SGEM Xtra: Lead Me On – What I Learned from Top Gun

Date: October 5th, 2022 Reference: Top Gun 1986 Guest Skeptic: Dr. Chris Carpenter is Professor of Emergency Medicine in the Department of Emergency Medicine at Washington University in St. Louis and co-wrote the book on "Evidence-Based Emergency Care: Diagnostic Testing and Clinical Decision Rules".  Chris will be moving to Rochester, Minnesota soon to become the Vice Chair of Implementation and Innovation at the Mayo Clinic. This is an SGEM Xtra episode about what we learned from the 1986 movie Top Gun. It is similar to the episode with kindness guru, Dr. Brian Goldman, on how Star Trek made us better physicians. When Top Gun Maverick was released on Memorial Day Weekend May 27th, 2022, I hosted a weekend extravaganza. This involved watching the original movie, playing beach volleyball and then seeing Top Gun Maverick. It was an epic weekend with friends from around the world. Chris Bond from Standing on the Corner Minding My Own Business (SOCMOB) and I even stood up and sang She’s Lost that Lovin’ Feeling at the local movie theatre. You can click on this LINK to see the performance. Chris Carpenter was booked to attend the Top Gun long weekend but COVID had other ideas. He tested positive a few days before the extravaganza. Chris did not want to become a  citizen of Canada for two-weeks in isolation, so he stayed home and missed the fun. We were back together again at ACEP22 in San Francisco. Each year we co-present at the Rural Section meeting. This year we reviewed ten recent publications, provided some critical appraisal of the studies and then discussed if the evidence would be applied differently in a rural or critical access hospital compared to a tertiary or urban centre. You can download a copy of our slides at this LINK. Being together again for the first time since 2019 was a great opportunity to record the Top Gun SGEM Xtra episode. There are so many different lessons/takeaways from the movie and we covered eleven (my second favourite number). Lessons Learned from Top Gun 1) Be Prepared To Fail: Lieutenant Pete Mitchell (Maverick) takes risks and sometimes they work and sometimes they do not work. He dropped below the hard deck to get the kill shot during a training session but was reprimanded. Maverick also took a chance in the bar and tried to sing She’s Lost that Loving Feeling. Lieutenant Commander Rick Heatherly (Jester): "That was some of the best flying I've seen to date — right up to the part where you got killed." Working in the emergency department mean you will fail (make some mistakes). You need to learn from these experiences and not let previous failures prevent you from trying. It's not the falling down that is the most important, but rather the picking ourselves up. 2) Never Leave Your Wingman: Maverick comes into Top Gun a bit of a loner. Only real friend is Lieutenant Nick Bradshaw Goose. He needs to learn to work together in a team. Have your team’s back (RNs, techs, docs, admin, etc). Early in the movie he helps a fellow pilot land his plane. Commander Tom Jardian (Stinger): "Maverick, you just did an incredibly brave thing. (Pause) What you should have done was land your plane! Maverick also leaves his wingman at one point at Top Gun while in a training session and loses. Later in the movie he stays with his wingman in combat and is successful.  This leads to the exchange between Iceman and Maverick Lieutenant Tom Kazansky (Iceman): "You can be my wingman any time." Maverick: "Bull----! You can be mine." Working in an emergency department takes teamwork and you need to be there for each other. This will be discussed further. 3) Asking for Permission: Sometimes it is better to ask forgiveness than permission. Maverick asks for permission to buzz the tower. He is told no but does it anyway. Maverick: "Requesting permission for flyby". Air Boss Johnson: "That’s a negative Ghostrider, the pattern is full."