An ER doctor on how to triage your busy life | Darria Long | TEDxNaperville

[Applause] welcome raise your hand and be honest if you've used the phrase crazy-busy to describe your day your week your month I'm an emergency room doctor and crazy-busy is a phrase you will never hear me use and after today I hope you'll stop using it too so come with me into the ER it's the Wednesday night before Thanksgiving 11:15 p.m. you're the overnight doctor and you just started your shift when you get a call there's been a multiple car pileup on the highway many injuries several ambulances are headed your way eta five minutes your er was already packed but here's why you cannot afford to use crazy to describe your busy because when we are in what I refer to as crazy busy mode we are simply less capable of handling the busy here's what happens your stress hormones rise and stay there your executive function in the prefrontal cortex declines that means your memory your judgment your impulse control deteriorate and the brain areas for anger and anxiety are activated do you feel that here's the thing you can be as busy as an emergency department without feeling like you're crazy busy how by using the same tactics that we use our brains all process stress in similar fundamental ways but how we react to it has been shown by research to be modifiable whether it's emergencies or just daily day-in day-out stress now contrast crazy-busy mode with how I think of us in the ER ready mode ready mode means whatever comes in through those doors whether it's a multiple car pileup or a patient having chest pain while stuck in an elevator or in another patient with an item stuck where it shouldn't be when you know you're dying to ask even on those days when you would swear you were being Punk'd we're not afraid of it because we know that whatever comes in through those ER double doors that we can handle it that we're ready that's ready mode we've trained for it and you can too here's how step one to go from crazy mode to ready mode is to relentlessly triage in crazy mode you're always busy always stressed because you're reacting to every challenge with the same response contrast that with ready mode where we triage which means we prioritize by degree of urgency this isn't just a nice way to get your to-do list done work by dr. Robert Sapolsky shows that individuals who cannot differentiate threat from non threat and react to everything with the same response have double the level of stress hormones which is why this is the first skill to learn so come with me back into that night in the ER the ambulances start rolling in you can't take care of them all at once but you don't have to because we triage red immediately life-threatening yellow serious but not immediately life-threatening green minor and we focus our efforts first on the Reds now here this part of the problem in crazy mode is that you are reacting to everything as if it is red so start by triaging correctly no your Reds there what is most important and where you can most move the needle now it's easy to be confused by noise but what is noisiest is not always what is most red in fact my severe asthmatic patient is most at risk when he's quiet but my patient over here demanding that I bring her flavored coffee creamer she's noisy but she's not red I'll give you an example from my own life last spring my house flooded my one year old was in the ER I was supposed to do a fundraiser for my four year old school and the final chapter of my book was beyond late maybe not ironically that was the chapter on stress my red tasks were getting my one-year-old better and finishing my book that was it remember relentlessly triage the house flood repair well once we had stopped and stabilized the damage it was no longer a red it felt red but it was in fact just a noise no no really it was quite noisy this picture on the far right is me wearing earplugs to focus on my book while the floor is being mechanically dried around me no your reds and do not let your non Reds distract you from them by the way it is liberating with a green task to every once in a while be able to remind yourself that's a green task no one's gonna die it's okay if it's not perfect now there's one last triage level that we use in the worst scenarios and that is black those patients for whom there's nothing we can do what we must move on and although it is gut-wrenching I mention it because you each have your own equivalent black tasks in your life these are items that you must take off your list I think many of you know what I'm talking about for me this was the fundraiser I had to step down because as we in the ER know if you try to do everything you have no hope of saving your Reds step two to go from crazy mode and to ready mode is to expect and design for crazy half of handling crazy is how you prepare for it so step one we tree step2 we designed to make those tasks easier to do come with me back into the ER that night at the highway accident several of those patients needed blood now transfusing blood can be life-saving but transfusing the wrong type can be deadly so to protect for that we have stringent processes you decide to transfuse order labs for blood type a dozen other decisions in about an hour later you can start the transfusion who thinks that in an emergency trauma there's not time for any of that so we design for it you see there's one type of blood that you can safely give to everybody type o-negative universal donor so every ER trauma Bay has a refrigerator and it has one thing in it type o-negative blood so in scenarios like these you decide to transfuse and can immediately start one simple design change saving time and dozens of decisions because you see in the ER we don't plan for if crazy happens we plan for when crazy happens not if I need to transfuse emergently but when because if you're ready for crazy then it isn't in fact crazy is it science shows us that the more options we have then the longer each decision takes and the more decisions we have to make them the more exhausted our brain gets and the less it is capable of making good decisions which is why this step two is about finding ways to reduce your daily decisions here are four easy examples you can use in your daily lifestyle plan plan your entire week's meals on the weekend so that when it's Wednesday at 6 p.m. and everyone's hangry and requesting pizza you have no decisions to make to get a healthy meal on the table automate never leave anything to remember that you could automate whether it's scheduling it as recurring or saved lists or recurrent purchases co-locate when it comes to extra I store all the equipment that you need for a certain activity together charged and ready so you don't spend energy looking for it and decrease temptations for anyone driven by sugar cravings anyone say I go ahead that itself is its own form of crazy mode and self medication for crazy mode but stop working your willpower design differently if a food is out of immediate reach such that you have to use a stool to reach it even when it's chocolate study participants ate 70% less without thinking about it I know let that sit for a second designed to make the choices you wish to make easier now let's finish this story what happened to that Highway accident in those patients some went to the operating room some went to the ICU but despite the sudden influx of all of those patients due to the systems like these everybody was able to get the treatment they needed and everyone made it to Thanksgiving which brings us to the third step to go from crazy mode to ready mode and that is to get out of your head come with me different story I'm working in a small satellite ER when a woman comes in in labor I realized that the cord is wrapped not once but twice around the baby's neck and I'm the only doctor I was scared but I couldn't let it derail me because you see we all get nervous we all get scared but it's what you do next that matters that first feeling isn't the problem it can be an important sign the problem comes we let it derail us when that internal monologue starts and we catastrophize and we start to get that tunnel vision that's how you think when you're in crazy mode and you cannot solve anything that way now I promise to come back to this story but first how do I get out of my own head there are many tactics that you may hear but for me I find it best in the moment to actively put my focus on someone else to deliberately make myself see the person in front of me see myself in the arena with them what do they need what do they fear and how can I help this may sound like a whole lot of warm and fuzzy to you but it's not in fact research shows that when you prime your brain with what is essentially compassion we disrupt that tunnel vision and internal monologue you widen your perception so your brain can actually take in broader information so you see more possibilities and can make better decisions try it know that your internal monologue can derail you and realize that when you get out of your own head you get out of your own way now what happened to that baby I focus not on my fear but on the mother and the baby and what they needed me to do got the cord off of the baby's neck and a healthy screaming kicking baby arrived just as a dad ran in from the parking lot hi you have a son I'm dr. Daria congratulations you want to cut the cord and for a moment the strong cries of a newborn drowned out the beeps and the sirens that are the normal sounds of the ER but there was also something else because when I walked back out of that mother's room I saw several of my other patients hovering nearby I suddenly realized that despite their own problems that had brought them to the emergency room they had all come together to root for this baby and they now together share in the joy because that is what happens when you go from crazy mode to ready mode others notice they want it to they just don't know how they just need one example which could be you own the busy but stop calling it crazy you've always had that ability but now you're ready thank you [Applause] [Music]

Channel: TEDx Talks

Views: 98,892

Rating: 4.9299126 out of 5

Keywords: TEDxTalks, English, Social Science, Brain, Life Hack, Personal growth, Psychology, Self improvement, Society

Id: Fe1z22_Qd9E

Length: 14min 7sec (847 seconds)

Published: Tue Dec 17 2019