‘My Mental Toughness Manifesto’ Part 2: PRACTICE

In MMTM Part 1, two-step cognitive appraisals were explained. This process dictates whether one enters a challenged or threatened mindset in the event where an immediate performance is required under acute stress. Feeling challenged, of course, is one of the two chief components of a mentally tough individual. “I am 100% committed” “I feel challenged” In this post, we will […]

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‘My Mental Toughness Manifesto’ Part 1: Understanding Cognitive Appraisals

It has been an exciting period for me recently. Last month I was at the International Special Training Centre (ISTC) in Pfullendorf, Germany, where I had the honour of speaking to a group of Special Operations Combat Medics in-training from eleven nations across NATO. Staying at the base, meeting the guys, and contributing to their fantastic 26-week course was […]

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The ‘Deliberate Practice Mindset’

Performance improvement is an interest of mine. I have previously blogged and podcasted about the strategies I employed to lift my game (from rock-bottom) when working in an extreme environment – a South African township ED. I first became aware of ‘deliberate practice’ after reading an excellent St. Emlyn’s post last year. I had never encountered the concept before, but […]

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How to write off your paperwork. EMJ Blog.

Emergency medicine is one of those specialities where physicians of all grades have to make their own notes, even the consultants. Medical and surgical bosses have juniors to scribe at the ward round, secretaries to type up dictated clinic letters, assistants to type op notes (most of the time). EM consultants, like their junior colleagues, still […]

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What do Emergency Medicine and Donald J. Trump have in common?

*Caution: Emotionally-charged post, pinch of salt required… personal feelings only and not the editorial view of the EMJ/BMJ. On the morning of the 9th November 2016, I woke up to the earth-shattering news that Donald Trump had been elected President Elect of the United States. It’s a moment I’ll never forget. Rain pounded menacingly against […]

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Live and let die

Everyone dies. It’s a sad fact of life and a tough part of any healthcare professional’s day. Some deaths are unexpected, and hit us hard. Thankfully, there are those that we know are coming, and this gives us the opportunity to try to give that person a peaceful and comfortable end of their life, and for […]

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Nuances of Neurogenic Shock

Even when the mechanism is highly suggestive for significant spinal injury, the shocked major trauma patient is haemorrhaging until proven otherwise; cue blood products and damage control resuscitation. When there is no evidence of external haemorrhage in the primary survey, the EFAST is negative, and the trauma series CT shows no evidence of bleeding, a […]

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