“On the other hand, I’m concerned about people whose
primary focus is on that adrenaline rush. That needs to be a part
of it, but that’s a small part of what we do. In some ways, it’s an
easier part, a more scripted part. Satisfaction in this field really has
to do with more long-term goals, about being part of a safety net,
helping people out, being involved in system issues, being
a generalist.
“You need a balance. You need to find people who’ve been
tested in the environment and thrive in it. People who cannot
multi-task or task switch, or think clearly in a crisis, or don’t handle
distractions well are not going to succeed in the ER. You have to be
able to handle distractions very well. I need to know that people
really have mature experience in the environment, and they’ve
been assessed as doing well. If I read a professional statement
that’s all about the adrenaline rush, I’m worried about that. If
they don’t have a mature understanding, it’s a career that’ll lead
to burnout if you don’t really understand all aspects of it.”
These comments were all given within the first minute of
my conversation with Dr. Shayne. Clearly he had thought these
issues through long before I called to interview him. I decided to
dig in further and ask him what the right personality type was for
an emergency room doctor.
While he was the first to admit that being a high sensation-
seeker is a piece of the puzzle, there’s more to it than that. He listed
many criteria that were needed for people to excel in the ER. Some
were what you might expect: the ability to make connections
quickly, excellent communication skills, broad experience in the
field. Some were less obvious. For example, Dr. Shayne described ER
physicians as a “flawed type of doctor.” He went on to explain that
most doctors are able to have a great deal of precision around
diagnosis, and this is an absolute necessity in most parts of the
field. In the emergency room it’s totally different. There’s no time
for that level of precision, not to mention the speed and chaos of
the environment make it impossible. ER doctors have to paint
things in broad strokes focusing on resuscitation, comfort care,
and then risk assessment. “We’re very different than other physi-
cians. People who have something big and bad, get handed off.
We’re rarely definitive. We operate with a lot of uncertainty and
a lack of precision. We’re really meant to be the screen to chaos.
You have to be comfortable being wrong. You have to have that sort
of ego, or lack of ego to not mind being wrong. That’s just different123 / All in a Day’s WorkDownloaded from https://www.cambridge.org/core. Access paid by the UCSF Library, on 11 Nov 2019 at 14:18:48, subject to the Cambridge