Tag Archives: inspiration

SMACC Chicago – don't miss the boat!

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If you’ve attended a SMACC conference or heard anything about them, you will be aware that it is the most exciting, inspiring, interesting, and educational critical care conference ever.
It is a non-profit venture dedicated to getting the best educators, clinicians, and researchers in intensive care, emergency medicine, prehospital/retrieval medicine and anaesthesia to share their knowledge, for free, through the medium of FOAM, embracing physicians, nurses, paramedics, and students.
You can access most of the content through podcasts after the event, but there is NOTHING like actually BEING THERE to experience the vibe.
And in 2015 it’s in Chicago. In the United States. It will be AMAZING.
You can’t look at the program without being blown away. Just look at the preconference workshops and you’ll become vertiginous trying to get your head around the the fact you can’t be in two places at once.
Why am I raving about this? What’s in it for me?
Like the other presenters I make no money from this – I dedicate my time, energy and passion for critical care and am so privileged to be a part of it. But as a do-everything-at-the-last-possible-minute emergency physician, registering for a conference is the kind of thing I’m often inclined to leave a few weeks until I can get round to it. But you CAN’T AFFORD to do that for SMACC Chicago. Not only will you waste money by missing the early registration discount, you might miss out completely: I anticipate registrations will be oversubscribed fast (this is the most anticipated conference EVER) and if you leave it too late you won’t be able to come and will be confined to the crowd who are forced to hear how great it was after the event from the people who were organised enough to actually get there.
So don’t miss out! You’ll feel like a muppet! Treat yourself to the best education at the best conference ever – pull your finger out now and register. And I’ll see you there.

Resuscitationist lessons from a self-protection master

UCIt’s better to have it and not need it, than to need it and not have it
My great friend and fellow Brit Lee Morrison is in Sydney again, teaching people how to save lives. Like a resuscitationist. But Lee isn’t a health care worker. He is a professional self protection instructor and martial athlete. The lives he is teaching people to save are their own and those of their friends and families. Lee has travelled the world and taught a diverse range of professionals including law enforcement and military special forces personnel. His current world tour will include the Czech Republic, USA, France, Russia and Germany after Australia.
What does this have to do with resuscitation? In my experience, almost everything. Hitting someone in self defence is technically very easy. Doing a resuscitative hysterotomy is technically very easy. Being able to do either of those things under stress can be difficult or impossible for some people.
Those who strive to understand and cultivate the Mind of the Resuscitationist know the importance of preparation through simulation under stress; the need to acknowledge and control the physiological and emotional response to stress; the necessity to train outside ones comfort zone and minimise the gap between simulated and real situations by optimising the cognitive fidelity of training scenarios; and the requirement to access the right mental state in an instant in which failure is not considered to be an option.
People who do not wish to witness the discussion or demonstration of violence or who cannot stand swearing should stop now. Those of you who want to see mastery in action watch the video below of Lee teaching in Germany.

I want you to appreciate the following:

  • Presentation style – how to connect with an audience and fully engage them through humour, passion, emphasis, intelligent discourse, and detailed explanations that connect emotionally and physically as well as intellectually.
  • The loss of fine motor skill under stress (2 min 13 sec)
  • The mindset of determination (2 min 48 sec) – consider how this relates to the perspective of the resuscitationist prepared to do a resuscitative thoracotomy under stress
  • How to influence and win arguments in a conflict situation by being assertive but providing a face-saving get-out for the aggressor. I have applied this multiple times in the resus room and in retrieval situations. (4 min 11 sec)
  • Training honestly – maintaining safety but ‘doing it like you f—-ing mean it’. Get out of your comfort zone and make the discomfort as real as possible. (7 min 37 sec)
  • How to minimise the gap between your training and what you’re training for, when legal, moral, and safety restrictions prevent you from doing the actual task for real as a training exercise. Using fatigue, pain, and disorientation as perturbations so you learn to recognise and mitigate their effects. (9 min 19 sec)
  • Accessing a single mental state that provides focus and prevents distraction from discomfort (11 min 40 sec)

If the video made you feel uncomfortable ask yourself why. If it’s because you consider yourself to be above violence and find the subject matter, language, and humour to be distasteful, that’s your right to feel like that. But try to dig a little deeper and ask yourself whether there are potential situations in your life that could confront you with fear or pain that you could be better prepared for if you trained with a different mindset.
When the situation arises that demands life-saving action and you are tired, hungry, scared, and discouraged by opposing advice or opinion, do you have the self-knowledge and resilience to see it through? If you don’t know the answer to that, isn’t it time you found out?
You can find out more about Lee at Urban Combatives

Hexagonal storm on Saturn's North Pole

Our solar system is amazing and beautiful and the wondrous discoveries continue. Watch this video from the NY Times on Saturn’s northern storm, shaped like a hexagon and larger than Earth:

This line from the video is inspiring:
Rings of ice, in a dancing ribbon of Aurora, sitting smack on top of a six-sided hurricaine. Another jewel in the crown of the solar system’s most photogenic planet.

 

Emergency Medicine – A Great Job

I was asked to speak at the Australasian Conference for Emergency Medicine‘s Annual Scientific Conference in Adelaide in November 2013. The title they gave me was ‘What a great job’. It was a great opportunity for me to explore some of the literature around what makes people happy, and whether emergency medicine has the ingredients to do that. It does. But not if you do too much.
The College has generously made available many of the conference talks as FOAM here.
Here’s my talk. The slideset is below.

2013 ASM: Dr Cliff Reid – What a great job from ACEM Digital Media on Vimeo.

How to Be a Hero

Kal-fly-iconI’m not a hero and don’t claim to be, but when I was given this talk to do for the SMACC 2013 conference I researched the topic and realised I’d worked with several of them.
The talk was the toughest I’ve ever given, because I cried while giving it, and knew that it wouldn’t just be the large audience in front of me who would know I was a wuss, but that it was being recorded for many others to find out too!

A full transcript of the talk, the slide set, and links to references from the talk can be found here.

GOLDen Educational Opportunity!

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SMACC was my all-time favourite conference ever. Its sequel, smaccGOLD, promises to be even better, as you’ll see from the program
The smaccGOLD online registration goes live this Monday 16th September at 8am in Sydney
This will be 11pm Sunday 15th in London, and 6pm Sunday 15th in New York
Make sure you don’t miss your chance to register for the best critical care conference ever!
Also check out the preconference workshops – a jawdropping line-up of medical masters covering everything you’d want to learn. The only difficult part is deciding what you won’t go to! Places are limited and expected will sell out quickly. Registration is on a first come basis.
Hopefully we’ll see you there.

smaccGOLD is a not-for-profit venture and I receive no payment for any participation in the conference or its promotion

Beherrsche die Reanimation

TLsm-icon The whole purpose behind my career and this blog is to save life. Like most emergency physicians I don’t see a huge number of resuscitation patients myself in a given week, so my best hope in making a difference is to develop my teaching skills so that I can motivate and inspire others to improve their ability to manage resuscitation.
The highlight of my week therefore has been the receipt of some email feedback from a colleague in Germany. An intensivist, internist, and prehospital doctor (I like him already) who tells me he found my ‘Own the Resus‘ talk helpful:


Dear Dr. Reid,

Few days ago, too tired too sleep after a long shift on my ICU (18 beds internal medicine ICU, I am specialist in internal medicine specialized in intensive care and prehospital emergency medicine in a major German city) I watched your talk via emcrit podcast. I was immediately caught, I soaked in every word, I was fascinated, watched it twice in the middle of the night and next afternoon I listened to it in my car driving to work.

At this very day I did some overdue crap beyond the end of my shift when I heard the ominous shuffling of feet and rolling of the emergency cart from the other end of the ward… “I think we need your help….”

There it was, difficult airway situation. Patient crashing.

Then what followed was a kind of “out of body experience”. I did what was necessary, made things happen like calling anesthesia difficult airway code, calling the surgeons, organizing fiber optics and meanwhile trying to secure that airway myself until i could dispatch anesthesia to the head and surgeons to the neck. Within few minutes there were 6 doctors and 5 nurses shuffling on 9 square meters…

I found myself 1 meter behind the foot end of the pts bed and with your talk in my head I found me consciously controlling the crowd. There was suddenly the messages of your talk and there was me. I don’t know how to put it into words, I wouldn’t have done something else in medical terms but thanks to your talk I had the vocabulary, the tools to reflect myself as the leader to be in charge of the situation somehow with more distance, and after a successful resus the 10 people involved in this code went off with a good feeling that everybody contributed in what they could and all for the pts benefit.

Your talk was a kind of transition to the next level for me: from the colleague who asks how to get out of trouble in many situations because he was often deeply in trouble, to the one who leads out of trouble.

With your talk many things suddenly became clear and I am looking forward to be able to work harder on this role of leading.

Thank you very much.

D

Dogmalysis


I made up a word a while ago: “dogmalysis”. It refers to the dissolution of authoritative tenets held as established opinion without adequate grounds.

DOGMA: something held as an established opinion; a point of view or tenet put forth as authoritative without adequate grounds

LYSIS: a process of disintegration or dissolution (as of cells)

It’s my favourite thing in medicine. I don’t know why – perhaps because of my admiration since childhood for irreverent scientists who questioned authority, like Feynman and Sagan. Or perhaps it is because I think at times we physicians need to experience the humility of having our ignorance exposed. This is necessary to keep medicine science-based.


My undergraduate and much of my postgraduate training consisted of being taught medical certainties that I was required to regurgitate under exam conditions. The reality of clinical practice then revealed the awesome irreducible complexity of biology in our patients who ‘don’t read the textbooks’. As we learn in emergency medicine to navigate the perilous Bayesian jungle to a ‘very unlikely’ or ‘very likely’ life-threatening diagnosis, and when we have to weigh up the benefit:harm equation of an intervention that could either kill or cure, we begin to appreciate that certainty without evidence – dogma, or faith – can be lethal.


The problem is, however, that our human brains seem to thrive on it. We have evolved a whole senate of cognitive biases, which enable us to function well in everyday social situations, but which prevent us from conducting an impartial analysis of objective clinical data. An enlightening example of the degree to which our interpretation of the same information can vary is illustrated by a handful of trials on fibrinolytic therapy for stroke, producing a spectrum of reactions from aggressive promotion to skeptical opposition.


Being human, I have no doubt that I am occasionally dogmatic about topics to which I erroneously believe I have applied skepticism. I appreciate the courage of trainees who have the guts to challenge my assertions and who demand the evidence to justify them. Keep doing it. Keep asking. Keep challenging.

Keep lysing the dogma.

No-one said it better than Carl:

Dogmalytic posts