One challenge at a time...

It's only been a couple of weeks since returning to work from my short break, and already the intensity and the stress of working in the ER is hitting me.

It's been amazingly busy in the ER lately, at both hospitals where I work. I think that's the expected flow of things in the winter months, particularly at the new year, when doctors are often away, flu bug hits, and patients travel and pick up new diseases.

It's been disheartening and often very discouraging, when I'm already maxed out in my mental abilities, working non stop as fast as I can to move from one patient to the next, while making sure I take my appropriate time and attention with each patient to make them feel like they got their fair share of my care, and to make sure I don't make mistakes or overlook anything in the midst of all this chaos. But the waiting room keeps piling up, and I keep falling behind, and they keep coming. And keep coming. And coming...

This made me think of one of the more favorite movies I watched recently, Matt Damon's the Martian. In the movie Matt's character got stranded on Mars and had to engineer his way to survival and to a eventual unlikely rescue. He encountered endless bad breaks, each one seems insurmountable, but yet he motored through, created a solution, and lived on. Towards the end of the movie he became a professor and answered a question from a student of how he got through his predicament. His answer was, "just focus on solving one problem at a time."

When the world seems crumbling towards you, if you start looking at all of the problems that are coming, you will feel defeated, you will feel there is no way out.

One problem at a time. That's all you can focus on. That is the only solution. Do each problem justice, focus, treat it as the only problem of concern right now, deal with it fully, then move on. That is all you can do. That is the only way to hack away at it.

It's a difficult but high level task to master. As a ER physician, part of your job is to maintain control of your department and manage resources, beds, nursing efforts, and patient flow accordingly. Never must you lost touch with the current activities and demands of your department. It is much like a general in battle. You job is to maintain a pulse on all corners, and be the first to know what to do to keep the department afloat. Having said that, you never lose sight of your primarily obligations, and that is your patients, each and every one of them, when they are sitting before you. In that moment, you learn to shut it all out, even for 5 minutes, and make them feel like it's just you and them then. You give them all of your attention, you try to think of what it is best for them. You deal with their problem.

One problem at a time.

Yesterday I had a very difficult shift. Because I was sick. I couldn't sleep the night before. I woke up with chills and rigors and vomited and almost fainted during my morning shower. I thought about not going in but by that point it was impossible to get a last minute replacement on an early Saturday morning shift. I took 5 minutes to down some warm fluids and half a cup of greek yoguart. Then drove on to work. I thought about the day ahead of me. It felt taunting.

Then I remembered Matt Damon's Martian. One problem at a time. At this point, my first problem is getting to work on time, and arriving safely.

45 minutes later, I arrived at the parking lot of my hospital. I gave a sigh of relieve. First job done. I'm here. On time. I can do this.

I walked in, asked my nurse for an anti-emetic for myself, then picked up my first chart.

I got through the day. Focusing on one patient at a time. Luckily the department was manageable. And I think I did a good job with them all yesterday. I was so relieved when my shift was over. I was so exhausted. But I got through it. Thinking about the Martian.

Today I'm off. Just woke up from a 12-hour sleep. I'm feeling better. Hopefully this will past swiftly before my next shift tomorrow.

One problem at a time.