1. What is the best advice you were given during your time in school that has had a lasting impact on your practice?
One lesson I remember from when I was an ER resident was when my preceptor told me about the idea of “mindfulness”. I was struggling to be able to focus on each individual patient whilst simultaneously attending to everything else going around me in a busy and noisy ER. I found myself constantly distracted by the department, trying to keep pace with flow, making sure I didn’t fall behind, and being aware of what was coming round the corner.
And so my preceptor brought up the idea of mindfulness, and trying to eliminate distractions and practicing being in the moment. “No matter how busy or urgent what is coming up around the corner, when you are with a patient, force yourself to block out everything else around you, calm yourself and give the patients those minutes with you, be in the space with them.”
It’s something I still try to practice to this day; it gives me clarity when dealing with a patient and gives them comfort that I am entirely focused on them. I still find it challenging to do, and I know I don’t do it that well very often, but it was a simple phrase and concept that is useful to carry with you, which I now also pass on to my Residents.
2. Tell me something that your patients have taught you?
The more you work in healthcare, especially Emergency, where you see a lot of undiagnosed problems, and the end result isn’t what you were expecting initially, the patients really keep you humble and grounded. You realise what you learn in textbooks, and the approach to certain things doesn’t always clearly apply, often the presentation isn’t what the problem was. As much as you feel confident in your approach there will always be cases that don’t fit.
A very significant case recently was that of a young lady who came in complaining only of shoulder pain. During the exam she mentioned that her massage therapist thought one of her ribs felt funny, and she actually asked me for a chest X-ray. The X-ray showed a very large mass in the chest area that was likely causing the shoulder pain. Had she not mentioned her conversation with the massage therapist, I wouldn’t have sent her for a chest X-ray.
There are many times that what we have been taught doesn’t fit, which is how you learn to be humble. It is important to listen to your patients, as often they give you the diagnosis if you give them a chance to tell you what they think is wrong. However you must also remain grounded and recognise that sometimes listening to your patients can lead you to the wrong path. Often patients are hoping for reassurance from their doctor, many want you to tell then they’re fine. So they will tell you their history in a way that is phrased to encourage you tell them they are fine. You must always keep your approach wide and listen critically when doing your exam. I still struggle with that and try to remember these lessons.
3. What are you doing currently/working on/interested in that is helping to impact our local medical community and/or local patients?
For my first few years I focused more on the clinical side, but I’m gradually trying to find ways to work more in my medical community. This past year I’ve found it to be rewarding to get more involved by joining the MSA and PES executive teams. This has allowed me to get to know more about how and why things happen, and the RMH organisation structure.
I share what I learn at these MSA executive meetings with my colleagues in Emergency and I’m still finding new ways to get more involved in my department.
4. What is some advice or wisdom you would like to share with your medical staff peers, or any new physicians joining our community?
I think the most important thing is for physicians to find what interests and moves them, and do more of that. In everything else there is a hierarchy that you are working towards, as a physician you don’t have that, so you need to find your own interests and incentives if you were to do extra work beside your clinical duties. It’s going to be the interests that drive you more than anything.
But at the same time, sometimes you must be exposed to something before you know if it is right for you or not. Once you’ve identified your interests, you can focus on what you feel you are naturally good at and find a way to express that interest and skill set because that’s what’s going to make you happy. But until you find it, getting involved in different things can help you find your own special skills and interests.