Lost in Normandy, taking heavy fire

General Theodore Roosevelt Jr (son of the roughriding prez, and a legend in his own right), led the 4th Infantry Division during the first wave of the Normandy invasion.

Not only was he the oldest person on the beach that day, but he was also the only general.

Landing on Utah Beach, ready for action, his landing craft had veered off course and he ended up a mile from the intended target. 

Despite this setback, he famously rallied his troops, declaring, "We'll start the war from right here!" 

His extraordinary bravery and unwavering leadership at the vanguard of the assault, despite the relentless barrage of enemy fire, stood as a profound source of inspiration to the troops under his command. 

Met by a sh*tshow

Chances are, you’ve walked in the door to work and it’s been chaos. That may have even happened today.

You’re task-saturated before figuring out your first task. 

For years, I would collapse inside when there were 10 ambulances in the bay, 27 boarding patients, and an overpacked waiting room. That set the tone for the entire shift and had a cumulative effect of galvanized misery.

Driving into work, I would hope and hope that the department wouldn't be a madhouse, but it usually was.

The irony of this is that overwhelm and chaos are predictable, even if we don’t know exactly when they’re going to happen.

"We’ll start the war from here"

In our most recent pod, Thom Mayer, MD used the above quote as an example of taking a pause and making a conscious decision to choose a response.

This is a critical moment. 

The only thing we fully control

Our attitude is fully in our control, though it might not always feel that way.

If you know that there’s a good chance of getting slammed when you walk in the door, how do you accommodate that reality? 

The path of least resistance is to complain or even deflate. That's what I did for 14 years -- all of residency plus the first 10 years of attendinghood. #idontrecommendit

That pattern can become a big monkey on your back.

Choosing to set a positive tone (internally and externally) will pay compounding interest as the day goes on, both in mindset about work and patient flow.

It’s not easy, and sometimes you’ll be overtaken by events of the day.

But more often than not, you'll be able to surf that massive wave of overwhelm.

Whenever something doesn’t go your way, imagine how you can surf it and not fight it.

The question for reflection... What do you need to put in place to galvanize this mindset? 

Keep on rocking.

Robbie O

Further listening

How to Pregame Like a Pro

3 Wickedly Cool Things You Might Enjoy

Action Drills

Emergency Doc Tim Henderson, MD is a deconstructor, disambiguator, and distiller of the highest degree. After listening to the Zero Warning Episode, he broke down Emergency Action Drills for 34 critical situations. Here’s his stuff. 

Easy Sim

Stimulus listener and PEM doc Maybelle Kou, MD, and her team have a free resource that is full metal kickassery. It's a DIY pediatric sim that you can do in your own resus bay tomorrow. Check out emergencySimBox. I kept looking for the pricing guide, couldn’t find it, cuz it’s free. It was developed for community EDs to take care of kids better. You had me at hello. 

Washing Stuff

I couldn't close this out without a new tool we're using in the kitchen. It's an over-the-sink strainer. That might not sound like much but it's been a lovely addition. We've got a double sink and leave it in place over the secondary.

When you're ready, here are 4 custom crafted springboards

Awake and Aware. May 1-3, 2024 Bend, Oregon. In person. Small group, high yield. Unplug - Dig In - Transform. This is a CME event.

The Flameproof Course. The Hidden Anti-Burnout Curriculum. 6-month bi-weekly course. Cohort 2 begins Feb 1, 2024. Sold out.

Next Flameproof cohort begins Sept 2024. Space is limited and this sells out. Join the waitlist for Cohort 3.

The Driveway Debrief. Our free 10-minute guided exercise to shake off the residue of the day

1 on 1 Coaching. Stuck, burnt, or lost that loving feeling for the job and not sure what to do next? We've got you covered.