach. I had forgotten about this dream – but it seemed to have come true~!

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Emergency medicine, and the loophole of love!

the loophole of love

With love we rise above,
Like the angel to the dove,
That flies high in the sky,

Above the the question of “why?”,
This should happen, or that should happen,
Instead taking “acceptance” as the key,

For only then will we be free,
From the visitudes of life,
For these are the ones that give it the spice,

Like a curry to its rice,
Remembering that there is no price,
In dreaming away,

So forget what “they” might say,
Because inside we can continue to pray,
For the gift of smiling yet another day,

And loving the present moment,

For in the end,
It’s all we have.

9-5-15

I recently started a new rotation of Emergency Medicine training, and before long have found myself immersed in all it’s beauty and simultaneous horror. Our speciality is full of energy, love and frustration. There are good days and challenging days, magic moments and equally frustrating ones, often intertwined into the same 10 hour shift, if not the same hour.

Most days are heavily mixed with both energies which makes it hard to have a frame of reference for an answer when someone from outside this world asks, “so how was your shift?”. For me, it is perhaps most truthful to answer this question with a guitar in hand. An example of this is provided with the the song titled “in the night drift”, that I have included at the end of this post.

Often the pressures within a single shift are high, but when compounded within a persons training period, or across sections of their career span, it is understandable that a soul searching doubt can easily set in, to the point where the question of “why am I doing this again?” is asked.

I am sure that this question gets asked by many in the field, perhaps with haunting frequency, regardless of whether one is a nurse, doctor or any of the multitude of other health “carers”.

Doctors, nurses, and the many other important ones

Whilst most would argue that “doctors and nurses” are at the core of health care provision, there is an array of other people, who occupy either named professions or unnamed roles. These people often contribute under the radar of recognition, but are making a huge difference in the field of emergency medicine everyday.

The list, in no particular order, includes but is not limited to;- physiotherapists, radiographers, clerical staff, nurse aids, cleaners, porters, special care assistants, pharmacists, translators, administrators, radiographers, laboratory staff, parking attendants, building engineers, ambulance and police staff, public health workers, aged care workers, counsellors and social workers, and not least the patients themselves and their families. We are all one, interacting together, in the common milieu of a single shift on the emergency medicine shop floor (a term that is often used to encompass the Emergency Department by Emergency Physicians in Australasia).

Why we practice emergency medicine?

Regardless of whether one is a doctor or has one of the many other important roles in this arena, perhaps Mel Helbert puts forward one of the best expositions of why someone would consider undertaking a career in emergency medicine in his recent talk titled from the EM essentials conference titled “why we practice emergency medicine”.

Mel, is the creator/founder of the EM Rap education channel, is a champion in emergency medicine education. When I use this term I mean it both literally, but I also mean to use it as a term from the field of “knowledge translation“, used to describe those who are proponents of change, in the evolving culture of crossing the “know-do” gap.

Whilst everyone’s story is interesting in their own unique way, Mel seems to have captured with his unashamedly honest exposition something that reaches out and inspires his audience, no matter if you love it or hate it, are within or outside the profession, or are simply curious about why anyone would want to do this job.

It was a really interesting 15 mins so I thought I’d share it here – thanks Mel!

The night shift

 
As promised, this is a song called “in the night drift” that I recorded directly after surviving busy nightshift, when I crawled back to my hospital accommodation and had a much needed sleep (albeit after a date with my guitar!). Enjoy 🙂

Developing EM – Brazil 2014

 

I really wanted to help out with the DevelopingEM conference because of the great philosophy behind this international educational collaboration.
 
Lee Fineberg and Mark Newcombe, are both Emergency Physicians (EP’s) with whom I work, are passionate about the international developing of the EM specialty, and have been working on the DevelopingEM conferences for years.
 
Three things that I have away about the “DevelopingEM” conferences from research I’ve done on the topic, and the recent interview that I conducted include that ;-

 

1) this conference is not about about being flashy, but rather it is about “walking the talk” 
 

 

2) it is about sustainable development of the speciality of Emergency Medicine, and 

 

 
3) it is about respecting, honoring, and supporting the existing local structures in EM training  (throughout my experience of 4 years of conducting research in Sri Lanka – whilst also supporting EM developing – this is a key strategy that can so easy be missed or overlooked)

 

Finally they also have a plan to repeat these conference through the same regions in a 4 year cycle – ie the conference structure is set to be sustainable, and one that we can all build upon. 

 

 
Natalie Thurtle is a past conference delegate who is also committed to the cause of developing the speciality of EM globally. She is also someone who I have worked with in the past, and someone who has herself conducted some amazing work through MSF involving the management of environmental poisoning epidemics in Central Africa. 
 
Her recent blog post highlights some of the unique aspects of the Developing EM conferernce from here perspective. Below is an excerpt (but the entire article is a good read);- 

 

 

“Many conferences focus on the practice of medicine in an ideal fully equipped setting with the assumption that practice is scientific. For me, recognising and understanding the political and inexact nature of health care provision – inequality of access, inequality of standard of care and the undue influence of corporate needs on research and guidelines, as well as pragmatism in the face of limited evidence, limited expertise or limited resources and our own fallibility – is a critical part of being a real physician.”

 

 

I hope the video and link offers you some informative and interesting information! 
 

 

Peace out
Bishan