Dr. Lalani (@ERMentor) is no stranger when it comes to wellness. He is without a doubt an individual who is always striving to improve himself on every level. Currently, he is the Assistant Program Director of the University of Saskatchewan FRCPC EM Program, creator of the blog ERMentor, and has recently completed his certification to be a Life Coach (check out his personal website here). When he’s not in the ED torturing his residents with his top secret set of tough questions, he can be found on the golf course working on his pro swing. Dr. Lalani is a mentor to many, and his residents often look to him for advice outside of medicine. Take a look at how he stays healthy in emergency medicine!

  • Name: Nadim Lalani CEd, MD, FRCPCLalani
  • Location: Saskatoon, Saskatchewan
  • Current job(s): Adult and Pediatric Emergency Physician. Assistant Program Director U of S FRCPC EM Program. Soon to be dad and ICF Certified Life Coach.
  • One word that describes how you stay healthy: “Constant practice” – I am still learning to be a picture of health.
  • Primary behavior/activity for destressing: In winter: Going to the gym then local coffee joint with a friend or book. In summer: Working on my golf game – usually with Bluetooth headphones connected to music on my smartphone. I find hitting chips and putts for a couple of hours meditative.

What are the top 3 ways you keep healthy?

  1. Sleep. I’ve learned the hard way just how important sleep is. I always nap before an evening/night shift and use a facemask and earplugs to block out light and sound. As a bonus, my cat Mookie is always there – he hasn’t missed a nap in 10 years! (I don’t know how he does it.)
  1. Train. No doubt – you need to be physically fit to be effective in EM. I work out with a personal trainer twice a week. I have improved tolerance of shift work and better sleep since I made this change. Being a fit person is more about changing who you are than it is the creation a new habit – so I let it happen gently, expect relapses, and actually gave myself two years to become this new person.
  1. Go easy on myself. Being healthy of mind and spirit is as important as having a titanium body. FACT: YOU ARE HUMAN! You need to be able to vent, share your hopes, dreams, fears, failures and inadequacies. Learn about emotional intelligence and mindfulness. Have an outlet … talk! (I also journal).

What’s your ideal workout?

Lifting RIBS! Seriously – 60 min of circuits that combine upper body, lower body, core and rowing/skipping/box jumps, repeated 3-4 times.  I also jog at a modest pace twice a week. But I need to make more of an effort to stretch.

Do you track your fitness? How?

I track my body composition every six months. I just got a Fitbit and am getting better at tracking my diet and cooking more at home. Although I think it’s more important to be fitter and see the gains in your work/life than to focus overly on body habitus. The literature is pretty clear on the inverse relationships between being overweight and job performance, workplace stress, branding and achievement – so I am trying to get “fighting fit”.

How do you prepare for a night shift? How do you recover from one?

Preparation: Sleep, hydration and nutrition. I hang out at home and do little. If I work out, it’s late in the afternoon followed by supper and a nap, for about 2-3 REM cycles. I get up an hour before shift to watch TV, Tweet, and Facebook in a room with bright light. I usually have a snack and grab coffee to go.

Recovery: Eat, hydrate, and nap [yup Mookie is there too]. I get up after about 4 hours. Again, post-nights I try to do little as I am cranky and have poor attention. I go to bed early and usually sleep the night.

How do you avoid getting “hangry” (angry due to hunger) on shift?

I sometimes struggle with this. The key is to plan your patient load/reassesses so that you can actually go for a meal, maybe have a protein bar handy just in case you get that trauma alert. I take time to eat in the nurses’ lounge and share banter. On nights, I have decreed 3 am as “Toast O’clock” at which time I usually crush a couple of PB and J pieces of toast with milk!

How do you ensure you are mentally in check?

Pre-shift: I listen to the right music to get my head in the right space. Never go in hungry, sad, angry, or emotional. In the car I take a moment to check in with myself – this is crucial these days with hospital overcrowding. I simply ask myself to do good work with each patient in front of me. I allow myself to plod along and try not to feel the pressure to “move the meat”.

On shift: Working in the ED is just like a video game! Be mindful of your emotional state as you go through the shift. When empathy levels are critically low – you need to power up! Take a break, eat, sit, then get back in the game.

Post-shift: My wife is my greatest support. This may sound odd, but I had to learn how to speak about my problems and understand that it’s okay to be vulnerable and show emotion. Recently, I treated a young healthy non-smoker with a new diagnosis of terminal cancer. He was crying, scared, and alone, and it got to me. I allowed myself a moment to process my feelings. I then shook it off and finished the shift. I came home and let it all out in my wife’s arms. Talk about ugly cry!

What are the biggest challenges you face in maintaining a longstanding career in EM? How do you address these challenges?

Changes – especially hospital overcrowding are killing job satisfaction. Thankfully I also work paeds and rotate through our 3 ED’s. This has insulated me from chronic exposure to our busiest site. I also do not work full-time and derive a lot of job satisfaction from training my residents. If you need help finding purpose and balance – hire a life coach.

EM is hard. There is no substitute for solid residency training and being a life-long academic. I am confident in my skills and knowledge – it has immunized me from the stresses of job. I also have a lot of fun at work and enjoy pulling pranks – like the time I secretly coached the ED volunteer on a Wellen’s Syndrome EKG. I then made a bet with my resident that the kid could interpret that EKG. He was like “that kid? In the volunteer vest? No freakin’ way!” You should have seen the shock on my resident’s face (when the kid threw back the EKG saying “pfft! That’s Wellen’s Syndrome! At least gimme something challenging!”) It was PRICELESS!

Maintaining a caring spirit. Being a human in medicine is emotionally exhausting. Learning how do deal with your emotions can help you cope and thrive – read up on emotional quotient (EQ). Also, life doesn’t give anyone a free pass. You will encounter situations that have the potential to destroy you. There is courage in seeking professional help to navigate through these difficult times.

Best advice you have received for maintaining health?

“Live richly” – fill your days with family, people, learning, meaning, and experiences – you only get one go-around.

Who would you love for us to track down to answer these questions?

Rob Woods
Shawn Dowling
James Huffman

Zafrina Poonja, MD

Zafrina Poonja, MD

Editor, How I Stay Healthy in EM series
Emergency Medicine Resident
University of Alberta
Zafrina Poonja, MD

@zafrinapoonja

Emergency Medicine Resident. Assistant Editor @ALiEMteam. Lover of travel, soccer, and boat shoes.