Performance Under Pressure: Add Another 6 Hours onto an Already Full Day? Sure!

You are at work, and just closing for the day at 5pm. You worked hard all day and completed everything you needed to perfectly. You tell yourself, I did well today, and I have earned my rest. Then someone comes in to tell you to stop what you are doing and prepare to work another six hours to finish this major project that just came in. How do you react? Are you upset? Are you angry? Does life seem unfair?

This exact situation happens every week, if not daily for physicians. There are always more ill people to care for, and sometimes its serious and cannot wait until tomorrow. Classically, Friday at 5pm right before you are going to close for the weekend is when a patient calls with a serious issue.

OK so you are going to stay and deal with the problem. Your boss is making you and you don’t want to let them down. How do you wrap your mind around it?  What do you do when you have to add on complicated tasks to an already hair-raising day? In the operating room, Surgeons are frequently asked to do this, as they must maintain a steady stream of elective cases (cases that are scheduled) as well as deal with emergencies that always come in. This means we are not resting on our laurels waiting for emergencies, we are constantly working and must make room for them. This is something that society expects us to do, and of course we also want to be able to do. We want to care for people who desperately need it.

But it can be emotionally, mentally and physically draining to add on a six-hour case to an already full day of operating. Not to mention, the lost time that we expected to spend at home relaxing after a day of well done hard work. It often feels like our only reward for working hard is more work.

So how do doctors do it and how should you think about it?

The first is that we love helping people. This is an amazing source of power that we tap into. To get to save lives and help your fellow human, whoever they may be, is something that is part and parcel to medicine. But if you think about it many jobs are like this. What if you need to cover for a fellow worker so they can go pick up their kids? What if you need to help a client or customer? We can draw incredible energy from the power of helping our fellow humans and bringing joy into the world. Its built into our DNA.

The second is training. Surgeons did not develop this stamina overnight, but trained ourselves for these incredible bursts over a decade of backbreaking practice. We build up the stamina to maintain a sustained focus for as long as need be over the couse of training and practice. The more you tell yourself, “I got this, I can handle the pressure” overtime it just gets more comfortable.

The third is that we convert our fear into energy. Emergency cases are often terrifying for patient and surgeon alike. But you don’t see surgeon’s freaking out and getting worried. Why? Because we use the fear and adrenaline to power focus and our drive to win at all costs. We use the flight or fight response and select the FIGHT option.  

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