Courtesy of Dr. Sudip Bose
Dr. Sudip Bose.
- Dr. Sudip Bose is an emergency physician and Cofounder and Chief Medical Officer at liveClinic.
- When he was being trained as a doctor, he was taught to check three things on any patient first, regardless of their complaint: airway, breathing, and circulation.
- As the CEO of his own startup, he translated this process into his own version of ABC: assess, break it down, and complete.
- He finds this system helps him prioritize problems without being distracted by anxiety or other emotional reactions.
When a patient arrives in the emergency room, I'm trained to check three things first: airway, breathing, and circulation. In the chaos of the emergency room, when patients are horribly injured and in great pain, it's tempting to bypass the sequence and immediately treat the injury and pain.
That would be a mistake.
Early in my career, I examined a patient who fractured his ankle so badly that the bone was protruding from the skin. While my first instinct was to immediately address this hideously painful injury, I suppressed this surge of empathy and completed my assessment. I quickly discovered his lung had collapsed.
If I hadn't followed the sequence and examined his entire body, the patient very likely would have died.
The lesson here: Address the quietly critical before you address the visibly urgent.
Unfortunately, your emotions are usually working against you. The amygdalae are two almond-sized lumps in your brain, one on each side. Their job is to connect a life experience to an emotion. When we encounter an intense situation, the amygdalae go into action and hijack the logical sections of our brains.
They're responsible for panic. Intense anger. Paralyzing fear. These emotions are a natural part of life, but they are also the enemy of good decision-making and effective performance.
As an emergency room doctor and a soldier, I learned how to deal with my instinctive emotions and perform under pressure. Now that I run my own startup outside of the ER, I've found I must exercise the same type of self-control.
In place of the ER protocol of airway, breathing, and circulation, I utilize a process of assess, break it down, and complete to determine the right actions to take in the face of a challenging business or personal situation.
For example, let's say you're running a startup business that's struggling to find customers and is under intense scrutiny from investors who are threatening to sell their stakes if the financial performance doesn't improve. That's exactly what happened to me.
One morning, we found a pornography website had hacked our website. Now thousands of physicians seeking our teaching material were getting more than they wished for. Our IT team detected the threat early on and believed the threat could be isolated and contained without taking the entire system offline. As CEO, the obvious temptation was to instruct the team to quietly handle the situation to avoid any harm to our reputation. We had enough problems already.
Instead, we assessed the situation objectively and broke down the possible scenarios.
Using my framework of assess, break it down, and complete, we determined the greatest threat to the life of the business would be to remain silent in the face of possibility that the hacker stole our customer data - and then a customer discovers from another source that their data had been compromised. Our reputation among all our customers would be irreparably harmed and we would be subject to legal action. Our fledgling business could easily be destroyed.
The proper decision: Notify all customers, investors, and law enforcement agencies of the security hack and explain everything we're doing to contain the damage and set up new protocols to better safeguard our systems.
Sure, it wasn't pleasant. But by not allowing my amygdalae to hijack my logic, we made the right decision and took the right actions. Sticking with a disciplined process in tough situations helps enormously.
We can't make panic, fear, and anger disappear from our lives. What we can do is create processes and routines that help us to perform at our best and avoid impulsive actions that may harm ourselves and others.
It works in the ER. It can work in business, too.
Sudip Bose, MD, FACEP, FAAEM, is the Cofounder and Chief Medical Officer at liveClinic. Follow him on Twitter @docbose.