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I am Dr. Christopher Hicks, Simulation/Resuscitation Fellowship Director: How I Stay Healthy in EM

2018-02-08T05:06:57+00:00

Dr. Christopher Hicks, is an emergency physician from Toronto, Canada. For Dr. Hicks, staying well is worked into every element of his day. When he’s not at work, he enjoys spending time with loved ones, and keeping active. His strategies for keeping mentally in check and being academically happy are something you’ll definitely not want to miss! Here’s how he stays healthy in EM!

  • Name: Christopher Hicks, MD, MEd 
  • Location: Toronto, Ontario, Canada
  • Current job(s): Emergency Physician, Trauma Team Leader, St. Michael’s Hospital; Clinician-Educator, University of Toronto; Simulation Lead, Division of Emergency Medicine; SHRED Simulation/Resuscitation Fellowship Director
  • 1 word that describes how you stay healthy: Consistency
  • Primary behavior/activity to help de-stress: Exercise, music, time with my super fantastic wife, kids, and dog.

What are the top 3 ways you keep healthy?

  1. Keep Active. Running, cycling, circuit training – I try and do at least one each day.
  2. Eat right. It’s not complicated – don’t eat a bunch of crap (Exception: No. 3)
  3. Be frivolous. Periodically do absurd, ridiculous, and largely meaningless things – you’ll be a better human for it.

“No one appreciates the very special genius of your conversation as the dog does.” –Christopher Morley

 

What is your ideal workout?

A long, cool, up-and-down trail run in High Park.

Do you track your fitness? How?

I use the Nike+ Run Club app to track run times and distances, and have a workout schedule of circuit training exercises that I refer to less often than I ought to.

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

The best way to mitigate the effect of night shifts is to not do them at all. I prefer Casino shifts if possible which are either 2200-0400h or 0400-1000h (our ED allows staff to schedule full nights or Casino shifts, depending on physician preference).

Pre-shift: For an overnight I get up a bit early on the day of, make sure I get some vigorous exercise and drink no caffeine after noon. I usually climb in to bed around 1930h and try to sleep for 2-3 hours pre-shift. When I get up, I try to eat something that resembles breakfast.

Post-shift: Recovery involves, predictably, rest and exercise. For a full overnight I’ll sleep 3-4 hours, then try and get up and be active. I avoid any non-clinical work that evening, try to do something relaxing, and get to bed early. The best part about Casinos is your day-after is preserved: it’s either a very early morning followed by an early bedtime, or post-shift rest from 0500-1100h or so followed by a semi-normal day.

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

Although I bring junk food for the department on overnights (and do occasionally stress eat after a gnarly resus), I try and stick to healthy stuff on shift: water, fruit, nuts, protein bars. I schedule snack breaks, rather than take them sporadically – I have a sense of when, on any given shift, I might try and break away for a coffee and a snack. I bring food that I can snack on during the shift, for those days when a break really isn’t feasible.

How do you ensure you are mentally in check?

At Work:

  • I turn some of the stuff I hate (commuting to work) into the stuff I enjoy (I run or bike to 90% of my shifts)
  • I have a very consistent pre-shift routine. Some would argue it borders on magical thinking – how and when I arrive at the hospital, what I do with the 20 minutes before my shift starts, what music I listen to.
  • I buy (heavily) into the value of psychological skills training to moderate stress and arousal on shift: controlled breathing, mental rehearsal, and cognitive re-framing are all part of my regular routine for managing complex events or dealing with high task load.
  • Leave it on the floor: My process on-shift involves a number of reassessment and cognitive check-points to help ensure that when I go home I’m satisfied I’ve put in the mental work in, and don’t tend to ruminate about my decisions after the fact.
  • Habit, not goals: Setting lofty goals is admirable, but (for me at least) often leads to disappointment; Instead, lean on habit – do a little exercise each day, read one new thing, do something awesome with your kids.
  • Say what you mean, and mean what you say: Be open and honest with your peers and colleagues, and when conflict arises, manage it. Mitigating language and passive-aggressive behaviour, while often embraced by institutional culture, line the path to self-destruction.

At Home:

  • Put the phone/computer down: I try to get non-clinical/academic/administrative work done during set periods of time, and then have a hard stop to my workday where I don’t answer emails or schedule calls. Whether its time to yourself, time with your family or friends, that non-work time needs to be protected above all else (granted, this is still a work in progress).
  • Time with your peoples: In the end, nothing matters more.

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

  • Staying current: The #FOAMed world has been a game-changer for me in terms of my ability to stay up to date. Take time out to be a learner (you are one anyway).
  • Stay humble: If you’ve been in EM long enough, this isn’t difficult. The job itself can be awfully humbling. With time you should get better at saying “I don’t know”, and perhaps even get used to saying it more frequently, not as an act of resignation but with a sprit of humble curiosity.
  • Staying optimistic: To thrive in EM you have to love solving problems, both big and small – that is the real day-to-day of your work. Getting your head around that will allow you to set realistic expectations for what you might expect to get out of any given shift.
  • Calibration: One of the biggest challenges in EM is lack of feedback on performance and outcomes, making it difficult to calibrate your skills. Actively seek feedback from colleagues, follow up on cases (both challenging and routine), and get used to learning from your mistakes (both little and big).

Best advice you have received for maintaining health?

Beware vaulting ambition.

Success for success’ sake is the express lane to the fires of hell. Avoid the impulse to pad your CV, publish something just for the sake of doing so (the answer to “Hey, should we publish this?”, when asked retrospectively, should almost always be “No”), gunning for that new academic position because the name sounds lofty and important. These are vacuous endpoints that can spin out of control in the recursive search for “success”. Let your curiosity be your guide, and devote your time and energy to answering questions that are most meaningful to you. You will be happier, you will carry more legitimacy in your field, and you’ll find it easier to partner with awesome and like-minded people, all of which will keep you engaged and focused on what matters to you. That’s success. The thickness of your CV is not.

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

Andrew Petersoniak
Evelyn Dell
Chris Denny

Zafrina Poonja, MD

Zafrina Poonja, MD

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