EM Mindset: Jason Wagner – The EM Hive Mind

Author: Jason Wagner, MD (@TheTechDoc – EM Program Director, Washington University in St. Louis) // Edited by: Manpreet Singh, MD (@MPrizzleER – Clinical Instructor & Ultrasound/Med-Ed Fellow / Harbor-UCLA Medical Center) and Alex Koyfman, MD (@EMHighAK – EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital)

When I was asked to write for a segment I’ve enjoyed for some time, I was very excited. Unfortunately the task became daunting as other pressures pushed it to the back burner for a while. In those several months dozens of great segments have been written for EM Mindset. And guess what? All those bastards stole my thoughts. It’s like they reached directly into my brain and took my dreams from me, and frankly the thought of Felix Ankel mucking about in my brain excites me as much as it scares me. How did they accomplish the “Mission Impossible?” They pulled off this heist, because we can still see the long shadows of the giants who created this specialty. In our young specialty even the most junior resident is only a couple of degrees of separation from one or more of our specialty’s great founders. For me it’s a single separation as I had the honor to train under Dr. Allen Klipell (one of the East Lansing 18). As we go about reinventing what EM is all about, many of our founders are still around to witness it. Despite my humbling position on the EM food chain, I’m going to give you my thoughts on the EM Mindset. You will find some of them in other’s pieces, because we are all born of the same hive mind.

You Can’t Know it All

You have to be comfortable acting on partial information. Rarely do we get the total picture of a patient presentation before we have to make a decision. Even worse; the sicker the patient the less info we often get before critical decisions must be made.

Don’t waste too much energy worrying about whether or not your next action may be the wrong one. Rely on your training to guide you in the right direction.

Know that at some point you will be wrong. When this happens reflect on what you got wrong and why. Don’t let the mistake break you down, rather use mistakes to make you a stronger clinician.

If you are interested in reading the rest of this and other EM Mindset pieces, please see “An Emergency Medicine Mindset,” a collection evaluating the thought process of emergency physicians. This book is available as ebook and print on Amazon.