Twenty-four is the number of hours in a day that you have to change someone’s life, and it’s also the jersey number of my favorite basketball player, Kobe Bryant. Basketball has always been a passion of mine, and my desire to compete is the source of my relentless, driven attitude. The fundamentals of basketball entail rigorous training, critical analysis of opponents, working well under pressure, and most importantly, teamwork.
At 3:30 a.m. while on night shift for ICU, a rapid response was called for hypotension secondary to atrial fibrillation with rapid ventricular response and chest pain in a patient who was admitted for an NSTEMI. After a directed history, physical and timely thinking, I deduced the patient was likely having an in-stent thrombosis despite a benign-looking EKG. Unable to reach a cardiologist, I called my attending, and we made the game-time decision to cardiovert the patient out of the atrial fibrillation. I treated her in the ICU as she underwent a series of multiple cardioversions before she underwent cardiac catheterization during which she was found to have in-stent thrombosis and significant triple vessel disease, subsequently requiring a CABG. Through this experience, I realized the importance of critical analysis in the ICU and that it has to occur rapidly to achieve the best outcome. I realized that working well under pressure is fundamental to both of my passions, coupling my past with my future and bringing about new depth to my relationship with the field.
The ability to stay calm in a tense situation is one of the most stressful yet rewarding aspects of both basketball and pulmonary and critical care medicine (PCCM). When the alarms go off as my patient’s oxygen saturation plummets or the patient goes into sustained ventricular tachycardia, I am reminded of the shot clock in basketball, forcing me to act and make a quick decision. Do we need to intubate this patient? Does the patient have a pulse? Do I need to shock? I maintain a calm composure as the interns and nurses look at me for instructions and guidance. Like my favorite player Kobe Bryant used to say, “Everything negative, both pressure and challenge, is an opportunity for me to rise.” My residency program does not have a PCCM fellowship, which has allowed me to flourish as a senior resident and gave me the opportunity to make life-saving decisions in the ICU. It also meant having the privilege to step up for a slam dunk myself, and this has equipped me with the confidence to work well under pressure.
As a chief resident, I am excited to have a leadership role working with younger residents and the opportunity to see them evolve. In the future, I see myself growing as a mentor and helping build the same learned confidence within them through teamwork. It is impossible to win without a team that collaborates with, supports, and trusts you. Seeing RNs, RTs, pharmacists, intensivists, and residents gather for rounds gives me the unique feeling of that pre-game huddle in basketball, which motivates me to give my best effort for the team. Additionally, my basketball experience has taught me to remain persistent amid disappointments and losses. Despite your greatest efforts, bringing home the win may not always be possible for your patients, but having the mental fortitude to persevere for your next patient is essential.
Stepping away from the beeping alarms and loud noises of the unit, I also found comfort during my pulmonary rotation and in our continuity clinic with my patients who have pulmonary pathology. I eagerly use our spirometry machine and cultivate lasting relationships with my patients with shared decision-making to ensure better compliance. Pulmonary medicine is literally a field that helps patients breathe better. Providing a better quality of life for my pulmonary patients in and out of the hospital seems like the perfect yin to the yang of busy ICU days.
As I lace up my shoes and step onto the ICU floor, a certain comfort overcomes me. It is certain that every day brings forth a new challenge, requiring me to step out of my comfort zone and allowing my fundamental knowledge to take over and carry my team to a win.
In the future, I hope to coach my own team as a teaching attending.
Navneet Kaur is a pulmonary and critical care fellow.
