Emergency medicine physicians serve on the “frontline” every time we walk into a shift but would be remiss to not acknowledge the unique challenges we have faced over the last few months, both as a specialty and as individual clinicians. Prevention of burnout and active wellness management is more important now than it ever has been. This month on our “How I stay Healthy” series, we’re featuring Dr. Mike Paddock, Staff Physician with the Regions Hospital EM residency program who shares his down-to-earth wisdom regarding what he does to thrive as a physician, educator, advocate, father, and friend.
Words of Wisdom
I appreciate a few good axioms… simple sayings and “rules” for practice. This creates internal struggle for me at an anatomic level, given I hate rules for rules’ sake… As an educator, I believe that our driving forces and communicable wisdom should be constantly questioned and examined for biases. We should seek new evidence with the understanding that our practice is constantly in flux.
With that, these are the axioms that have personally served me well:
- “Don’t be lazy”. As EM physicians, we are given great range in our scope of practice. It is on us to do the necessary thing for the patient, even though there may be [lots of] barriers. I remind myself of this internally when considering the time and efficiency aspects of my practice. It’s my way to ensure that “the right thing” doesn’t fall way to the business of medicine.
- “Fight the good fight”. I am the walking, talking example of privilege. I can do great things with determined intent. It’s my duty to utilize that privilege for my patients to address their needs, which often have nothing to do with a specific management plan – it often requires advocacy of their needs in a fractured system. I relish in this duty and try to share this with all learners.
- “Be vulnerable”. I can find no truer or simpler way to guide how I educate learners at any level. I try to remember my roots, where I came from, who helped shape me into who I am. I want those coming-up to know that what makes us who we are is messy and complex; having real conversations with learners about insecurities and my own mistakes creates a culture of support and growth.
A Day in the Life
As with most EM physicians, there really isn’t a typical day for me and this day-to-day variety is something that gives me a great deal of happiness. That being said, there was obviously more variability prior to COVID-19, social distancing, and distance learning. Still, as a father to two young boys, we have created some simple routines that provide a bit more structure to the now daily fluidity. Much of our day to day now involves creating a safe, supportive, and still FUN environment for them.
My partner, Melissa, has created a learning environment for both of our boys that has a nice daily schedule that isn’t TOO rigid. We watch a morning message from the boys’ teachers on an iPad, and then identify goals for the day. We use a Kanban board to allow choice for the day’s tasks. Days DO NOT always go smoothly and we have found that giving ourselves grace and allowing our little creatures to just “be ok” or “not ok” has been important too. We try to remember that right now, learning looks very different, and showing our children love and kindness trumps their practicing math and reading skills. I think they thrive in an environment of spontaneity and it’s my wife and I who have to remember to allow ourselves to be spontaneous and go with the mood. If it’s wild and fun, that’s good for wellbeing too – we just try to go with it!
We use an Apple HomePod in our living room/kitchen areas to hold spontaneous dance parties. Usually, one of the kids asks Siri for something random… lately it’s been anything off the Trolls World Tour Soundtrack. For those that haven’t seen it, what are you waiting for? There is a subtle undertow of exposing social injustice, rewriting history, and rejecting manifest destiny! There is a great scene with a troll rave at the beginning… We mimic that with some sick pretend DJ gear, crank it up, and let loose.
On days that I’m working clinically, I like to have an obscene amount of coffee prior to starting; my new COVID shift routines don’t allow me to consume it at work.
Here’s me rocking my new morale scrub cap (Game of Thrones House Stark FTW!), and my brown bag of PPE. In my brown bag is a wash basin that has my N95 in a tupperware container (no hands = reduced contamination!), my ‘tubin goggles, and my face shield. I wipe the shield down after every COVID encounter and it goes in the wash basin to dry, ready for the next patient.
I usually listen to a podcast on my drive in. My favorite non-medical podcasts?
- “Radiolab:” Formerly hosted by Robert Krulwhich, now retired and an amazing scholar and educator
- “The Daily” from The New York Times
- “Today Explained” by Vox Media: A daily deep-ish dives on popular news
- “Reset:” Various tech-influencing-society topics
- “The Vergecast:” My guilty pleasure and the perfect balance of nerdy tech goodness and social/political commentary.
Overall wellness recently has necessitated creativity and requires planning given social distancing. Much of what gives me happiness is the great spontaneity of life – this is in short supply right now.
I’ve recently just simply tried to be more reflective of the small things in life – things that bring me and my family joy: A run around the Minneapolis Chain of Lakes, a silly dance party in the living room, sitting on the porch with a hot cup of coffee, snuggling our new puppy, or just getting lost in music (exploring a recently inherited vinyl collection!).
Our new dog Swiss was re-homed from The Regions/HealthPartners Residency Program Coordinator, Amy Koonce. She was looking for a varmint hunting dog. This dog don’t hunt. Like, at all. She is the laziest thing on four legs, exactly what we needed to keep the energy down in our house. It felt right to focus some love and energy on another living thing at the start of the COVID stay at home orders. I grew up with dogs, and a home with one just feels complete to me.
As far as handling home and work schedules, I don’t believe in any such thing as work-life balance – My work is my life, my family is my life. There are times where my oath and duty make my priorities shift to clinical care and teaching. There are times when my family’s needs make my work life pale in comparison.
How do I keep it all straight? Everything, I mean everything, goes into a shared iPhone calendar with my wife ASAP. The randomness of shift start times, meetings, teaching sessions, research, and administrative work has to get wrangled somewhere. Everything that is a priority to either of us, or our kids, goes there. We make sure to check the schedule frequently throughout the day and stick to it as best we can. It is the only way we’ve been able to keep it working.
When I’m at home, and there isn’t an item scheduled? I focus on being the best co-parent I can, and just be Dad. It is the single most important job I will ever have, and I try to remind myself of that as often as I can. The things that bring me the most joy right now are the trips into the mind of my kids. The way in which they ask a curious question, or try to explain a concept, or tell a story! I get little packets of joy frequently in those moments, and they sustain me in a way I didn’t know was possible before I became Dad.
Any and all feedback is welcome as we continue to resurrect this series! We would be happy to hear from you, especially if you have specific wellness resources to share, would like to be featured, or are interested in hearing from any particular EM rockstars. And if you missed them, check out our other “How I Stay Healthy” posts.