I asked Dr. Walter Himmel to give a talk at EM Cases Summit 2021 on what he has learned in 40 years of practice. Herein lies his profoundly thoughtful answer, that is especially relevant during the COVID pandemic – a special edition EM Cases video podcast of his live presentation at The Summit…
Podcast production, sound design & editing by Anton Helman
Written Summary and blog post by Walter Himmel, edited by Anton Helman November, 2021
Cite this podcast as: Himmel, W. Helman, A. Managing Adversity with Walter Himmel. Emergency Medicine Cases. November, 2021. https://emergencymedicinecases.com/managing-adversity-walter-himmel. Accessed [date]
Do not underestimate your power to help or to harm
What you do matters deeply. As a health care professional, every interaction you have with a living being has the power to improve or to harm. At times in a small way and, more often than realized, in a profoundly life-altering manner.
Everyone tells you what they expect but no one tells you how to fulfill those expectations
CanMEDS 2015 expectations for physicians in Canada
There are similar expectations for all health care workers, that you should be all of the following: professional, communicator, collaborator, leader, health advocate, scholar, and expert. Exactly how to measure and do all of this is not fully detailed.
How to fulfill the expectations placed on you
Two skills are required for a meaningful and satisfying 40-year career: empathy and curiosity.
Empathy so you don’t get angry and curiosity so you don’t get bored to death.
The fifth habit of the 7 Habits of Highly Effective People is “Seek first to understand, then be understood.”
“People need love the most when they deserve it the least.”
– Lou Holtz, football coach
Life satisfaction comes about through managing adversity rather than chasing happiness
Happiness is a momentary state and easily evaporates. A meaningful life and a life of satisfaction (a life of self-respect) is the product of managing adversity. Developing a high adversity quotient takes practice and planning and a philosophy that adversity produces growth. I tell my residents that they learn little or nothing when things go well. Failure is more likely to produce growth.
Empathy requires the ability to suspend one’s feelings while under attack. Practice and preparation are necessary.
System 1 and System 2 Thinking is applicable to more than decision making in the ED:
System 1 thinking is pattern recognition. System one is used most of the time, is efficient and usually correct but occasionally dead wrong.
System 2 is methodical, rational, and logical. This takes work and preparation. It only occurs in a clear mind. Such a mind only exists when one suspends one’s feelings and is intellectually humble. Intellectual humility is the ability to consider that you could be wrong and totally so. Then by suspending one’s certainty, one can begin to think more clearly and in a manner free from pre-existing beliefs and assumptions.
Seeking knowledge mandates reading and exposing oneself to completely opposing views and opposing sources of information. Partially because of the internet and social media, one is at risk of being exposed to biased and monolithic views. Seeking and studying inputs you don’t like is becoming a necessary skill to developing a more balanced concept of the world.
Cynefin framework to help manage adversity and complexity
Life and Emergency Medicine present eclectic problems. Some issues are simple, some complicated, some complex, and some chaotic. The inability to recognize the difference produces clouded thinking and polarized relationships.
Preparation and practice, empathy and logic, and the capacity to suspend one’s assumptions and feelings are the powerful tools for a good career and life. However, it takes practice on a daily basis and considerable planning and learning in advance.
For streaming access to all the talks, procedural videos and rants from EM Cases Summit 2021 from Nov 2021-Feb 2022 visit emcasessummmit.com
Drs. Helman and Himmel have no conflicts of interest to declare
Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.