When you are at the lowest of lows after a devastating case, how do you recover in real time? It’s certainly not easy and it takes a clear plan of action to do it well.
In this episode, pediatric hospitalist Sarangan Uthayalingam walks us through a difficult case where nothing was working. He felt frozen in inaction and the patient, a newborn, did not survive. Immediately afterward, he was in a deep emotional hole, profoundly self critical, and still had his entire shift in front of him with other patients to care for. What happened next was quite extraordinary – a reset, recalibration, and reframing of intent and mental state so that when the next critical infant came in (which they did in short order) he was not only up to the task, but a better clinician. Sarangan breaks down exactly how he did this in granular detail.
Much of the discussion springboards off of Stimulus episode 65
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Highlights from the episode…
On the front of Saragngan’s journal, he has a summation of his purpose as a physician:
“I’ve died 41 years. I’ve not lived 41 years. Because it’s time we’ll never get back. So every moment moving forward is a gift and on top of that gift.
I’m privileged to be a pediatrician where parents don’t know me from a hole in the wall and give me their trust to care for their child -their most prized possession – I get to take care of them. Make them healthy. Save their life. I mean, what other job comes with that implicit trust? And because of that, I owe it to them to be the best physician I can be. There are different domains in that and one of them is to be knowledgeable and an expert in that moment.
I always think I’m going to be a lifelong student. I’m always going to be growing and studying. That’s the privilege and pact that I’ve made to all the patients that I’m going to see. “
For further discussion, check out Episode 63
Sarangan’s steps for the point of care reset, recalibrate, and reframe
- Create a little mental distance between you and the event. It’s hard (or nearly impossible) to reset and recalibrate when intensely emotional. Usually this involves a bit of time (or movement, breath-work, etc). This wasn’t one of the 5 steps listed by Sarangan, but I added it in because in the story told in the pod, a bit of time elapsed before the next steps of the sequence happened.
- Reframe the event from something that happened to you to an event that happened and you were present. In this event, most of what happened was not in your control.
- Check your inner dialogue.
- Revisit your purpose (best to have this thought out beforehand) and allow it to outweigh the pain that you’re feeling in the moment.
- Earn forgiveness with tangible actionable tasks that will allow you to remove any self-doubt. How will you learn from this and be better for it?
- Connect with your SOS person – an empathic listener who is going to receive your distress and not try to fix anything.