Explore The Space

In our final episode of 2018, we have a proper A-list MD, Dr. Gurpreet Dhaliwal, joining us. He is a master diagnostician who never fails to dazzle an audience with his process for evaluating and solving the most challenging cases. We discuss how he learns and trains, the need to look for “desirable difficulty” and how his mistakes are his most valuable tool. This is our first Grand Slam episode! All 4 Pillars of Explore The Space are fully engaged in this conversation! Key Learnings 1. Why Dr. Dhaliwal should be an A-list celebrity in medicine 2. Is Sherlock Holmes the right popular culture comparison for Dr. Dhaliwal? 3. What Dr. Dhaliwal does that gets such a response from an audience 4. How practice and his training program allow him to reach his maximal potential 5. Shifting information from short term memory to long term memory and how to extract it when needed 8. What is the number #1 enemy of learning… 8. The importance of tempo in optimizing his process to provide patient care in a busy environment 9. Extrapolating the skills Dr. Dhaliwal uses into any profession where someone wants to do their work better 10. Diagnostic error and why Dr. Dhaliwal keeps track of each case where he got the diagnosis wrong 11. The value of discussing mistakes and the opportunity we miss in medicine when we don’t do this. 12. Anchoring bias and how it plays into error creation 13. Does he make diagnoses while walking around with the public? Links New York Times article by Katie Hafner The Mechanics of Reasoning Diagnostic Excellence Tags #hospitalist, #medicine, #podcast, #UCSF, #teaching, #education, #FOAMed, #reasoning, #heuristics, #podcast, #learning, #error, #mistakes, #diagnosis, #clinicalreasoning, #internalmedicine, #memory, #celebrity, #sherlockholmes

Dr. Keith Murray is an Emergency Physician at University of Pittsburgh Medical Center and serves as Medical Director for Pittsburgh SWAT. He was a part of the first responder units that entered the Tree Of Life Synagogue during the mass shooting that occurred there on October 27th. He joins us to discuss becoming a SWAT Medical Director as well as his experiences before, during and after the shooting. Key Learnings 1.   Defining the role of a Medical Director for a SWAT team 2. Finding a niche in being part of a First Responder unit as a physician 3. The scope of responsibility for a SWAT Medical Director 4. The things Dr. Murray carries when going into the field 5. Drilling and training for a mass shooting 6. Notification about the Tree Of Life Synagogue shooting 7. What allows Dr. Murray to drive towards danger 8. Arriving at Tree Of Life and entering the building 9. Ready to fight versus ready to save lives: tactical versus medical awareness 10. Assessing the wound patterns from an AR-15 assault rifle 11. Rescuing two wounded SWAT officers and the end of the engagement 12. The post-incident debriefing and recovery process 13. What feels different in Pittsburgh after the shooting 14. Back to work in the ED the next day #podcast, #doctor, #emergency, #trauma, #massshooting, #drilling, #SWAT, #firstresponder, #debriefing, #physician, #training    

Eric Byrnes comes back after writing a book and completing the Triathlon Across America. We cover transitioning from Major League Baseball, how his definition of mental toughness has changed, and creating Team Go-Hard. Key Learnings 1. Eric & I start the podcast saying nice things about one another 2. Being asked to talk about The Mental & Physical Edge 3. How Eric using triathlons to dig out of a post-baseball career rut 4. The Triathlon Across America: 55 days from San Francisco to Manhattan 5. Creating Let Them Play Foundation to help address the lack of physical activity programs for America’s children 6. Dopamine Jumps in Philadelphia! 7. Eric’s definition of mental toughness 8. How we create a feeling of confidence in ourselves 9. “Don’t Take Your Feelings So Personally” 10. Eric’s personal philosophies and how his father helped define them 11. The book, the blog, the Tri Across America, and what’s coming up for Team Go-Hard 12. What Eric and I will discuss next time he comes on the show (hint: ankle the size of a watermelon will be heavily featured)   #triathlons, #ultramarathon, #mentaltoughness, #training, #baseball, #majorleaguebaseball, #triacrossamerica, #gohard, #ucla, #medicine, #podcast, #phillyphanatic, #childhoodobesity, #ADHD, #endure, #resilience

Rabbi George Gittleman is the Senior Rabbi at Congregation Shomrei Torah in Santa Rosa, CA. Over the course of navigating crises like September 11th, the Sonoma County Wildfires, and the recent Tree of Life Synagogue shooting, he has run the gamut of experiences in leadership under pressure. He joins us to discuss the extraordinary insights he has gathered and the tools he uses to be at his best when it is needed most. Key Learnings 1. Recognizing when the normal parameters around leadership go away 2. Learning to handle a community crisis and his own fight or flight response 3. Dealing with his community needs after 9/11 and what he learned to do differently 4. The desire to flee when the Sonoma County Wildfires broke out and how he pushed through 5. How Rabbi George overcomes the flight response so he can lead effectively 6. The power of using the emotion within an environment as a leadership tool 7. How self-discovery informs effective leadership 8. Recognizing and dealing with leadership failures 9. Disruptive behavior and how he overcomes it 10. The impact of mental agility and emotional stability in a crisis 11. The impact and evaluation of the recent Interfaith Ceremony 12. What professions would be good to cross-pollinate with around leadership 13. The personal cost of leadership, how he restores himself, and the importance of a good work environment The Interfaith Solidarity Service can be viewed here. #leadership, #rabbi, #disaster, #selfdiscovery, #crisis, #fightorflight, #delegate, #wildfire, #PTSD, #selfawareness

Dr. Taylor Brana is a Psychiatry resident and the host of The Happy Doc podcast. He joins us to discuss bringing fresh eyes to key challenges facing physicians, some key drivers of happiness & fulfillment, and creating his fantastic new project. Key Learnings 1. The origins of The Happy Doc and asking the question “are there happy doctors?” 2. Focusing on both rebuilding and maintaining physicians at all stages of their careers, especially early on 3. What is consistent among medical students, residents, and attendings who are still happy in medicine 5. How the evolution of confidence, especially at career transition points, can build or erode happiness 6. Moving from an awareness phase to a solution phase 7. The importance of rebuilding culture through teams in medicine 8. The Happy Doc and emphasizing happiness, regardless of your profession 9. The Voice Project and expanding ways we can learn #happiness, #satisfaction, #physicianburnout, #burnout, #medicalschool, #residency, #depression, #podcast, #medicine, #hospitalist, #culture, #hospital, #burnout, #leadership

Dr. Mary Brandt is a Professor of Surgery, Pediatrics, and Medical Ethics at Baylor College of Medicine in Houston, Texas and is in full-time clinical practice as a Pediatric Surgeon at Texas Children’s Hospital in the Texas Medical Center. She joins us to discuss the rapidly growing physician response to a tweet around gun violence in America and the #thisismylane movement. Key Learnings 1. The power of doctors sharing pictures of the aftermath of gun violence with #thisismylane, #itisourlane, #itisourlane 3. What really enraged physicians in the wake of the NRA’s tweet about physicians and gun violence. 5. Using the power of these stories to move the conversation about gun violence from a political issue to a public health issue. 6. Stories of gun violence from a Pediatric Surgeon. 7. The disconnect between the perception and reality of what bullets do to a human body 8. How managing bullet trauma degrades physician wellness 9. The steps needed to push this movement forward in the right direction 10. The importance of setting a template of kindness around the conversation of gun control 11. Resolving the quandary raised by impulsive behavior, access to firearms, and gun-related death 12. What happens when a physician has a conversation around access to guns with their patients 13. Dr. Brandt creates the next viral hashtag! #asktosavealife Dr. Brandt’s blog, www.wellnessrounds.org Here is the recent American College of Physician article on reducing firearm injuries & deaths in the United States. Per Gunviolencearchive.org on 11/14/2018: 12,746 deaths due to firearms in the United States We’ve tackled gun violence on Explore The Space before, here’s ACP President Jack Ende in episode 63 

Dr. Nina Shapiro is a Professor of Surgery specializing in Pediatric Otolaryngology at UCLA. She is also a highly sought-after speaker on medical topics across the media spectrum. She joins us to discuss her new book “Hype” and how we discuss controversial topics with the public and with patients. Key Learnings 1. Dealing with the question of “who are you to write a book about general health issues?” 2. The rocket fuel of hype in medicine and choosing the title of her book. 3. The value of rational conversations physicians can have with patients on topics their patients feel are important. 4. The missed opportunity of not explaining the science behind a medical recommendation. 5. Similar skills for communicating to a general audience and in the office with patients. 6. Avoiding a “me against them” dynamic and building one of shared decision-making. 7. What’s been the most popular topic for discussion on her book tour and are we training doctors to answer that question. 8. A surprising topic she was rarely asked about when meetings fans of her book. 9. Responding when doctors are told to “stay in your lane,” particularly around gun control advocacy. 10. Important takeaways and the road forward in dealing with the new world of medical information. The article by The Jewish Nurse in the wake of the Pittsburgh synagogue shooting referenced in this episode can be found here. Dr. Shapiro also released an article in Forbes Magazine just after our interview, please read it here.

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Dave Berke is a retired Marine fighter pilot and Top Gun instructor who now is a part of the leadership team at Echelon Front. He is back for a fourth time on Explore The Space to continue our exploration of team based culture. Every time we have these conversations, I’m fired up for the next one. Key Learnings We start off with another round of Quick Hitters! When work spills over into life Why excelling at work is a recipe to do well elsewhere Keeping friends and family informed as a cornerstone of work-life balance Communication skills as a hard-won lesson in maintaining relationships and building a successful career #leadership, #TopGun, #culture, #medicine, #relationships, #podcast, #worklifebalance

Lizzie Johnson is a reporter for the San Francisco Chronicle who covers wildfires in California. She joins us on the eve of the one-year anniversary of the Wine Country Wildfires of 2017 to reflect on what happened, how the community has rallied, and the challenges still facing the recovery. Key Learnings Becoming the “Fire Girl” Arriving in Santa Rosa after the fires started Reporting from the ruins of Coffey Park How this wildfire impacted the sense of safety for people across the world Being a reporter and allowing people speak their truth about their experience How communities respond to a disaster and how it evolves over time Impressions of the recovery in Sonoma County at one year Global perceptions of the wildfire, climate change and an international “voyeuristic sense of horror” The one-year anniversary coverage