Darth Vader in the ER

Would Darth Vader make a good emergency physician? Yes…according to guest author Dr Javier Benítez. 

I recently read an article on why Darth Vader would make an effective project manager and found it fascinating the similarities between running an emergency department and being a project manager. 

Top 10 reasons why Darth Vader would make a good ER physician

10. Darth Vader prioritized brutally. Same thing for emergency medicine, there is no way to get around this. You have prioritize, and prioritize, and do it over and over until the end of your shift. You have to take care of the sickest first, and then keep the department on a constant flow.

9. Vader made decisions based on objective data, not whims. As physicians we are trained to think like scientists and that entails; gathering information (history and physical), analyzing it, coming up with a differential diagnosis, a work up plan, then results and disposition. As frustrated or enamored we feel about certain patients the right approach to medicine is to come with a disposition based on the objective data obtained.

8. Vader made commitments. Our most important commitment is first do no harm or as Amal Mattu would say ‘primum non killem’. We have also made other commitments such as improving our practice by keeping up with the literature, to teach others, and give 100% when we are working.

7. Vader took time to recharge, relax, and get some perspective. We value our time off, time with our families, traveling, enjoying our hobbies. This is necessary to avoid burnout, and stay happy in this field. When you come back to work and you are recharged, your performance is so much better after being rested and have enjoyed your time off.

6. Vader managed risk and expectations….pre-emptively. As emergency medicine physicians we are always on the look out of what can go wrong and be ready for it. Whenever we are about to be intubate someone, if we are not thinking of plan b, c, d we are not preparing appropriately. We should be ready for the life threatening or limb threatening outcomes and act accordingly. We should also be ready to perform any other role of the team. We should learn how to manage pumps, ventilators, mix drugs, get IV access. Also make sure you discuss with the rest of the team what the plan is, so that everyone is on the same page.

5. Vader was a very ‘persuasive’ fellow. We act as patient’s advocates, and we must first get the patients to cooperate with our plan. We know what’s right for them and we have to know how to talk to the patients, consultants, nurses, and family. When we talk with consultants we have to get them on our side to see the patients. This requires lots of communication skills, not only do we want what’s best for patients, but we also want this consultant to trust us for future calls or consults.

4. Vader picked a methodology and stuck with it…until it didn’t work. We work in a stressful environment, and we make life changing decisions with almost no information. But no matter what, we have to pick a treatment and be ready to change it as soon as we see it not working.

3. No problem is too big to tackle. Just like Amal Mattu says, in emergency medicine you have to have a healthy level of paranoia. We still have to be optimistic about what we do, no matter how difficult the resuscitation, the diagnosis, the treatment, the patient, the consultant. We have to push through and see that our patients are well taken care of. We have to be enthusiastic and be true team leaders to get the group to work as a team and be proud of the work performed.

2. It’s never too late to do the right thing. Our job does not only entail scientific choices, but we also have to consider the ethical repercussions of what we do. We revisit those tough cases in our minds, or with colleagues, and we always have to ask ourselves if we did the right thing at that time with what we had. Even Darth Vader did the right thing in the end.

1. Vader was never afraid of getting his hands dirty. This goes with the fact that as doctors we are expected to know what each member of the team does. We also have to know how to perform their roles and be willing to do them any time. We need to know this, not necessarily to micro-manage, but to better coordinate the team as a whole.

There you have it. I think these are just a few points of what makes a good emergency medicine physician. I am sure there are more out there…

Javier Benítez, M.D.