AAEM NEWS PRESIDENT’S MESSAGE
Controlling What You Can When Things Feel Out of Control Lisa A. Moreno, MD MS MSCR FAAEM FIFEM — President, AAEM
Being President of an organization
like AAEM has already been a blessing to me in more ways than I can possibly express. One of those ways is the opportunity to form close working relationships with the incredible people who are part of the Academy. Recently, the Wellness Committee has been a special source of inspiration with its focus on mitigating the isolation created by COVID-19, and the Women in EM Section has been equally inspiring with its focus on combating physician suicide. Physician suicide rates are more than twice those of the general population.1 The well-known Maslach Burnout Scale considers emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment to correlate highly with depression and burnout.2 In 2020, emergency physicians are increasingly experiencing these factors. We are seeing needless death in unprecedented numbers. We are discouraged by patients dying alone, and by our inability to touch our patients and our colleagues, to have in-person conferences and meetings, and to gather socially. Our personal impact is diminished by the conditions in which we are working, including the increasing takeovers of our departments by corporate medical groups. Employers, legislators, and insurers purport that the years of extra training and study EPs undertake brings no increased value to our patients and that we are easily replaced by NPs and PAs. A recent study shows that “younger age, surgical specialty, low academic rank, academic main practice, female gender, numerous night shifts, and living alone” most highly correlate with high levels of burnout.3 At home and at work, we are surrounded by people who feel unable to cope. Tempers are flaring. Many people need someone to blame. The slow return to normal is not coming fast enough, and things feel out of our control. Over and over, the wisdom of a children’s film comes to mind: “We’re calling this ‘Controlling what you can when things feel out of control’.”4 And as Olaf pointed out, there is indeed a great deal that we can control.
the best treat we can give ourselves. With gyms closed, many people are slacking off on exercise. Work outs help both our physical and our mental health. Get a buddy to work out with, and be accountable to each other for healthy eating, working out, and getting enough sleep.
We Can Protect Our Mental Health “It’s okay to not be okay” is more than just the title of a Korean TV series. This phrase has been reassuring health care professionals that there is no stigma in needing help. The stigma of mental illness is giving way to the image of strength shown by asking for help when we need it. One of the highest compliments we can pay another is to admit our vulnerability and ask them for help. Opening up about our own doubts and emotional exhaustion gives permission to those around us to own theirs. Being human does not equate to being weak. Take time each day to meditate or pray. Connect to the Higher Power who is in control. Write poetry, keep a journal, listen to music (literature shows it is a mood changer!), and follow the advice of the Wellness Committee from the last issue of Common Sense.5
We are discouraged by patients dying alone, and by our inability to touch our patients and our colleagues, to have in-person conferences and meetings, and to gather socially.
We Can Protect Our Physical Health There is no longer any doubt that masks/face covers work. The CDC has shown them to be 97% effective in the prevention of COVID-19 transmission. Beyond this single most important thing that we can do to protect our health, we also need to ensure that no matter how hard and how long we are working, we must take time to eat well, exercise well, and sleep well. Busy people get too much “take out,” depressed people feel like they’ve “earned a treat,” and lots of kindness has been shown to us by local restaurants sending food to the ED. But let’s reframe that: What we sometimes think of as “treating ourselves” with sugar, fat, and processed food is really hurting ourselves. A fresh, natural plant-based diet is COMMON SENSE NOVEMBER/DECEMBER 2020
3
