SGEM Xtra: Holding Out for a Hero – Lessons from The Dark Knight

Date: December 11th, 2022 Dr. Dennis Ren Guest Skeptic: Dr. Dennis Ren is a pediatric emergency medicine physician at Children’s National in Washington, DC. You may also know him as the host of this season’s SGEM Peds. This is an SGEM Xtra for the holidays. We have done previous shows on what we have learned from Star Trek and Top Gun. It is hard to believe that we have not done an SGEM Xtra about what Batman has taught us about medicine and life. The release of Season#9 of the SGEM as a PDF book seemed like an excellent opportunity to discuss Batman. This is because the book has a DC comic theme.  Some people might find that a bit dark. However, this edition arrives at a time of uncertainty. We have been navigating our way through a pandemic, understaffing, emergency department closures, boarding crises, astronomical wait times sometimes barely keep our heads above water and struggling to do everything we can to care for the patients who depend on us. Despite the challenges we face, I hope the SGEM has been a beacon in the darkness, a bat signal, to remind us that the application of the principles of evidence-based medicine is more important than ever. We discussed this early in the pandemic with Dr. Simon Carley from St. Emlyn’s. Before we start talking nerdy about Batman, I think it is important we give a shout out to Dr. Tayler Young. She is a first year Family Medicine resident at Queen’s University. Her interests are quality improvement and Free Open Access to Medical Education (FOAMed). Tayler did Season#8 book with an Avengers theme. SGEM Season#9 contains the an introduction by Dr. Chris Carpenter. He takes us back to 1934 and the start of DC comics. Batman first appears in 1939. The first page for each chapter has the clinical question, the SGEM bottom line and introduces the guest skeptic. Next comes the case presentation and some background material. This is followed by the PICO with each letter looking like the superman symbol. Each episode has the authors’ conclusions and the appropriate quality checklist to probe the study for its validity. The key results are listed. The Talk Nerdy To Me section has a Green Lantern theme. This is followed by the clinical application, what do I tell the patients and a case resolution section. Each chapter ends with any other FOAMed resources, twitter poll results and the Paper in a Picture infographic by  Kirsty Challen You can listen to the SGEM podcast and hear Tayler discuss the layout of SGEM Season#9.  You can also download all the previous SGEM books clicking on this LINK. Batman and How it Relates to Medicine and Life We discuss eleven ways that Batman relates to emergency medicine and life. You can listen to the entire discussion on the SGEM podcast available on iTunes. 1. Emergency Medicine is Batman If I were to pick one superhero that embodies the practice of emergency medicine, it must be Batman. He is a detective, a tactician, strategist. He is truly a jack of all trades. He has knowledge of criminal justice, psychology, forensics, chemistry, just to name a few. Sounds very similar to emergency medicine where we act as primary care providers, pediatricians, intensivists, cardiologists, neurologists, psychiatrists, often during one shift. Batman also has a lot of cool gadgets just like we have many tools in our arsenal when practicing emergency medicine. I think some of us might even carry a fanny pack (utility belt) on shift. 2. Vulnerability One of the things that sets Batman apart from other superheroes is that ultimately, he is human. He can get fatigued. He can be hurt. This quality makes me appreciate him more. Dr. Tim Graham shared his powerful story of burnout on SGEM Xtra: Everybody Hurts, Sometimes. We have witnessed people working in emergency medicine perform heroic acts every day, but it’s important take a moment to check in on each other. The pressure and stress can build up and it is ok not to be ok,