Resilience: The Art of Failing Forward | Sasha Shillcutt, MD, MS, FASE | TEDxUNO

perfection perfection is a word I have strived for my entire life my entire career perfection is a word I thought if I was perfect if I could get the perfect score if I could look perfect if I could get a perfect score on this exam if I could I would get the procedure perfect for this patient if I could be the perfect mother I would find joy I would find determination I would find

resilience

and I would find success I am here to tell you that I have actually learned just the opposite. throughout my career my time as a mother my time as a wife as a sister as a daughter my time as a doctor in a very male-dominated field but the greatest joy in my life the greatest success the greatest

resilience

the tenacity the fun the the meaning has come from my imperfections it has come from a place of failure if we think about what success is what resilience is what makes people truly brave and what they are we think about what is on the top of the iceberg we think about all the things that They enable people to succeed and when we are in scenarios like I am now, we often brag about our grants, we have received our publications, all the awards and recognitions and all the wonderful things we have done, we don't show them to the world. times what's under the iceberg all our failures our trials our tribulations for example this is me last week I spent the last week in a tropical place and the photo of me that you see here in green is the one I posted on my Instagram feed I look perfect my skin like a glow, you can imagine there are butterflies circling above my head, but I actually spent several hours in my hotel room thinking about this talk working on different projects eating a bag of Twizzlers that I didn't post. on Instagram because that's not what we post and that's not what we project, we want to project perfection while I was thinking about my life and thinking about what I want to share today.

I want to go back and talk to a young doctor. cut I want to tell you things I want to tell you today number one I want to tell you that resilient people share their failure they are not afraid to admit when they have made a big mistake or a small mistake they don't Hide behind a veil of perfection in 1961, an obstetrician and gynecologist from Australia published a five-sentence letter in The Lancet and basically said, "I think I have failed." I have noticed that I have been treating nausea and vomiting and he is giving me a sedative. to several of my patients who are pregnant and those patients have given birth to babies who were stillborn or who are missing limbs.

I think this is something that I have really contributed to and given to my patients. Has anyone else noticed this? He took me five sentences. in an immense failure of a complication to save thousands and tens of thousands of future babies, that drug was thalidomide and its ability to share what we depend on in science, we depend on sharing negative studies, the things that come out are complications , but when it comes to ourselves we often do not share those failures we are too afraid I would also tell your doctor that she will cut resilient people turn vulnerability into their strengths they are not afraid to see where their weaknesses have failed them they do not They are afraid to surround themselves with people who really point out those weak points and are very open about it.

I would tell a young doctor that she will eliminate those resilient people so that they will be resilient. You want to normalize failure in my profession. Doctors have one of the highest suicide rates in the country, we are on the front lines caring for people, we see people in their most vulnerable state and that takes its toll on us and is devastating. I personally lost four of my fellow friends to suicide and there was a research team in 2013, Swak and Schweitzer, who decided that they were going to study this, they were going to look at doctors who work in high acuity T areas, like the surgeons, and they would try to figure out what makes this surgeon may have suffered a complication, a failure, a professional failure, get up and move on versus his colleague or his colleague who has a lot of Sudi anxiety, depression, and suicidal ideation.

What makes these two surgeons different. They found four main variables and one of them was so One interesting of them was that the doctors who were resilient, the surgeons who could go through a very difficult complication or a professional failure and then recover, had what they called a margin of failure, they accepted that they themselves, being in this field, were going to move

forward

. have complications, they would probably fail at times, compared to other doctors who had an allistic ideal of perfection, which is what we are trained to do in medicine from a very young age, we are trained to get perfect scores, get a perfect score so we can get to the perfect university and the perfect scholarship and those doctors who were the most resilient accepted a margin of failure.

I would also tell and tell the young doctor from the beginning that she will cut and that she thought it was cool to be a perfectionist. Something very important, probably the most difficult thing about failure. I would tell him to look for feedback on his failure. I want to take you to a very tragic story. This is a true story. It happened to me. I had a very successful medical school career that I was on. At the top of my class, I was inducted into the Medical Honor Society, I was chief resident, and I never shied away from difficult cases.

I took a lot of pride in the fact that I was very, very good clinically and nothing could really stop me and I was I'm not afraid and it had been about six months now as a cardiac anesthesiologist working in the operating room and I was on call one night and the buck stopped with me. while he had ten other anesthesiologist doctors who were there in training. He was the on-call assistant for a very young patient who came in and through a series of complications and very unfortunate events, our OR team lost that patient and I can still hear, as I stand here today, the beeping of the heartbeat. heart and the horrible sound of silence.

I was so devastated because this had never happened to me before and although the fax revealed that it wasn't completely my mistake, it wasn't really anyone's mistake, it was a series of events and a very sick patient that didn't matter. Convinced this was my fault, I went home in the morning and sat comatose on my couch. He didn't even know how to process the events of the night because he had never failed like this. I thought so. I thought about walking to the hospital the next day and I saw another patient and I couldn't bring myself to do it.

I called my husband, wrote a resignation letter and told my husband that tomorrow I will go to work and hand in my resignation letter to which he said, okay, if that's what you need to do, of course, in his mind it was thinking all of our student loans were crazy, but he came home that night and sat with me and I still hadn't moved, I was just overwhelmed. I was overcome with shame and I couldn't face going back to the hospital. I felt so terrible that I had contributed to this and at about nine o'clock at night my phone rang on the other end of the line.

It was one of my partners. He was in his early 70s. At that time, he was about to retire, he had a very long and successful career and he asked me a question, he said: how are you? and on the other end of the line I couldn't talk, I just sobbed and the most amazing thing happened, he sobbed, and then he started sharing with me a similar event that happened to him and he started offering me feedback on my failure, he started offering me feedback on this complication that I never thought I would have, he started giving me and telling me and normalizing me through his own experience what had happened and what I had to do to process it and then the last thing he told me changed the trajectory of my career changed Who I am as person as a mother as a wife as a wife sister as a friend told me tomorrow you have to go back to work you have to get up and you have to take care of the next patient who needs you and the next patient who needs you and he taught me to seek feedback for my failure which was okay fail and process it and fix it and ask for help, I would also tell dr. shell cut, the most important thing here is to miss

forward

.

I would tell him that he is going to fail a lot and that it is okay to fall as long as you get up, brush yourself off, look to your right and left, see who is around and search. Comments and I'll leave you with this last story. Now fast forward 1213 years and dr. shell cut is in the cardiac operating room and we are doing the case and his cell phone rings and it is his 13-year-old son who is an hour away and has just finished a basketball game. He had to take the bus because his mother is working and His dad is working, so he's alone at a basketball game out of town and he whispers to me, Mom, you have to come pick me up, and of course, I instantly think that he broke his arm, he hurt himself.

I told him, well. Why do I have to come look for you? What's going on? Well, they fouled me with five seconds left in the game. I went to the free throw line. We were down by one and I missed both of my free throws. I really need you to come. Bring me mom, I can't get on the bus, I know what none of my teammates will look at me, I let everyone down, it's really bad here mom, you have to come get me, I can't, I can't get on that bus and ride. at home with my classmates everything inside me wanted to be a mama bear I'm going to look for you baby just wait but I knew it was my time to teach him so I told him what I want to let you get on the bus I have to get on the bus and in tears in the operating room he I told my son that I was there.

I know what it's like to disappoint everyone and feel embarrassed, but that's called life and you have to get on the bus, so I hope I left you some inspiration today and I hope that maybe you thought about a time when you failed, maybe If you're still holding on to that shame, move on and remember to get on the bus.