Happy Valentine's Day to all the amazing women physicians out there! As a woman physician, you face unique challenges when it comes to relationships and finding true love. Your demanding career often takes up a significant amount of your time, leaving little room for personal life and relationships.

I generally don’t like to go to the same vacation location twice. It’s a big world, and with limited time on this earth to explore, I find it’s best to go somewhere new. Yet, at the end of Feb 2022, I felt a familiar feeling of exhaustion. I had survived another COVID-19 surge of working as an emergency doctor during the pandemic. While a beach vacation is far from an instant cure from burnout, I do find it a helpful as part of recovery from an intense period of work.

As an emergency physician, there are countless situations on shift that may be produce grief, anxiety, anger, sadness, or frustration. Most psychologists recommend that we lean into our emotions, “feel our feelings.” Unfortunately, this is not practical for many of us during our workday. During residency, the concept of what to do with these difficult emotions was never explained. There were some generalizations about the importance of getting together with friends and colleagues to share and commiserate. Yet, how often and how to do this without it turning into an unproductive venting session was seldom explained.

The first time I heard about the concept of a life mission, I recoiled. It seemed potentially self-aggrandizing. Yet, the more I thought about it, it made a lot of sense to spend time really thinking about the purpose of my life. As a physician, I always have a lot of competing interests. I have more opportunities than hours in a day. In a previous post, I discussed aligning my time with my values. Values were easier for me to define and develop. A life mission seemed too big.

2020 was an unquestionably rough year. Yet, most of us in healthcare figured that if we just hunkered down and waited for the vaccine, everything would be okay. Well, 2021 heard that and said, "Hold my beer." Amy Cuddy and JillEllyn Riley coined the term "pandemic flux syndrome," in an article they co-authored in August of 2021, just as Delta began to surge. This term described the angst that so many of us were feeling as things returned briefly to somewhat normal, then the rug was pulled out so hard during the Delta wave. While pandemic flux syndrome varies in presentation, it is generally a mix of anxiety, worry, grief, frustration, and confusion about the present and the future.

            By the end of emergency medicine residency, I was confident that I would work in academic medicine. I love learning, teaching, and writing. My residency and first five years of my attending career was in the Navy. After residency, I stayed at the same program and became the simulation director for the emergency department and later an assistant program director. When it became time to leave the Navy, I was confident that I would stay in academics, and based on what I knew, choosing a university-based program seemed to be the right step.

Time is my most valued commodity. Starting in medical school, it felt like my time didn’t belong to me, and there were always competing demands on my time. In residency, there are weeks in which you work 80 hours, and that leaves hardly any time for the very basics of sleep and eating. Finally, as attendings, we gain some autonomy back in our lives. It may not feel like it, but we do have choices about how we spend our time. Most time management programs emphasize efficiency, and by the time we finish residency, few physicians struggle with efficiency. Rather, we need new approach to time that center on our needs and values.

Life is full of challenges. It is critical to have a strong circle of people supporting you. There are several key relationships we all need to thrive personally and professionally.

Imagine you’re on a basketball team. The members of the team all practice individually with team members that play their respective positions, e.g. with other point guards or forwards. They never practice as an entire team until the actual game. Sounds crazy right? Yet, this is what we frequently do in healthcare. Perhaps the residents get together for a sim day, and there’s a nursing skills rodeo day, but rarely, if ever do we train together.

Simulation education is dependent upon the premise of suspension of disbelief. This is a contract with learners in which there is acknowledgment of the limitations and artificiality of simulation. Yet, this is not a pass for educators to shrink from every opportunity to make the simulation experience as realistic as possible. In the simulation field, realism is described as fidelity, i.e. a high-fidelity simulation has a high level of realism. Every time we ask a learner to pretend, we make it a little harder for them to truly engage in simulation exercise. 

I have a love-hate relationship with emails. I love the rapidity of communication and the ability to collaborate easily with people across the globe. On the other hand, the rapidity of emails leads to poorly constructed messages that lack substance and that can reach us 24 hours a day. Here are a few strategies I use with emails to stay organized and to maintain my sanity as well!

Brene Brown’s podcast recently devoted an episode to First Friggin’ Times (FFTs). It is full of great advice for getting through a FFT in life, but some FFTs in medicine need a different approach. Below is some advice for getting through a medical FFT as learner and also some points for educators guiding others through FFTs.