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A Musing Pediatrician

When your brain is full...

Gregory Lawton, MD, Pediatrics, General, 06:37PM May 1, 2014

I am exhausted.  

The past three days have been spent sitting in a classroom (albeit a very nice one) for an accumulative 17.25 (CME) hours.  I feel like Calvin (of & Hobbes fame) asking Mrs. Wormwood if he can be excused.  "My brain is full."

I have just returned from an EPIC electronic medical record (EMR) builders course at the EPIC campus in Wisconsin.  In the world of EMRs, EPIC is the 800 pound gorilla, laying claim to the fact the by 2015 over half of the population of the United States will have a record in EPIC.  The purpose of my course was to learn how to make it easier for physicians in the outpatient network at Children’s Hospital of Philadelphia to document patient visits in a way that minimizes the number of expletives uttered.

But I digress...did I mention that my brain was full?

Patients sometimes exhaust me.  Some days there is not an easy visit to be found.  C'mon, I mutter just gimme one quick ear, or a wart, or conjunctivitis.  Instead, every visit is a mystery, or a complicated explanatory process, or an exhaustive social/behavioral issue.  After some clinical days, my brain is vey fill.

Most Mondays find me working on EPIC from home form 730 or so until 130 when I head off to the office for afternoon and early evening patients. By the time 130 arrives, I am usually nursing a moderate EPIC/email/meeting/project headache. A funny thing happens, however, when I start my clinical afternoon.  My headache abates.

The same thing occurs on the flip side.  Too many clinical needs can take their tolling the solitude of EPIC offers a refuge.  It's not a matter of shifting gears.  It's most like going from left brain to right brain. 

Professionally, we all need to achieve balance in order to provide for our patients all they deserve and all we are capable of.  Voluntarily putting the nose to the grindstone serves more to spite one's face than to serve the very patients who depend on us to be at our best.  If our brains are full or we are tired or distracted or depriving ourselves of an outlet, are we doing anyone any favors?  

When was the last time you took a vacation?  Or volunteered at a clinic?  Or spoke to a parents group?  Or attended a (non-EPIC) CME?  When was the last time you refreshed yourself, and allowed a different part of your brain to fill up, giving a break to the bursting side?

Tomorrow, I refuse to do EPIC.  Instead I will see someone I haven't seen in five days, an actual patient.  My patient and their parents expect me to be fresh and alert and at my best.  

I'm starting to feel better, already.


About This Blog

My main job, as a general pediatrician, is “to explain, to reassure, and to know when to refer,” because most of what I see is a variation of normal. This blog discusses the art and science of pediatrics as well as the challenges and rewards of seeing newborns through to adulthood. It also looks at events in the world and how those events affect children, parents, and, the pediatricians who care for them. Look for it twice a month.

Look for me on Facebook at A Musing Pediatrician,

Follow me on Twitter at @amusingpedsdoc,

Disclosure: L. Gregory Lawton, MD, has disclosed no relevant financial relationships.Poll: Do you feel you have the time, expertise, and materials necessary to manage concussions in your patients? Yes - I have this now.|Not yet - but I will be getting this soon.|No - I don't feel prepared.|I don't think this is an area for the general pediatrician or family practice doctor.|

  • Gregory Lawton

    Dr. Gregory Lawton is a pediatrician with the Children's Hospital of Philadelphia (CHOP). He attended Jefferson Medical College in Philadelphia on a scholarship from the US Air Force and completed his pediatric residency at a teaching affiliate of the University of California, Davis at Travis Air Force Base, California.

    From 2000 to 2003, he served as the pediatrician at Hanscom AFB in Massachusetts.  

    He exchanged the polyester Air Force uniform for cotton fiber in 2003 when he moved to the Philadelphia suburbs to work for the Children's Hospital of Philadelphia.  He sees patients at CHOP Care HighPoint.

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