Volume 32

February - 2022

Cover: Red SHouldered Hawk

Having a moment to walk around my neighborhood, hearing birds chirping in the crisp morning air while the marine layer spreads over the sky has truly been such an amazing joy of my time in residency. Having the peaceful sounds, smell of the ocean water, and time to reflect on my experiences and difficult cases in the emergency department allow me to not only focus myself, but remain grounded. I highly recommend anyone who is stressed or focused on difficult patient outcomes to allow yourself the opportunity to step back, calm yourself, and view everything from a new perspective.

Letter from the Editors:

Welcome to Art of Emergency Medicine, an online blog featuring amazing works of art created by your Emergency Medicine colleagues, along with their own stories of wellness and inspiration. Each month we try to focus on a new topic within wellness, and this month we’re trying to tackle the basics of Imposter Syndrome.

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Imposter Syndrome is never an easy topic to speak about, especially amongst each other in a high-performing and high-anxiety specialty, but given that data shows at least 70% of professionals experience it at some point in their career, we believe that it is important to provide a basic framework and language for discussion along with some short pointers on small changes you can make today.

Imposter syndrome may present in a variety of ways, but typically it can be seen as

• Inability to realistically assess your own competency

• Attributing your success to external factors (or luck)

• Fear of not living up to expectations

• Berating or self-deprecation of your own performance

• Setting unrealistic goals for your self

• An internal sense that you are not as competent as others perceive you

The difficulty with imposter syndrome is that it creates a self-fulfilling prophecy and leads to a relatively vicious cycle. Those who experience are known to work harder on projects, completing all tasks, refusing to seek help, and essentially “overworking” to accomplish their task as driven by their own anxiety to succeed and not be “found out as a fake”. Ultimately, when the task is completed successfully, those with imposter syndrome attribute the success to the overworking and not to their own skill. Unfortunately, this creates the self-fulfilling prophecy that they will start a new project and believe the only way to succeed is through overworking. Ultimately, this can create a spiral leading to severe anxiety and presentations of depression.

Does this sound like you? Are you not sure? Ask yourself some questions to help you identify your own imposter syndrome!

• Do you agonize over small mistakes or flaws?

• Do you attribute your success to luck?

• Are you sensitive to even constructive criticism?

• Do you feel as though you’re about to be found out as a fake?

• Do you downplay your own expertise?

• Do you feel as though you are never doing enough?

Did you answer yes to one or more of these questions? It may be worth sitting down and talking with someone or doing some additional reading on imposter syndrome and identifying your imposter. In general discussion, there are five types of imposter syndrome that each present slightly different:

• The Perfectionist: Sets excessively high goals, feels they must do everything themselves, rarely is satisfied by success because “they could have done better”.

• The Superhero: Driven to work harder by feelings of inadequacy, addicted to the validation others give for work effort and not the end goal itself, often stays late to complete additional projects to the detriment of social and personal relationships

• The Natural Genius: Expects to get everything right on the first try and will avoid tasks where they are not naturally experienced, establish ridiculous expectations for their skill and become anxious when they are unable to meet them.

• The Soloist: Believe that asking for help is a sign of weakness and reveals your inadequacies, has a habit of refusing assistance to prove their own worth to the detriment of the final product and their own time, often defers praise if they received help

• The Expert: Fear that they will never know enough and be exposed to not have a solid knowledge base, procrastinates on projects seeking additional information to the detriment of the final product and time, constantly driven to study because they feel they are inadequate in their knowledge.

Have you identified your imposter? Then the next thing to do is open conversation and dialogue. Seek some additional help! And you can take these steps below to start making changes today:

• Talk About It: You’re not the only one going through this. 70% of us are, and it is freeing and supportive to know there are others with you on your journey.

• Celebrate Your Accomplishments: You’re amazing and the steps and hurdles you’ve overcome to reach your current position are to be celebrated. Develop a habit of identifying 3 things you did well each day.

• Question Your Thoughts: Rewrite the script in your head. Don’t focus on how you feel out of place surrounded by successful or smart people, focus on how much you can learn being among them.

• Make Mistakes: Edison didn’t create the lightbulb immediately. Space X didn’t get it right on their first rocket. Mistakes happen and it is a perfect way to learn and support your own growth.

• Stop Comparing Yourself: Everything is at a different stage of their journey and learns differently. You cannot compare yourself to others, instead focus on your own path and achievements.

• Avoid Self-Deprecation: Even jokes may hurt. A portion of everything we say gets internalized and it may make you start to think they’re less of jokes and more about truths.

We hope this helps you develop a framework for further discussion and that you bring it to your colleagues moving forward! As always, please reach out for any questions or further discussion.

Sebago

I always love the shapes and patterns that can come to life when photographing still water. My first trip to Maine certainly didn't disappoint, though having a co-resident to act as local guide definitely helps.

Major Tom

I found painting to be a very therapeutic hobby. When I paint, I just think about the process of painting. I don’t think about bills , work, stress, patients, etc.... My brain is focused on the painting and gives my mind and body a break from the everyday stressors. Without painting, I think I would have burned out long ago, as the process of putting paint on a canvas, slows my brain down to process.

Untitled

Cast ARt Patches

The emergency department isn't very fun for kids, especially if something traumatic requiring a cast has happened. The patches I make help make the entire situation less scary. I use the medical materials for my art to make the entire process less intimidating. If they see that the fun designs on their cast or bandage are made out of the same material the whole process seems less frightening. The cast patches are made from colorful coban wrap and an acrylic adhesive backing. We make thousands of cast and bandage patches a year now and send them all over the world.

Do you want to see your art shared with the community? Don’t forget to submit today!

Finally, don’t forget to share Art of Emergency Medicine with your colleagues, friends, and family on Twitter or Instagram and like us on Facebook for all the latest news!

This Months Featured Artists:

Andrew Thorne, MD

I am an emergency medicine resident at Harbor-UCLA with a passion for wilderness medicine. I began pursuing photography in medical school as yet another way to engage with the outdoors and share the beauty I find with others.

Giuliano De Portu, MD

I was a professional photojournalist and went to medical school at 33. Currently still doing imaging for fun! You can see more images at www.giulianodeportu.com.

Jack Cameron

Bandage Art started with a need to entertain children in a fast-paced emergency department. I had an abundance of medical supplies but a lack of toys. I started designing cast art of popular children’s characters made out of coban. From there the designs became more requested and I developed a way to apply them better to their casts. I would work on them in my spare time to hand them out to my patients. The figures were so popular that I created an IG account, bandageartists, to share with the medical and veterinary communities. From there the demand has only grown and we send cast art all over the world.

Scott Goldstein, MD

I am a dual board certified emergency/EMS physician in the Philadelphia area. After a spending years looking for an outlet I went to one of those paintings with wine one night with my wife. After that, I tried on my own and unknown to anyone (even myself) I wasn't half bad. I became self taught in painting of acrylic on canvas and painting coffee on watercolor. See more of his work on Instagram.

Jonathan Warren, MD

A PGY-2 at Harbor-UCLA Medical Center and founder of Art of Emergency Medicine. His hobbies include photography, hiking, Netflix, and dogs. He’s always on the lookout for the next adventure. Find more of his photography on Instagram.

You can learn more about the artists featured in this and other volumes at our contributors page!