The Emergency Mind

A passage about the fear of consequences from The Emergency Mind: Wiring Your Brain for Performance Under Pressure by Dan Dworkis MD PhD:

In or out of the emergency department, all emergencies share three common structural characteristics:

• Emergencies involve uncertainty.
• Emergencies have high-impact outcomes.
• Emergencies occur under significant pressure.

Whatever the potential impact of a situation is, fear of this impact can lead to paralysis; you can find yourself unable to make a decision because you are so preoccupied with what the impact might be. Of course, not making a decision is, in and of itself, a decision.

A big part of residency training is just accumulating enough reps that you aren’t paralyzed by indecision, especially when stressed or confronted by novelty.

More broadly: even abdicating a decision to maintain the status quo is itself a decision. There is no escape from time, which will always take us from point A to point B.

The consequences will come. The question is, will you make deliberate choices to achieve the best outcome? Will you reflect on not just your outcomes but also your process to ensure you grow?


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