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May 16, 2013

BehindTheMedspeak: Why I burst out laughing when someone tells me something is urgent

Below, excerpts from a chapter of my upcoming book "Think Like An Anesthesiologist."


When I get emails or phone calls or texts from people telling me about how important something is — and how I must respond RIGHT NOW — my first reaction is always to snicker.

Gimme a break.

"Can't intubate can't ventilate" — that's urgent.

The rest is piffle and very small beer and can just wait until I'm good and ready to deal with it.

Unless you've stood over a patient's increasingly cyanotic face, unable to intubate or ventilate, while the O2 sat meter's beeps get lower and lower and slower and slower, and felt the sweat running down your butt crack, you have no idea what "right now" really means.

Rule of thumb: In otherwise healthy adults, permanent, irreversible brain damage begins after five minutes of hypoxia.

In children, or adults with compromised pre-existing physical status, less.

Sometimes significantly less.

Trust me on this.

May 16, 2013 at 08:01 PM | Permalink


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There's nothing like a major traumatic life event to prompt a dramatic shift in priorities. In fact, if such events weren't so darned traumatic, I'd wish for one every year, to keep my priorities sane.

As it is, I'll stick with never having another one, please.

Posted by: Phillip Winn | May 21, 2013 4:25:21 PM

Yeah, but ventilation is a Stat event....

Posted by: 6.02*10^23 | May 17, 2013 11:38:54 PM

akkkkk! so wise... both of you. Joe, did you not once describe yourself as pathologically patient? I wish I had time for that, but there's so much that needs to be done right away!

Posted by: tamra | May 17, 2013 12:07:07 PM

People think their little lives are waaaaay too important. I know I was one of them. I ended up dropping several things in my life that others felt were inconvenient for them because my doing it was something that made their lives easier.

Sad part is, all they needed to do was slow down, much the same way I am.

That said, one of my snarkie things I do is that I have all my email systems dropping 'URGENT' emails to the bottom of my list. As I get about 100 messages a day and respond to maybe 5 of them, they get ignored. Even my boss has learned URGENT means that he'll have to wait a little longer than if it were sent in a calm rational way that respected all the space around me. Life is too important for everything to be urgent all the time.

Posted by: clifyt | May 17, 2013 9:49:20 AM

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