Cotillion Lessons for EM Residents
ACADEMIC AFFAIRS COMMITTEE
Mary Claire O’Brien, MD FAAEM
I
grew up in Philadelphia—what, do you have a problem with that? Philadelphians are direct and out-spoken. “Say what you think, mean what you say.” Imagine the consternation of my Philadelphiaborn but Southern-grown daughters when I forced them to attend “Cotillion.” Of course I made them go! Dear Mrs. Francis O’Brien (sic), The National League of Junior Cotillions, Winston-Salem Chapter, requests the pleasure of your daughter’s company at their Annual Spring Ball. Philadelphia Mother’s response: “Hell, yeah!” Winston-Salem Mother’s response: “Miss O’Brien accepts with pleasure the kind invitation of the Junior Cotillion to attend the Spring Ball.” Yes, I made my daughters wear knee-length party dresses, white gloves, and black patent leather shoes, so they could learn to say, “Good evening, Mrs. Featherbottom. May I present my mother, Dr. O’Brien? Mother, this is Mrs. Featherbottom, my astrophysics instructor.” Who doesn’t want their kid to learn that? Give your young people the verbal and physical skills they need to get along, whatever they do.
Independent of any physiologic changes, expansive poses have been shown to cause people to feel more powerful.
Emergency medicine faculty, here are a few Cotillion Lessons for your residents. FIRST IMPRESSIONS COUNT!
Patients in crisis are bewildered and frightened by the emergency department. Sometimes trainees who are trying to put them at ease will say casually, “Hi! I’m Jesse, your resident!” Not cool. A) The patient might not know what a “resident” is, and B) Jesse looks so young! Is this hipster actually in charge of my emergency? Isn’t there a (real) doctor in the house? Jesse would be better off to say, “Hello, I’m Dr. Brown.” DRESS FOR THE OCCASION.
Medicine is a profession and residents are physicians. Understandably, they wear their scrubs to conference both before and after their shifts. We welcome them in jeans and T-shirts when they come to conference on a non-clinical day. But if they are presenting at conference, there is an expectation of professional business dress. Faculty members should model the same. STAND UP STRAIGHT!
I will never forget riding up the elevator in 1989, Chicago O’Hare Marriott Hotel, minutes before my ABEM Oral Board exam. Perfectly competent emergency physicians were hunched in the corners, flipping through index cards and mumbling ACLS algorithms. What is that? The proper stance prior to a certification exam is: Wonder Woman! Hands on hips, feet placed shoulder distance apart, chin up, standing straight. “Your body language shapes who you are,” says Dr. Amy Cuddy, a famous social psychologist, author, and speaker. Dr. Cuddy has a wonderful TED talk on “expansive” versus “contractive” postures. Her research while at the Harvard Business School demonstrated that subjects who stood for two minutes in a “power pose” had lower salivary levels of cortisol and higher salivary levels of testosterone, compared to those who adopted “contracted” postures. Independent of any physiologic changes, expansive poses have been shown to cause people to feel more powerful. The Wonder Woman posture is an excellent adjunct whether or not it actually changes the hormone levels in your saliva. Tell your residents to try it the next time they have to take an exam, give a presentation before a crowd, or have a “challenging conversation” with someone. Standing in this posture for two minutes beforehand actually helps. Explain to your residents how to use “contracted” postures with patients who are frightened or in pain. Tell them, if you can’t sit down, bend down. Keep your arms close to your body. Speak softly. Dr. David Wagner is one of the founding fathers of emergency medicine. He taught us, “The patient will remember the five minutes you sat in a chair better than the 20 minutes you stood at the bedside.” Countinued on page 18 >>
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COMMON SENSE JANUARY/FEBRUARY 2023