101 personal & philosophical experiments in EM A

Some years ago I delved into a little philosophy. Not the clever stuff that Michelle Johnston reads, more the stuff that you find in airport bookshops. I particularly enjoyed two books. Firstly Zeno and the Tortoise, largely because of the tag line “This book will make you sound cleverer than you are” (it didn’t) and secondly an exercise book of sorts by Roger-Pol Droit entitled 101 experiments in the philosophy of everyday life. This second title captured my imagination as a series of exercises to help us think more clearly about difficult and unusal questions, and that is why several years later we decided to collate some of the St.Emlyn’s blog posts into 101 personal and philosophical experiments in Emergency Medicine.

These experiments based on blog posts from the St.Emlyn’s team are designed to make you stop and think about what we do, why we do it and what our purpose is as EPs. Is that a bit wooly? Perhaps, but as we move through our careers at the breakneck pace of EM it is sometimes wise to stop, think and listen to our purpose.

You will of course notice that there are fewer than 101 experiments in the table below. Worry not, there are many more ideas on the way that we will post in time.


Exercises 1-10

 The Experiment  The Blog Post
 1. Imagine the last words that you would want to hear in the emergency department.  Little white lies in the resus room. We deal with death in the ED, it’s part of the job for us, but the last moments for our patient. Consider the last words that you would want to hear.
 2. How effective are you as a clinican?  What your NNT? Do you make a difference to the patients you see and if so what is the magnitude of that effect in terms of outcome?
 3. What do people call you in the ED? What’s in a name? Do your colleagues call you something different to your patients? Are first names the norm, an aid or a barrier?
 4.  Is it more difficult to praise rightly than to blame?   Is this what we mean by critical care? How do you feedback to colleagues and trainees. Do you choose your words wisely for mobidity and mortality reviews?
 5. Do you manage life as well as you manage death?  An Easter message.
 6. Do you encourage parents to attend paediatric resuscitations in the ED, or do you keep them out in the relatives room? But what about the parents?
 7. How do you lead the variable/various team ED?  Teamwork in resus.
 8. Are you a fast or slow emergency physician and does it matter?  Can you get the doctors to work faster?
 9. How and can you raise a concern in the resus room?  PACE with @HArrisCPD
 10. Let’s think about feedback  Testing, testing…Making feeback more than just noise.


Exercises 11-20

 11. Are you at risk of burnout? How would you spot the signs? Do you know anyone else who is close to the edge and what would you do about it?  Too tired to sleep, too wired to sleep.
 12. Does a reaction tell you anything about feedback? What are you expecting when you give feedback on a miss or poor patient outcome? Do you want the recipient to be happy, sad, or does it not really matter?  Giving bad feedback……
 13. Think about what it means to be told that you’re wrong in the resus room. Do you know everything about your speciality? If not then how do you find new information and how do you react when challenged?  Coping when your registrar knows more than you do…
 14. How do you debrief yourself and your team? Can you learn to be a good debriefer, and what do people think of your debriefs in the ED?  It’s good to talk: Debrief in the Emergency Department
 15. Leadership comes in many forms. Would the approach on the football pitch be the same in the resus room?  Sir Alex Ferguson and Emergency Medicine
 16. Are you a racist, misogynist, weightist EP? Do you consider yourself to have neutral views on these and other patient and colleague characteristics?  Do Emergency Physicians judge patients?
 17. When was the last time you really ‘made’ a certain diagnosis? Are you a diagnostician, or do you just guess a probability? What language do you use when talking to colleagues about the certainty of diagnosis?  Wrestling with risk at SMACC2013.
 18.Do you make rational life and death decisions? Ethical dilemmas in Emergency Medicine part 1
 19. When was the last time you said thank you? Where are you on the praise:criticise ratio? How, when and why do you say thanks?  Attitude of Gratitude
 20. Do you, should you, shouldn’t you treat ViPs differently in the ED?  There’s a vIP in the ED


Exercises 21-30

 The Experiment  The Blog Post
 21. Do you always hear what you think you hear. Why the message doesn’t always get through.  Miscommunication in the ED
 22. Is it wise to be anonymous in the world of  #FOAMed?  Anonymity – a little too much fun.
 23. You probably think you’re awesome, but how do you know if you are any good as a trauma or resuscitation team leader?  Are you a good trauma team leader?
 24.You might be looking for the next big thing, but marginal and incremental benefits may be easier to achieve. What can you marginally improve in your practice?  Marginal gains, Matt Parker, F1 and the ED.
 25. Is Primum non nocere timeless or ridiculous?  Ethical dilemmas in emergency medicine Part 3.
 26. Do you really deserve the success that you have?  Who’s that girl?
 27. The standard you walk past is the standard you accept.  Do you walk past? 
 28. When you just ‘know’ something is not right.  Feeling in the gut or thinking in the brain..?
 29. Can you ever ‘do no harm’?  Is Primum non nocere timeless or ridiculous?
 30. Do women in EM have a difficult balancing act in behaviour?  Am I intimidating? Sarah Payne guest blogs at St.Emlyn’s


Experiments 31-40

 The Experiment  The Blog Post


Experiments 41-50

 The Experiment  The Blog Post


Experiments 51-60

 The Experiment  The Blog Post


Experiments 61-70

 The Experiment  The Blog Post


Experiments 71-80

 The Experiment  The Blog Post


Experiments 81-90

 The Experiment  The Blog Post


Experiments 91-100

 The Experiment  The Blog Post


Experiment 101


Cite this article as: Simon Carley, "101 personal & philosophical experiments in EM A," in St.Emlyn's, April 27, 2013, https://www.stemlynsblog.org/ppe-101/.

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