Dr. Rotte is an emergency physician currently practicing in New York. His passion for traveling, love of hiking, and commitment to eating right are some of his secrets on how he maintains wellness. Dr. Rotte shares how he is able to get away, travel, and stay well, while keeping up with his work demands. We could all use a little of Dr. Rotte’s passion for life long learning! Here is how he stays healthy in EM!

 

  • RotteName: Masashi Rotte, MD, MP
  • Location: New York, NY
  • Current job(s): Assistant Professor, NYU/Bellevue
  • One word that describes how you stay healthy: Division
  • Primary behavior/activity for destressing: Travel

What are the top 3 ways you keep healthy?

  1. Activity. I commute by bicycle so I get at least an hour of exercise every day I work.
  1. Travel. I travel as often as I can. One of my favorite activities is hiking so whenever I can get out of the city or (even better) out of the country, I try to find a destination where I can get some hiking in. In order to get time off, I stack my shifts as much as my schedule allows. Sometimes that means I end up trading into less favorable shifts so I can stack together days off. But when I’m standing at the peak of a trail in Zion National Park or Torres del Paine looking out on snow-capped mountains, a few extra night or weekend shifts seem pretty insignificant.
  1. Mininizing . 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).I think mental health is as important in our job (and intertwined) as physical health. I’m single with no kids (I do have a remarkably handsome cat though), so the main sources of stresses in my life are focused around my work life. To minimize work stress, I try to get everything that’s expected of me done as well as I can and as quickly as possible. For example, if my chair sends out a survey to the faculty or my medical director forwards me a patient complaint, I address them as soon as possible.

What’s your ideal workout?

I go to a gym that has branches near both of the hospitals I work at. Because I get at least an hour of cardio in during my commute, I primarily lift weights at the gym. My gym has a pool at a few branches, so I swim instead of lifting some days. I’m not a “gym rat” by any means, but learned most about what I know about weight lifting from reading, The Weider System of Bodybuilding, and from taking advice from coaches in high school and college.

Do you track your fitness? How?

I don’t track any objective data such as my weight, heart rate, or steps per day. If my credit card bill is particularly high or my scrubs are a bit more snug, I know I’ve been eating out too much lately.

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

I find the most important part of preparing for a night shift is to take a nap before I head into work. Even if it’s only 30 minutes, it refreshes me and prepares me for the night.

I stack my night shifts to get them out of the way. After a string of nights, I usually feel pretty run down, but I find that it’s important to get back into a regular sleep schedule as soon as possible. To do this, I try not to sleep all day after my last night shift, but rather take a short nap and then try to get up and do something productive so that I can get back into a normal sleep schedule.

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

When I was an intern, I noticed that I had a lot of nervous energy during shifts and one side effect was that I would constantly snack. So if I brought a bag of chips or cookies to work they would be gone halfway through the shift and I quickly got chubbier than I care to remember.

I worked with one attending who would bring in a huge tupperware container of fresh vegetables. I realized that if I emulated him and brought in healthier snacks I could keep up my habit of nervous eating, but I’d be chowing down on carrots and apples rather than salty carbs.

New York City has a lot of produce stands on the street where you can pick up a huge bag of fresh fruit or vegetables for $5-10. I usually stop by one of these stands on my way to work and load up with fruits and vegetables to snack on. I always try to bring in enough to share with the residents, nurses, and other staff.

How do you ensure you are mentally in check?

In our field, I think it is vital to be on time and mentally prepare for the duration of a shift. I really do love my job and I work with great co-workers and residents, so I’m usually happy and motivated during my shifts.

However, if you’ve got significant family or personal issues going on, it might be impossible to be completely focused during your shift. For residents who deal with long hours and myriad expectations, I think it’s imperative to reach out to your program directors for support or guidance early on, if you have any outside issues that are interfering with work.

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

I think “burnout” is a huge challenge in our field. The stress of treating difficult patients, dealing with unprofessional or unresponsive consultants, or managing boarding patients, while new patients keep checking in wears all of us down over time. Additionally, the field of EM is rapidly changing and we now have observation medicine, doctors in triage, patient satisfaction scores, and ever expanding metrics applied to us. Whether or not you are for or against these changes, they are all here to stay.

When I was a resident (and constantly stressed out), I tried to consciously identify what about EM was causing me stress and think about ways to manage those factors. One factor was the feeling that I didn’t have enough knowledge to perform well at work. To manage this area of stress, I identified limitations in my knowledge base and addressed them head on. For example, I didn’t feel like I knew enough about interpreting EKG’s, so I bought several books on the topic and studied them until I felt comfortable reading EKG’s on my own. As an attending I read journals, periodicals, and blogs to keep expanding my knowledge base and reinforce diagnosis or management for diseases I may not have recently treated.

Another factor for me is job satisfaction; I didn’t want to feel like I went to medical school and residency just to earn a better paycheck. I choose to work in an academic environment rather than in a community setting because I truly believe in the adage “see one, do one, teach one.” By teaching medical students and residents, I am challenged to understand the pathology or procedure being discussed inside out. I also take personal satisfaction in being able to clarify the reasoning behind my medical decision making when a medical student or resident asks me questions about patient care.

Finally, I’ve found that working constructively with colleagues is imperative to minimizing stress at work. I’ve seen residents and other attendings (and unfortunately myself at times) behave in a condescending or unprofessional manner towards other doctors, nurses, technicians, clerks, and cleaning staff. There is nothing to be gained by making yourself feel better than a colleague, no matter their role in the hospital, but much to be lost. If a cleaning staff is sweeping the floors in your area, take the 30 seconds to pick up your bag, move your chair, smile, and thank them for keeping the ED clean, rather than just sitting there and making them sweep around you. If a nurse or tech questions your orders for a patient don’t respond with snark comments, but listen to their concerns and consider if you might have missed something. If you are pleasant and professional it’s likely that colleagues will respond to you in kind and your shifts will be that much more pleasant (and less stressful).

Best advice you have received for maintaining health?

Stop eating when you are full (I do not follow this advice very often).

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

Pranav Shetty

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.