How to Mentally Prepare for a Crisis Like an ER Doctor

Reminding yourself of your true mission can help you let go of what you can’t control

Dan Dworkis, MD PhD
Forge
Published in
4 min readSep 10, 2019

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Credit: Vincent Hazat/Getty Images

AtAt one o’clock in the morning, the emergency radio goes off — a team of paramedics is calling with a critical case. They’ve found a young child in cardiac arrest, blue, and not breathing. It’s going to be up to you and your team to try to get the child’s heart started again.

You have five minutes before the patient arrives. What do you do?

As an emergency doctor, I’ve responded to this type of situation hundreds of times. What I’ve learned is that while external groundwork is clearly important (we need to set up equipment and mobilize the necessary resources), it is the internal preparation — how we mentally ready ourselves in the moments before a crisis — that can make all the difference.

Everyone faces emergencies at some point in their lives. Maybe the one coming your way is a loved one needing surgery, or layoffs at work, or the familiar pull of addiction. Whatever your crisis, you can use the same tools that we use in the emergency department to respond as smoothly and effectively as possible.

Accept reality

The first thing I do when facing a critical case is to take a deep breath and accept what is about to happen. This certainly doesn’t mean I like what’s to come, or even that I’m okay with it. It simply means I recognize the reality and commit to facing it fully. Wishing things were different only takes up energy that I won’t be able to spend on solving the problem.

In these moments, it helps me to have a phrase that I repeat to myself as a mental anchor. I cycle through a few of these depending on what feels right for the moment, from simple motivations (“Time to go to work, Dworkis”) to deeper reminders of my purpose. If things are looking grim for a patient, I sometimes propel myself to keep going with, “Well, at least they’re not on fire.” If they actually are on fire, the thought becomes, “Well, at least I’m not on fire.”

Identify the areas in which you have control

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Dan Dworkis, MD PhD
Forge
Writer for

Emergency Doctor. Applying knowledge under pressure. The Emergency Mind Book: bit.ly/emindbook