• Torres. Inspired by Daenarys Targaryen. Breaker of

Break the Wheel.

"Those who can't do, teach."

Bunk that. I am insulted when persons joke about my teaching skills.

And try to figure out why I love teaching.

1. Realize up on what you don't know. There is a lot. Slowly. Pace yourself.

2. Read up on the stuff you really love. Be the expert who will never be satisfied in accumulating knowledge.

3. Keep on reading even after you pass your oral and written boards

read up on F.O.A.Med via twitter, blogs, emails, what's app group chats.

4. Do simulation via biosim, or with hyperrealism.

A lot of imagination is required. But effort to learn new skills. Or to keep your procedure skills sharp.


Aim for Ecmo.

Aim for ER-Reboa.

Aim for ultrasound techniques like Measuring TAPSE on the heart.

Using ultrasound to perform your first femoral ilia fascia block for hip/femoral fractures.

Those are just examples.

Do not wait for ACGME approved for your needed procedures for Emergency Medicine Residency requirements.

Do not wait for AAEM or ACEP for their guidelines to change.

Do not wait for ATLS to use permission normotension, use of an Abdominal Aortic Junctional Tourniquet device, or doing a needle thoracostomy in the 5th intercostal space where the chest tube will get in.

To do a common femoral artery cut down when the ultrasound probes are broken, and the central line kits are all used up.

Do not wait for ACLS to eventually make an Advanced ACLS course

that endorses Double Sequential Defibrillation,

Use of esmolol drip, Geniculate ganglion block for refractory ventricular tachycardia.

realizing lidocaine is not so bad, maybe safer than Amiodarone. And maybe Procainamide is better than both.

And realize Phenytoin is not only for seizures, but can be used for V. tach.

Lets break that mold of academic medicine in Emergency Medicine.

If you realize you are getting outdated in your way of managing patients. Even getting outdated by the methods taught by the texts of Rosen or Tintinalli.

"Clinical Dementia" is a clinical descriptive disease on performance and teaching when treating patients. Not the medical dementia caused by Lewis bodies.

Break the Wheel as Daenerys Targaryen wishes.


Be Grateful.

Be thankful for the best holiday in the world, Thanksgiving.

Then Break the Wheel.

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