Without question, the delivery of emergency care and advanced cardiac life support (ACLS) requires special people in the right roles at the right times. As a pre-medical student, I approach life-saving and emergency medical care from a different perspective than most – I am a cancer survivor. Facing my own mortality reinforced the importance for me to lead a life of purpose. The opportunity to save lives is the greatest and most meaningful gift I can possess, and I am now following my dream to practice as a physician. My experiences as a patient on the receiving end of emergency care underpin my passion and dedication for medicine. My background in law enforcement allowed me to take part in basic life-saving, and my pre-medical studies have further reinforced the gravity and significance of providing patients with life support care that is thorough, decisive, flexible and caring.
Emergency care providers practicing advanced and pediatric life support skills are the front-line personnel in the war to save lives. Emergency care is the purest of medical practice; the involved practitioners pay no mind to creed, opinion or social status. There is no time to procrastinate or revisit a set of circumstances at a later, more convenient time; preservation of life is the only concern. From the assessment of responsiveness to the reading of an ECG, administration of drugs, ventilation and beyond, critical choices made by emergency medical personnel have a resounding ripple effect that shape and determine if a patient’s life will continue or cease. For the medical student, even more important than observing and learning the emergency system of care protocol is the recognition and appreciation of the physician’s role to do no harm, and consider every life precious. Nowhere can it be seen better than within the emergency care environment that the practice of medicine does not often allow for do-overs or mulligans.
From the viewpoint of a 39-year-old woman who has faced adversity within a medical diagnosis, I approach trying circumstances and problems in life with tenacity and resolve. These attributes were cast from the same fire as the irons of my fight to save myself from death. I am not easily broken. It is here where my personal approach to preparing mentally and physically to engage in life-saving techniques is rooted. Within my own health struggles, I have learned first-hand that all life is precious, and therefore approach ACLS with unwavering intention to do all that is within my power to save lives and do no harm in the process. With regard to my mental approach to ACLS delivery, I view each life as unique and special. Each person in a dire ACLS situation deserves 100% of my focus, and that moment before the case is encountered is a moment of centering and concentration; a time of preparation. Deep respect for human existence and the innate desire to preserve life allows me to immediately focus on the matter at hand, and essentially establish a mental list of priorities to provide the best possible chance and environment for critical care success. I strive for sound decision-making in a rapidly changing environment which includes the ability to think in three dimensions: evaluating the case, its needs and how I can perform decisively to meet those needs. Before and during the performance of life-saving techniques, it is also necessary to accept that critical care often occurs in a sea of commotion and turmoil. However, mental preparation also includes introspectively finding the calm in that commotion, and remaining resident in the cerebral space where my training and experience cannot be oscillated by chaos and disorder. This includes grounding myself in the fact that acute focus is compulsory if lives are to be saved. Physical preparation begins with living a healthy lifestyle and managing my own stress outside of the emergency department, including ample rest, proper nutrition and self-care. In the moment, physical preparation involves controlling my own adrenaline response, lowering my heart rate, and ensuring that all I may need for the incoming case is present and at-hand. Facing the personal adversity of cancer has imbued in me the desire to approach high-stress and life-threatening situations with a sense of strength and grace that is a direct mental and physical carryover to my future performance as a physician.
Mental and physical preparation for performing critical care and ACLS work also involves my ability to contribute to the emergency care team. Teamwork is a cornerstone in my approach to trauma medicine and ACLS. For example, a physician on duty in a hospital’s emergency department does not and should not operate in a vacuum, and an effective ACLS response requires the input, action and flexibility of an entire team of healthcare professionals with the collective goal of improving patient outcomes. Approaching ACLS from the standpoint of teamwork extends to the patient’s caregivers; their input can provide vital help on the patient’s condition to the ACLS personnel. Developing and maintaining rapport with teammates assists in conveying my commitment to the efforts of the care team, and the health of the patient. Working together as a functioning unit in the face of trauma and amidst lives hanging in the balance requires confidence in the collective aptitude and trust in each other.
As a pre-medical student with a somewhat non-traditional background, who has performed basic life support on-the-job, been personally affected by cancer, and saved by a critical care team with exceptional ACLS skills, emergency medical care has been my greatest professor, supporting my ethos that all life carries value beyond measure. Observing and working in emergency care situations has instilled the importance of being ready for the challenges faced by critical care personnel who must strive to mentally and physically prepare themselves so that they may exhibit peak performance necessary to save lives and deliver optimum care to patients presenting in their most vulnerable state.