Ep 162 Managing Adversity with Walter Himmel

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.

7 Habits of Highly Effective People. Stephen Covey

Emotional Intelligence. Daniel Goleman

Truth has many faces that must be understood in order to manage adversity

Opposites can be concurrently true.

“The test of a first-rate intelligence is the ability to hold two opposed ideas in mind at the same time and still retain the ability to function.”

- F. Scott Fitzgerald.

There are two essential fundamental truths in EM and in life:

(i) Intellectual: look at the facts and consider the truths that they bear out.

(ii) Moral: love is wise and hatred is foolish. We must learn to live together or we shall certainly die together (I suggest option one).

Bertrand Russell Message to Future Generations

https://www.youtube.com/watch?v=ihaB8AFOhZo

Think probabilistically in medicine and life. Diagnostic decision-making is not a simple binary yes or no.

Emergency Medicine Decision Making: Critical Choices in Chaotic Environments. 2006. Weingart, Scott and Wyer, Peter

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.

Antifragility is a more useful concept than resilie...