Inside the Emergency

Each Shot of Satisfaction is related to one of the seven steps back from burnout in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on your journey to a fulfilling life of caregiving.

Originally published August 10, 2011 – This Shot of Satisfaction relates to Step 6 -CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with this same person or situation. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.


When we step inside the life or death emergency, we simultaneously have full command and access to the consciousness of our right brain and our left brain . We are fully connected through the activation of our desire to care for another. – Dr. Frank

In the Emergency

In my ongoing quest to help us all become more satisfied care givers, I was inspired by a recent TED talk with Dr. Jill Bolte Taylor. Dr. Taylor is a Neuroanatomist, who had a “stroke of insight” when she experienced bleeding in her brain. Take a look at her fascinating lecture here: Dr. Taylor Ted Talk

Dr. Taylor shows us how the right hemisphere of our brain is focused on the present moment – the right here and right now. Our right brain thinks in pictures. Information, in the form of energy, streams in simultaneously through all of our senses – sight, hearing, smell, taste and touch. Once inside the right brain, this sensual information explodes into an enormous collage of what our present moment looks like, sounds like, smells like, tastes like and feels like.

Our experience of reality, if we go by our right brain, is that we are an energy being connected to the energy all around us. We have a sense of connection to one another through the viewfinder of our right hemispheres as one large human family. In the “right here, right now,” we are all brothers and sisters on this planet, here to make the world a better place. In this present moment we are perfect.  We are whole.  We are beautiful.

Dr. Taylor goes on to tell us that our left brain is an entirely different place, where we think linearly and methodically. Our left brain is concerned with the past and the future. Our left brain is designed to take that enormous collage of sensual information from our present moment and begin separating and categorizing it, organizing and re-organizing details upon details upon details. Our left brain then associates all of this information with everything we’ve ever learned in the past and projects it into our future.

Our left brain thinks in language. Our left brain is that ongoing chatter inside our heads that connects me and my internal world, to my external world. It’s that little voice that says to me, “Hey, you gotta remember to pick up bananas on your way home so you can eat them in the morning.” It is that calculating intelligence that reminds me when I have to do my laundry. But most importantly, it is that little voice that tells me, “I am.”

As soon as our left brain says to me “I am,” I become separate (from you). I become a single solid individual detached from the energy flow around me. It is our right brain that is responsible for the experience of unity and our left brain that is responsible for our experience of individuality.

Engaged care

I’m always saying that humans are hard-wired to care and I am not making it up. Caring actually makes us feel good. All of us who work in the Emergency Department are here for the Lazarus moment – when someone comes to us nearly dead in the midst of having a heart attack or drowning in their own fluids in congestive heart failure or pulmonary edema. We thrive when we take care of patients who have been shot or stabbed. We love we are faced with and are able to defeat the Angel of Death. Why?

Have you ever noticed that when we step inside a “real” emergency, everyone knows his or her role and position on the team? We know where everything is, even equipment we have not seen in months. We act as a team, as one single organism. We become a hero working within a group of heroes. We experience flawless teamwork. We seamlessly anticipate each other’s needs and fulfill them. Our desire to care and make a difference is fully engaged and we all act in unison on that desire. We feel connected to something larger than us. We find meaning, significance and purpose in ordinary and simple tasks like starting the IV or pushing the medicine.

For me personally, when I step inside the emergency, I become aware of everything that is happening simultaneously. I can track six conversations at once. I can think through it all, assimilate it all, handle it all, knowing exactly what needs to happen next. It is as if I step through some doorway into a zone where I lose my ordinary self, and can see, hear and feel everything going on around me. I know you have experienced this for yourselves whenever you have stepped inside the emergency to save another’s life, no matter what position on the team you hold. This is where our care for others causes our entire brain to light up. This is where caring for others gives us full access to the totality of our own experience of humanity.

When we step inside the life or death emergency, we simultaneously have full command and access to the consciousness of our right brain (unity and sensuality) and our left brain (language and calculation). We are fully connected through the activation of our desire to care for another. We naturally move through the energies of full presence, connection, empathy and compassion. And if that does not feel good, if that is not miraculous, if that is not larger than ordinary life, if that is not heroic, if that does not contain intense pleasure, meaning, purpose and significance, well, I don’t know what does. This is why we love emergency medicine. This is why we became nurses, doctors, and medics. This is why we work in the hospital. This is why we crave this sort of satisfaction, and this is why the only way we can feel this good is to lose ourselves in the care for another.

Get your copy of "Back from Burnout: Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care" at amazon.com

Get your copy of “Back from Burnout: Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care” at amazon.com

In order for us to find this kind of satisfaction in all our patient encounters, especially those mundane moments, we have to consciously connect to our desire to care and make a difference for every patient.  When we are dealing with the everyday challenges of patient care that push our reactive buttons, we need to exercise the power of our free will and consciously choose to give True Care.  By injecting True Care into ALL of our patient encounters, we can transform even the most mundane into miraculous events.

TAKE ACTION

In order for us to find this kind of satisfaction in all our patient encounters, especially those mundane moments, we have to consciously connect to our desire to care and make a difference for every patient.  When we are dealing with the everyday challenges of patient care that push our reactive buttons, we need to exercise the power of our free will and consciously choose to give TRUEcare.  By injecting TRUEcare into ALL of our patient encounters, we can transform even the most mundane into miraculous events.

Best ever,
Dr. Frank

 

I Am Because We Are

SOS CLASSIC - In Gratitude

“Sometimes, if I have the time, I will just sit with these people and hold their hands and try to make them laugh, try to help them forget about their problems for a little while. Sometimes that’s the only medicine we have to offer them.” – Lois Silo

Each Shot of Satisfaction is related to one of the seven steps in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on your journey to a fulfilling life of caregiving.

Step 6 – CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with this same person or situation. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.

Originally published June 8th, 2011

“One of the sayings in our country is Ubuntu – the essence of being human…We think of ourselves far too frequently as just individuals, separated from one another, whereas you are connected and what you do affects the whole world. When you do well, it spreads out; it is for the whole of humanity.”  –Bishop Desmond Tutu

Ubuntu: A South African philosophy roughly translated as,
I am what I am because of who we all are.

Dear Doctor Frank,

I wanted to share with you a recent experience I had on a trip to Malawi, Africa. I was there on a research project and was hosted by the people from a non-profit called Raising Malawi. They are an American organization that is doing amazing work with the country’s poor and their more than one million orphaned children.

Despite its overwhelming poverty, Malawi is considered “the warm heart of Africa,” and to this I can attest.  We were welcomed everywhere with smiles and open arms. I have never experienced a population with more love and appreciation for life’s simplest gifts. To many Malawians, if the sun is shining, they have a little food in their bellies, and a hand to hold; they consider it a good day. They are unconcerned with their petty differences and regularly work together to help one another.  They share in each other’s difficulties and rejoice in their blessings.

I was thinking a lot of you Frank, on one of the tougher days we had there… We visited many of the sites around the country that are supported by Raising Malawi. One of them was a sort of urgent care clinic that was built at the center of several densely populated villages, about 20 kilometers from the nearest hospital. Because many of the villagers are quite poor, they don’t have cars or even access to any kind of public transportation. So they must travel by bicycle or simply use their own two feet if they need medical care–not a great situation when they are sick or injured or eight months pregnant and need to get to the hospital.  This facility tends to the ongoing needs of the villagers who mostly suffer from malaria and pneumonia and HIV-related illnesses. Patients are expected to pay a small fee for each visit, but many of them cannot afford the 50 Kwacha (about 27 cents in American money). Still, no one is ever turned away for lack of funds. When we arrived one steaming hot afternoon, there were about three-dozen men and women sitting quietly and patiently in the waiting area. In a country known for its warm smiles, these folks looked uncharacteristically grim, yet not one of them complained about the hours-long wait. Inside we were greeted by Lydia, the head nurse, a sharp-looking Malawian woman in her forties whose crisp white uniform barely masked her unmistakable sense of weariness and stress. I asked Lydia how many patients she sees each week. She said they see on average about 150 per day, five days a week, beginning at 5am and ending about 12 hours later. I asked her how many other nurses and doctors worked there. She looked down and her voice cracked as she spoke, “Just myself and two technicians.”

Lydia gave us a tour of the rest of the facility and we met the volunteers who work in the makeshift pharmacy. On good days, they are able to give prescription medicine to most of their patients in need. But many days, they simply don’t have the supplies necessary and must send the patients away with nothing. I asked Lois Silo – one of the amazing women who run Raising Malawi and is on the front lines every day – how they maintain hope when things often seem so overwhelmingly bleak. Her answer made us both cry. “Sometimes, if I have the time, I will just sit with these people and hold their hands and try to make them laugh, try to help them forget about their problems for a little while. Sometimes that’s the only medicine we have to offer them.” In a country where the life expectancy is about 45 years, these people are grateful for whatever care they receive.

Before we left, we visited with some of the 200 or so people who had gathered on the lawn in the afternoon sun in the hopes of getting a free mosquito net from Unicef that day.  But when the truck failed to show up, many of them left on foot. I suddenly felt embarrassed that we were traveling in an air-conditioned car. But as we passed the villagers on the dusty road, they all stopped, smiled and waved. Some of them shouted “zikomo” – Chichewa for “thank you.” I asked Lois why they would thank us, and she said they probably assumed we had come to help. I wished I could have helped each one of them that day. I remembered all your Shots of Satisfaction where you expressed to your fellow caregivers that sometimes all it takes to make a difference is to feel the pain of another and not try to fix it or to quickly write a prescription, but just to sit with them, cry with them and understand them. I know many of those people didn’t come to the facility that day expecting medicine they knew was likely not there. They just came to have their hand held and to get a smile or a hug and to know that someone truly cared. I know each of them left with something.

I’ve attached a photo of Nurse Lydia and Lois, as well as some of the people who were waiting for care that afternoon. I hope we can remember these Healthcare Heroes in our prayers and send them some much-needed love. I feel blessed to have had this experience and I feel so much gratitude for all my own blessings. Throughout the journey I kept thinking of the old maxim, “To whom much is given, much is expected.”  Indeed, we all have a lot of work to do!

With so much love,

Michael Seligman

Nurse Lydia with Lois Silo

Nurse Lydia with Lois Silo. Malawi 2011

Raising Malawi Clinic

Raising Malawi Clinic

I am what I am because of who we all are.  Now go care, make a difference and change (y)our world.

All my best,

Signature

Frank D. Gabrin, D.O

Get your copy of “Back from Burnout: Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care” at amazon.com

 

You Can Change Everything

SOS CLASSIC You can change everything

The amount of effort we exert to overcome our human nature and look for the good is directly proportional to the amount of goodness we will create for ourselves, our patients, our hospitals, and our communities. — SOS Classics are reprints of Shot’s of Satisfaction that Dr. Frank Gabrin shared as he wrote his works Back from Burnout, Care 101 and Booster Shots. Each shot contains a glimpse of Dr. Franks personal journey back from burnout.

Step 4 – CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with this same person or situation. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.

 

Originally published April 13th, 2011 (edited)

If You Get This, You Really Can Change Everything!

Every day, in every situation, problem or circumstance, there is both good and bad, light and darkness.  It’s up to us to choose what we want to see. We can view our environment as though we were tourists, everything seems so charming when we are tourists.  Or we can view our surroundings like a spy, looking to see what’s wrong and searching for dirt.

The famous book, “The Secret,” taught us that opposites don’t attract, rather like attracts like. So when we see and speak the bad by complaining and trash talking, we attract the bad right to us. We actually are making things worse for ourselves.  Unfortunately, focusing on the bad is an automatic process. It’s human nature.  It’s what we do unconsciously. That’s why we are surprised when we find ourselves miserable and in pain and suffering. We don’t see how we are creating our own hell and what, if anything, we can do about it.

What the book, “The Secret,” fails to teach us is that if we want to attract the good, we have to make an effort to overcome our human nature to see the bad. We need to make an effort to see the good in every situation. Once we see the good, then it will be easier to speak the good, do the good, and attract goodness. This process of attracting good requires us to recognize our unconscious, automatic behaviour and step outside our robotic ways.

My personal hero, Albert Einstein, would have been able to help poor Justin Timberlake find his way again. There is a principle in quantum physics that has long fascinated philosophers and physicists alike. It states that through the act of watching, the observer affects what is being observed. Although Einstein was not able to prove this in his lifetime, researchers at the Weizmann Institute of Science have credibly documented its validity. Their experiment, reported in the February 26 issue of Nature (vol. 391, pp. 871-874), showed that what the observer believes will happen actually influences what happens.

In the field of social sciences, we have learned the same thing. The term, the “Observer’s Paradox” was coined by William Labov.  This concept essentially demonstrates that we will see what we expect to see.

When we expect to see the bad, we connect to the bad, and we live the bad day that ultimately leads us to more chaos. But when we look for the good and do the work of injecting positivity, appreciation and enthusiasm into every action, then we live the good day. We are incredibly powerful. Whether we are aware of it or not, we are creating our reality every day, moment to moment.  We are responsible for our experience. No one else.

There is no bargaining with the laws of the quantum world. You can be the cause, or you can be the effect. When we allow our unconscious behavior to rule our day, we will experience its effects. But if we do the challenging work of looking for the good, we take control and can become the cause. This is how we become a much happier, self-actualized, and powerful person. This is how we can feel good about ourselves and the world we live in.  This is how we become the kind of person those around you aspire to be and to be around.

The amount of effort we exert to overcome our human nature and look for the good is directly proportional to the amount of goodness we will create for ourselves, our patients, our hospitals, and our communities. This is real, lasting, quantum satisfaction.

It’s springtime. This is a spiritual time for all of us, a time for renewal, rebirth, rejuvenation and freedom.  During this time, I would like to invite you to live the words of Mother Teresa, it may not be easy, but do it anyway.

People are often unreasonable, irrational and self-centered.

Forgive them anyway.

If you are kind, people may accuse you of selfish, ulterior motives.

Be kind anyway.

If you are successful, you will win some unfaithful friends and some genuine enemies.

Succeed anyway.

If you are honest and sincere, people may deceive you.

Be honest and sincere anyway.

What you spend years creating, others could destroy overnight.

Create anyway.

If you find serenity and happiness, some may be jealous.

Be happy anyway.

The good you do today, will often be forgotten.

Do good anyway.

Give the best you have, and it will never be enough.

Give your best anyway.

In the final analysis, it is between you and God.

It was never between you and them anyway.

TAKE ACTION

Make a quantum leap today. Your perception creates your reality. Choose to see only the good. Be the cause of a new and better reality.

Do it because you care, because you want to be the cause of your own satisfaction, because you don’t want to lose your way, because you want to help, to care, to make a difference, change the world and save the day!

All the best,

Signature

Frank D. Gabrin, D.O

Get your copy of “Back from Burnout: Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care” at amazon.com

 

You Amaze Me

SOS CLASSIC You Amaze Me

We often take for granted our talent, our training, our dexterity, our quick thinking, and our treatment of others with compassion and human dignity. We all need to know how lucky we are to work with each other and to do what we do. — SOS Classics are reprints of Shot’s of Satisfaction that Dr. Frank Gabrin shared as he wrote his works Back from Burnout, Care 101 and Booster Shots. Each shot contains a glimpse of Dr. Franks personal journey back from burnout.

Each Shot of Satisfaction is related to one of the seven steps in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on your journey to a fulfilling life of caregiving.

Step 4 – CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with this same person or situation. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.

 

Originally published April 6th, 2011 (edited)

You Amaze Me

This week I was witness to a moment that took my breath away. It was a powerful experience, yet seemed to pass unnoticed by everyone else. I was in an exam room with a patient when the loudspeaker barked, “Dr. Gabrin, Room 4 – immediately.” I took off and arrived to find a colleague attending to a 10-month old boy in dire straits.

Hours before, this healthy baby was out to dinner with his parents – a nice, young couple. At the restaurant, the dad noticed his son was breathless and turning blue. Right away, another patron stepped out of his ordinary role and gave the child CPR; no equipment, just bare hands and mouth-to-mouth. The 911 team arrived quickly and efficiently got the child to the hospital.

When I got to the boy, our nurses were starting an I.V. while my colleague examined him.  Anesthesia was on their way and soon a working diagnosis emerged. Before long, the child was on full life support and in a helicopter on his way to the closest tertiary care pediatric center. Last I checked, it looks like the little boy will leave the hospital completely normal. Another life saved. Score one for the miracle of modern medicine!

It took a group of individual souls working together to rescue this child. From the hero in the restaurant to the medics, nurses, doctors, pilots, flight physicians and the folks at the pediatric hospital, I can easily count two dozen or more. As I witnessed our staff in action – their concentration, compassion, empathy, technical skill – and the way they talked with the parents and grandparents, I was overwhelmed with emotion. While I only played a supportive role, it occurred to me that if this were my case I might not have noticed all the truly extraordinary healthcare heroes who did not notice themselves.

I asked some of the staff after I made the dreaded call to the tertiary pediatric center (“Is the baby, okay?”) if they realized what just happened. I wanted to know if they were aware of the miracle that occurred. I wanted to know if anyone else noticed how we all worked in unison, each doing their part to help, to heal, to console, to comfort, and to truly care.  Most of them did not notice. To them, it was all just another day in the ER.

I applaud their humility. But we all need to know how amazing we really are. We often take for granted our talent, our training, our dexterity, our quick thinking, and our treatment of others with compassion and human dignity. We all need to know how lucky we are to work with each other and to do what we do.

TAKE ACTION

Stop and take notice. Acknowledge the good you see others do. Congratulate each other. Tell your co-workers how proud you are to work alongside them. You are the individuals who make miracles happen every day.

Take that thought in for just a second.  It will give you the strength to get back to caring, to making a difference and changing the world one patient encounter at a time. You are the unsung modern heroes of healthcare.  I am blessed to walk among you.

All the best,

Signature

Frank D. Gabrin, D.O

Get your copy of “Back from Burnout: Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care” at amazon.com

Getting It

SOS CLASSIC Getting It

Remember that there is a precious gift in every fleeting moment, which is why we call it the “present.” Don’t let your time slip into the future – get, stay and be, PRESENT so that you can fly like an eagle! — SOS Classics are reprints of Shot’s of Satisfaction that Dr. Frank Gabrin shared as he wrote his works Back from Burnout, Care 101 and Booster Shots. Each shot contains a glimpse of Dr. Franks personal journey back from burnout. Find out more at clear2care.com.

Each Shot of Satisfaction is related to one of the seven steps in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on your journey to a fulfilling life of caregiving.

Step 4 – CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with this same person or situation. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.

Originally published March 3, 2011 (edited)

 My Cousin “It!”

A few years ago, I learned a very important lesson from my friend Carmen. She was a charge nurse who I really loved to work with. When under pressure, she would always look at me and say, “Focus on ME.” You might think, “Wow, how selfish!” But she said it to remind me that “it” was about being present. “It” was about her needs as the charge nurse, which was really thinking of the needs of all the patients and staff in our department.

I know now that some of the things that I am most sorry for, or wish I had never said or done, happened when I “lost it” – when I stopped being present and began to feel overwhelmed. It was usually at this point, in any busy shift, that I would shoot Carmen a look and remind her that her “needs” were responsible for inviting my two extremely irritating friends into our Emergency Department – JASO (“Just A Smidge Overwhelmed”) and TFO (“Totally Freakin’ Overwhelmed”).

I realized something new and something very powerful while attending a patient’s bedside this week. This patient just wasn’t “getting it.” Despite my attempts to “explain it” she still didn’t “get it.” She was disruptive, argumentative and intoxicated. I found myself getting irritated and angry to the point of frustration and I “lost it!” Now I am mortified, humiliated and embarrassed and I won’t be able to “forget it,” but in that moment of losing it, I was truly overwhelmed. What I learned is that the reason I was so overwhelmed is because I wasn’t in the present moment. I was somewhere else entirely. I was not present with my patient. My head was focused on the past and on the future.

What stops us from being able to be present, in each and every moment of our lives, is our fears and concerns about something that already happened, or something we think may happen. In my case, the department was really busy and the acuity was high. I was the only physician and the magic 3:00 a.m. hour was nearing and staffing would drop down to only 3 nurses, a secretary and me. The department was already 8 patients beyond capacity, and I was wondering how in the world I was going to be able to fix it.

My mind was going from in the past, “God, I wish I’d worked harder in the beginning of the shift so that some of these patients would already be on their way,” to the future thinking, “How am I ever going to be able to care for all of these people and get them what they need?” I was not in that moment present with my patient. This is what placed me in a state of being overwhelmed… and I that is why I “lost it!”

The garbage that erupted in the ED when I exploded was intense and messy. “It” affects not only me, but everyone around me. So when I ask myself, “How can I change so that I have the capacity to change things for others?” The answer is simple: “GET PRESENT, and then everyone will GET IT!”

TAKE ACTION

Remember that there is a precious gift in every fleeting moment, which is why we call it the “present.” Don’t let your time slip into the future – get, stay and be, PRESENT so that you can fly like an eagle!

With humility and respect,

Signature

Frank D. Gabrin, D.O

Get your copy of “Back from Burnout: Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care” at amazon.com

 

 

SOS Classic – Happy Giving of Thanks

SOS Classics are reprints of Shot’s of Satisfaction that Dr. Frank Gabrin shared as he wrote his works Back from Burnout, Care 101 and Booster Shots. Each shot contains a glimpse of Dr. Frank’s personal journey back from burnout.

Originally published November 24th, 2010

Shot of Satisfaction Classic

Each Shot of Satisfaction is related to one of the seven steps in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on your journey to a fulfilling life of caregiving.

Step 6 – CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with the same situation or person. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.

 

Happy Giving of Thanks

Let’s face it – Thanksgiving can be an awful time for us Health Care Hero types… Thursday night, the floodgates will open and we will go non-stop until Monday. Folks will eat too much and use too much salt. Grandpa will retain fluid and Grandma will have trouble breathing. Some will come to us looking for a note so they can call in sick. Others will drink too much and cause a family feud in their living rooms. The homeless will come to us cold and hungry.

We will be expected to work long shifts and deal with patients who may appear to be milking the system… Many of the patients who arrive for care will have psycho-social difficulties. Many are not as functional as you or me. Some are homeless, uneducated, alcoholic, addicts… Still, none of them will get up in the morning and say, “I will do less than I am capable of today.” Believe it or not, they are doing their best. So how do we do our best in a terribly challenging scenario?

Cause or effect?

Please allow me to share a true story with you. ~ A 23-year old woman was presented to the ED via ambulance complaining of chest pain. Upon arrival, the patient denied experiencing chest pain and stated that her “real” complaint was a toothache and she wanted a refill on her Percocet. She had already seen a dentist 2 weeks prior, who referred her to an oral surgeon for wisdom tooth extraction. She never made the appointment. When asked why she called an ambulance for an existing toothache, she replied: “I can call the ambulance anytime I want – my Medicaid will pay for it.”

Instead of treating the patient kindly and quickly, the normally mild-mannered ER doc exploded and began lecturing the patient on the proper use of EMS. The patient began to cry and called her family, who in turn made threats of violence to the physician, who countered with her own threats of violence. The Police department got involved, as did the hospital administrator and medical doctors. The doctor was instructed to help the patient however possible to avoid negative press. The patient the left the ER with Tylenol and a prescription for amoxicillin.

Did this physician create satisfaction for herself and her patient? Was she the cause of a new and better reality for everyone involved?  Or was she the effect of her patient and a broken system?

Be the change

What this physician automatically reacted to, rather than consciously respond to, was the patient’s sense of entitlement. But if she had taken a closer look within herself, she would have seen the same sense of entitlement existed within her. She would have seen that she felt entitled to only take care of “real emergencies” and to be treated with respect because she is a doctor.

At the end of the day, the only thing this physician experienced with her unchecked reaction was more pain, more suffering, and more chaos. When we react in this way we are the effect and not the cause. But this does not have to be our reality. We are health care heroes and we are capable of doing the impossible and creating miracles. If we want to create our own satisfaction, we need to consciously activate our free will and make a change.

TAKE ACTION

This Thanksgiving weekend, when you find yourself pushed to your limits and about to explode, please stop. See the helpless person in front of you – suffering and in pain. Know that they are doing their best. See your own reflection within their sense of entitlement. Then consciously do YOUR best. GIVE. TRUE. CARE.

Make a difference and create satisfaction for your patient and yourself.  Your reality depends on it.

All the best (thoughts)!

Signature

Frank D. Gabrin, D.O

Back from Burnout:  Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care

Get your copy today at amazon.com
Get your copy today at amazon.com

 

SOS Classic – Your Inner Child

SOS Classics are reprints of Shot’s of Satisfaction that Dr. Frank Gabrin shared as he wrote his works Back from Burnout, Care 101 and Booster Shots. Each shot contains a glimpse of Dr. Frank’s personal journey back from burnout.

Originally published November 9th, 2011

Shot of Satisfaction Classic

Each Shot of Satisfaction is related to one of the seven steps in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on your journey to a fulfilling life of caregiving.

Step 6 – CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with the same situation or person. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.

 

Connecting with your inner child again is not always a good thing!

Let’s be honest.  We are all slaves to our inner child.  Push the wrong button and we react just like we did when we were 3 years old.  The fact is, we will remain slaves to this reactive nature unless we become cognizant of what is going on inside us at the cellular level.  At every moment, in the pre-frontal cortex of our brain, all sorts of automatic neurochemical reactions are happening unconsciously, instinctually and involuntarily.  We can’t help it.

But today is the day you get the tool that allows you to escape your outdated, automatic reactive physiology.  That tool is the “TIME OUT.”  Let me explain…

Overcoming our reactions

The pre-frontal cortex is the most thoughtful, feeling part of our brain.  It controls the functions of forethought, judgment, impulse control, organization, planning, learning from past choices and past mis-steps, empathy, compassion and insight.  Many refer to this lobe of our neuroanatomy as “The Executive,” because it acts like the Boss.  It is the place where decisions and choices are made.

Animals do not have the capacity to overcome their physiologic, automatic, instinctual reactions to stimuli in their environment because they do not have much, if any, pre-frontal cortex.  But thanks to our pre-frontal cortex – which makes up about 30% of our brain – humans have the unique power of Free Will.  We have the ability to overcome our automatic reaction to stimuli in our environment and interrupt our animal-like reactions.

The secret is to become aware of our impulsive, habitual, robotic, reactive-like impulse and interrupt it.  Then we can exercise our innate power and choose to think, say, or do something different.

Mind over matter

Dr. Daniel Amen, a neurologist who is considered an expert in the clinical interpretation of brain imaging in modern science today, tells us that the pre-frontal cortex is also where our conscience resides.  (It’s interesting that the word “con-science” means to go against physiology.)  Dr. Amen believes that this is the place where our brain’s cellular physiology and neurochemistry intersect with the thoughts in our mind.  In other words, this is the intersection of our mind-body connection.  Here, the thoughts in our mind affect the grey matter in our brain, which is where the popular saying, “MIND OVER MATTER” comes from.

When Dr. Amen looked at the brain scans of individuals who have problems in their pre-frontal cortex, he noted that they have short attention spans and are easily distracted.  These individuals are not able to make good judgments.  They are poor planners and do not have the capacity to learn from their past mistakes.

These individuals also have deficits of dopamine, the “feel good” neurotransmitter involved in the experience of pleasure and reward.  They are constantly looking for the next feel good experience to generate some more dopamine for their ailing system.  Some would call them pleasure seekers.  Their out-of-control, reactive inner child constantly holds them hostage.

Choosing to feel good

What we learn from these individuals with deficits in their pre-frontal cortex is that, if they can interrupt the automatic process, they can inject a new thought and make a conscious choice to act differently and thus generate a positive way to feel good.  This is the science of behavior modification.

In this sophisticated symphony of neurochemistry, one thing is clear:  What we think matters.  Positive thoughts make us feel good.  Negative thoughts bring us down.  By interrupting our brain’s automatic response system (our physiology) with our thoughts (our cognizance or consciousness) we can make the choice to feel good by taking control and injecting positive thoughts.  Through this process we become the cause of our good feelings, rather than the effect of people or situations in our environment.

TAKE ACTION

Today, exercise your innate power of choice, your Free Will.  Pay attention to the thoughts that make you feel bad.  Interrupt that thought and inject a new thought that makes you feel good.

Use the “TIME OUT” tool to hijack your automatic, habitual, instinctual reaction.

  1. Become aware when something or someone activates your automatic physiologic reaction.  (When you get your buttons pushed.)
  2. STOP:  Realize that the problem is not the problem.  It is your automatic reaction to the situation that is the real problem.  We may be “hurt” or “angry” — but needing to be “right” only prevents us from finding a creative solution and coming up with a thinking-feeling response that has the power to change the situation and make everything better.
  3. Identify your reactive thoughts/feelings and make the choice to inject a new, positive thought that will empower you to be the cause of something better.
  4. Finally, speak or act from this peace of mind consciousness where you inject new energy that allows you to get what you really need, rather than what your impulsive inner child wants right now.

All the best (thoughts)!

Signature

Frank D. Gabrin, D.O

Back from Burnout:  Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care

Get your copy today at amazon.com
Get your copy today at amazon.com

SOS Classic – Going Up!

SOS Classics are reprints of Shot’s of Satisfaction that Dr. Frank Gabrin shared as he wrote his works Back from Burnout, Care 101 and Booster Shots. Each shot contains a glimpse of Dr. Frank’s personal journey back from burnout.

Originally published January 11th, 2012

Shot of Satisfaction Classic

Each Shot of Satisfaction is related to one of the seven steps in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on your journey to a fulfilling life of caregiving.

Step 6 – CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with the same situation or person. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.

Going up

Every day, in every situation, we are given the opportunity to choose happiness. The secret to choosing happiness, in work and in life, lies in our conscious choice to invest our energy into the process, rather than to have our happiness dependent on the outcome. The idea is that it’s not whether we win or lose, but how we play the game.

In every choice we make to say something or do something, one of two things happens: We either gain energy or we lose it. When we make a positive choice, we gain energy and we feel empowered. When we pick the salad instead of the burger, when we go the gym instead of lying on the couch, we feel like we’ve won. We beat our laziness. We win each battle by injecting energy and effort into the process of choice. By thinking and behaving in this way, we gain even more power to make positive choices for ourselves, to make better decisions, to make the right move when another challenging situation occurs.

As we invest more effort into the process of making better choices, our next steps become clearer. We are able to see where we need to go in terms of our health, our relationships, family, community, business, finance, and even in our spirituality. With each positive choice, we gain confidence in ourselves and we feel a sense of accomplishment. We start to feel more resilient and self-assured. We feel like we are on top of our game, on top of the world.

Going down

When we go the other way, when we choose the burger instead of the salad, we lose energy and we feel lazy. We lose our motivation to get off the couch and get to the gym. We reach for a beer to relax and the next thing we know, it’s late the next morning and start the day already feeling defeated. Our energy spirals downward. We feel disappointed in ourselves; we feel we have lost something. We become unmotivated, vulnerable and fragile. We start settling for less. We feel like we are just holding on, just getting by. The smallest amount of chaos or challenge can completely overwhelm and defeat us. One negative choice can snowball into depression and, in extreme cases, despair.

A friend of mine used to always tell me that life is like a downward escalator. Think of what it would be like to be traveling upward on an escalator that was going down. You would have to constantly be injecting more energy, or exerting more effort, to overcome the downward motion of the escalator to actually get to the next level. The minute you stop exerting yourself, the escalator will carry you down to the bottom.

The energy of life

Life is the same way. We can only get to the top if we inject more energy into the situations we encounter in our everyday lives. Murphy’s law, and the quantum mechanics involved in thermodynamics, tells us that our lives will be disorganized and chaotic unless we continually inject energy into the system.

Universal law says that if we want more order in our life (less chaos) we must invest more energy into our life. We only get more out of life if we are willing to invest this energy by putting more effort into making better, more positive, pro-active choices. There is a caveat, however: We can never be attached to the outcome.

Happiness lies in the process

Our investment and our focus have to be in and on the process. When we live this way, our outcomes will be incredible. Our lasting satisfaction and happiness comes from our investment in the process, in our life, and in our effort of putting our energy into the caring of our selves and others and thereby making a difference. Our happiness lies in each step of the process towards losing the weight, saving the money, lifting the weights, or going after the girl.

Our happiness cannot be dependent on the goal (when we lose weight, when we have money, when we get the girl). It must be on the process, the work or the effort. Only when we have happiness and joy within the process of going after something, will the things we want finally show up in our lives.

TAKE ACTION

Throw in the white towel. Surrender to the fact that even though there are no free lunches, no get-rich-quick schemes and no easy-way-outs, you have the power to choose your happiness right here, right now. We all want more out of our lives. The energy we need to inject into our lives to get it is none other than the energy of “life” itself.

We can be extraordinary people living extraordinary lives if, and only if, we are willing to choose to do the work. To exert the extra energy into each and every choice, or situation, we routinely encounter in everyday “life” to overcome the destructive forces of entropy, chaos or disorganization and overpower the constant downward motion of the escalator.

We need to see each choice we make as a pivotal one. Injecting energy takes us up, lifts us higher, gives us wings, makes us more powerful, successful and self actualized. Anything less and we are automatically going down.

Where do we get the energy we need? From the first choice we make to do the work… energy generates more energy.

Just as the receiving is always in the giving, our happiness and satisfaction lie in our effort to do the right things, say the right words, be the better person, and do our very best. The accomplishment and the glory are in the process of watching the pounds fall off and the six pack develop.

Right now, this moment, surrender to doing the work of becoming someone better than you are today.

Live and Love the process. Become someone new. Reinvent and recreate your life. Inject true care into each and every choice. This will make you feel good right now and get you to wherever you want to go.

We have to give our ALL in order to have it ALL!

Signature

Frank D. Gabrin, D.O

Back from Burnout:  Seven Steps to Healing from Compassion Fatigue and Rediscovering (Y)our Heart of Care

Get your copy today at amazon.com
Get your copy today at amazon.com

SOS Classic – All About You

SOS Classics are reprints of Shot’s of Satisfaction that Dr. Frank Gabrin shared as he wrote his works Back from Burnout, Care 101 and Booster Shots. Each shot contains a glimpse of Dr. Frank’s personal journey back from burnout.

Originally published February 2nd, 2012

Shot of Satisfaction Classic

Each Shot of Satisfaction is related to one of the seven steps in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on your journey to a fulfilling life of caregiving.

Step 6 – CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with this same patient. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.

Today, its all about you!

The single most important thing I have learned on my journey is that in order for me (or anyone for that matter) to get satisfaction from any personal encounter, I have to make it about you. I have to ask myself, what is it that you need? How can I give to you? How can I make a difference for you? 

As I move through the ED, to a patient’s bedside, or a difficult meeting, I tell myself, “Today, this moment, it’s all about you!” It is amazing how this shift in perspective changes my experience of life, professionally and personally.

Making it all about another person can be extremely difficult at times, especially when I am feeling unappreciated or disrespected. Yet, I know that when I let go of those feelings and focus on my desire to care and make a difference by acting with human dignity, tolerance, kindness and compassion, I feel good. 

This may seem entirely ridiculous or even unfair, but if you can suspend your rational thoughts about the ridiculousness and give this concept a try, you will see that you can be happy all day long.

You can gain satisfaction from all your encounters, everywhere you go, no matter what you do. All that is required is a flip in the direction you run your energy. Instead of making it all about ourselves, we make it all about others.

The force is with you

Quantum physics, karma, the Universe, whatever you want to call that energy force, dictates that we get back what we put out. That means connecting with, thinking about, and feeling the person in front of us and giving them what they need especially when we need it too.

Helping you find satisfaction in your daily work is my passion. Why? Because I am selfish. I want to see you, and everyone I encounter, happy, engaged, successful and satisfied. There is no greater prize in life for me than your success.

TAKE ACTION

Today, when you feel uninspired and you are facing a stressful challenge, or you find yourself upset or melancholy, flip the switch in your next encounter and engage in TrueCare. Make it all about you by making it all about them. You will feel refreshed, enthused and engaged…in short, satisfied all day long!

Go ahead, make my day. Make yours great!

Signature

Frank D. Gabrin, D.O

Back from Burnout:  Seven Steps to Healing from Compassion
Fatigue and Rediscovering (Y)our Heart of Care

Get your copy today at amazon.com
Get your copy today at amazon.com

 

 

SOS Classic – The Last Time You Danced

SOS Classics are reprints of Shot’s of Satisfaction that Dr. Frank Gabrin shared as he wrote his works Back from Burnout, Care 101 and Booster Shots. Each shot contains a glimpse of Dr. Frank’s personal journey back from burnout.

Originally published February 21st, 2012

Shot of Satisfaction Classic

Each Shot of Satisfaction is related to one of the seven steps in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on your journey to a fulfilling life of caregiving.

Step 6 – CIRCLE BACK to the beginning. If you’re not being effective, remember what you want and execute the first five steps of REFLECT again, with this same patient. Regroup when the encounter is over so you can do it all again. Remember your desire is to care. Look for a fresh opportunity to care again.

 

When was the last time you danced like Snoopy?

Can you honestly remember the last time you did the “Snoopy Dance”—especially at work? I think it’s high time for all of us to start thriving, instead of just surviving. Don’t you? We are all hungry for happiness. So let’s get happy NOW—not tomorrow, not next month and not next year. The question is: How?

As I set out on my life, I wanted to be happy and I believed it would come “when…” When I got into medical school… When I “survived the first two years of medical school” and finally got on to the floors of the hospital and to the patient’s bedside… When I finished medical school and got to put on the longer doctor’s coat and started my internship… When I got into my emergency medicine residency… When I finished the residency and became an attending emergency medicine physician…

You’d think that after more than twelve years of waiting for the “when” of happiness to come, I’d have figured it out back then. Yet despite all the triumph, success and achievement I would continue to have, in those days, I would still feel unfulfilled and unhappy.

Looking for the next best thing

This pattern is universal among physicians, nurses and allied health professionals industry-wide. As a group, survey and studies show that we are not very happy. We are stressed, overburdened, over-worked, and under-appreciated. We have some of the highest rates of divorce, addiction, depression and suicide across all populations. 

And it is from this empty, unhappy place that we try to give care and deliver satisfaction to our patients.

Seems like most of us still haven’t found what we’re looking for. As the Type-A overachievers we are known to be, we run around trying to gain more: more knowledge, more power, more expertise, accolades, health, peace, security, companionship, love, whatever. We are constantly looking for the next best things in the false hope that it might bring unhappiness or fulfillment.

We’ve had it all along

In general, why does anyone do drugs, alcohol or other compulsive addictive behaviors? To feel a little contentment, some control, so we don’t feel the pain of not having what we really want. Zig Ziglar says, “The chief cause of failure and unhappiness, is trading what you want most, for what you want, now.”

The reason we settle for less is because there is a flaw in our logic. We’ve all heard that if we really love someone or something, we must set it free. If it comes back, then it’s ours. But we have to let go, to really have. In other words, we have to give, if we want to get.

We all came to these professions with a pure and uncorrupted desire to make a difference, to do something meaningful and be connected to something larger than ourselves. We can have all the happiness and fulfillment we are looking for, right now, if we are willing to let go and give care.

We can use the pain and the lack we feel to create a desire, a motivation for a better reality. And we can get that something better by doing what we love to do: providing true care for others. Because in that moment, when we make an energetic investment to improve things for another, we will create a channel for all the energies of joy, happiness, power, peace, security and lasting fulfillment to flood our system and cause us to dance like Snoopy, right here and right now.

TAKE ACTION

Look for opportunities to go outside yourself and give your energy away to another. Walk into the room and instead of saying, “Here I am,” try saying, “There you are, I have been looking for you, how can I help?”

Finally see that you what you’ve been looking for has been right here all along.

Signature

Frank D. Gabrin, D.O

Back from Burnout:  Seven Steps to Healing from Compassion
Fatigue and Rediscovering (Y)our Heart of Care

Get your copy today at amazon.com
Get your copy today at amazon.com

 

 

Shot of Satisfaction
Antidotes for Burnout and Compassion Fatigue
Thursday, December 17, 2015
A Pot of Gold

Each Shot of Satisfaction is related to one of the seven steps back from burnout in the process of REFLECT. My hope is that, by sharing with you how I apply these steps in my daily life, it will help you on … Continue reading