“One of the residents that I was working with was yelled at once by somebody else because he had cried while giving a family bad news. I think everyone knows when you’re giving them bad news; it’s not like a big secret. You maintaining a great deal of composure doesn’t change that fact. I think that we’re allowed to be human. If we force ourselves not to be human or have any degree of human emotion, that’s obviously not putting us on the path to wellness and certainly if we force other people not to be human that’s not putting either them or us on the path to wellness.”
—Ilene A. Claudius, MD
Breaking bad news to patients and families is a fact of life for an emergency physician. More than 300,000 patients die in emergency departments each year from either traumatic or nontraumatic cardiopulmonary arrest, and an even greater number are diagnosed with a new life-threatening or life-altering illness, such as cancer, stroke, or traumatic brain injury.1 We stand at the front lines for these patients and families when they are first confronted with death or their own mortality. It is up to us at these moments, not their specialists or family physicians, to comfort and support them in a time of need. While intensely fulfilling at times, this type of demanding emotional support can also be incredibly draining in an environment that never sleeps and never stops moving.
|“Dear colleagues. The unbearable has happened…last Friday we discovered that one of our residents was tragically taken from us… It appears that the resident took their own life in response to acute grief…”|
– Dr. Christopher Doty (Program Director, University of Kentucky EM Residency Program)
Calling ALL Emergency Medicine (EM) physicians – residents and attendings alike! It shouldn’t take Dr. Doty’s story or the loss by the resident’s family, friends, and colleagues suffered in order for us to recognize the importance of wellness. Our specialty is known to be high risk and it is surprising that we are so late to the game to try and change that. Well, together we can. We are a strong group of people. We see, hear, touch, and smell things that would make the average person nauseous. We are problem solvers and leaders.
This year’s JGME-ALiEM Hot Topics in Medical Education journal club features the systematic review on residency wellness recently published in the Journal of Graduate Medical Education (JGME). This week, share your thoughts about this timely topic and paper on the blog, on Twitter (follow #JGMEscholar) and during a live Google Hangout with author Kristin Raj, MD (@KristinRajMD), Christopher Doty, MD (@PoppasPearls), and Jonathan Sherbino, MD (@Sherbino). Ultimately, a curated summary of our discussions will be published in the JGME. Some of your best tweets and blog comments will be featured.
“The hardest thing for me was trying to find time to do things aside from being a resident. When you’re working six 12 hours shifts in a week, there’s only so much time left in the day to do anything else. Especially in the winter, you wake up, you get to work before the sun comes up, you work a 12 hour shift, you leave, and the sun’s gone. By the time you get home, you have enough time to wash the grime off, shovel a sandwich in your mouth, and pass out. And there was nothing else except for that.”
– Anand Swaminathan, MD
Unless you are living under a rock, many healthcare and public media platforms are talking about the insidious problems with burnout in the health professions world. One thought leader out there is especially vocal about wellness, resiliency, and mindfulness — Dr. Zubin Damania (alter ego: ZDoggMD). For instance, do you know the difference between empathy and compassion, and why that is important to differentiate this as a clinician? We were honored to have him join the Wellness Think Tank to field questions that we peppered at him, specifically around resident wellness.