Lessons Learned: Driving in the Cyclades

I attribute my love of sports cars to my paternal grandmother, Guillermina Castillo. One of my earliest childhood memories was seeing Grandma whip up in front of our house in her late 1970s Pontiac T-top Trans Am—a sleek, black sports car emblazoned with the famous yellow Firebird smothering the hood. This car was flashy and awe-inspiring, albeit a little tacky. To this day, my own favorite car was a souped-up manual transmission Honda Civic SI with racing bucket seats my husband and I owned when we first got married. It was no surprise we had to sell our beloved coupe when trying to manage kids and car seats.

During our vacation to Greece this summer, I had the opportunity to drive a manual transmission for the first time in nearly 10 years. I had to essentially re-learn stick shift. While it was exciting to revert back to tight steering and quick acceleration, this personal challenge came with a deadline. I had to literally get “back up to speed” before my husband left the island of Paros for a work conference out of the country, or the kids and I would be stuck in town.

Narrow shoulders, blind curves—and, um, driving off a cliff into the sea—got the better of me the first week. I quickly diagnosed my own anxiety: palpitations, shortness of breath, and hand sweating. How do the locals dead stop on a vertical incline and shift into first gear without drifting backwards or stalling? Unfortunately, avoiding hills in Greece is nearly impossible. The kids became creative and offered a myriad of suggestions of “Things to Do Without Driving!” It sounded like defeat.

However, having faced years of 12+ hour shifts with gunshot wounds, heart attacks, strokes, and the list continues, I knew I could handle this. While my son held his breath—and desperately clutched the door handle—around every curve, we successfully made it to the beach on our first outing. It wasn’t necessarily smooth, occasionally getting lost and once even accidentally running over a turtle, but we made wonderful memories and explored all the island had to offer. In the end, I was able to taxi four kids in the car and accelerate out of first gear on a hill without stalling, all while belting out Hamilton! I was proud of myself, and my children witnessed me conquer a fear through practice, patience, and perseverance.

Upon returning to NYC, I was back riding the subway reflecting on the summer when I had a realization. While driving in the Cyclades, it was so easy for me to go fast, but much more challenging to drive in first or second gear. The comparison to my chosen profession became obvious.

As Emergency Medicine physicians, our lives are built around working in the fast lane. The fast-paced environment we inhabit rarely functions in first, second, or even third gear. We are always, and arguably, most comfortable operating in fifth or sixth gear. We thrive when there is momentum, and every day, we handle bumps (like the poor turtle we honored with a moment of silence) in the road with skill and grace. Life is a lot harder when you have to slow down for a blinding curve or come to a dead stop on a hill.

Re-learning stick is akin to my efforts for establishing well-being initiatives within Emergency Medicine. As Emergency Medicine physicians, we need to mentally and physically give ourselves the time and permission to live and work in slower speeds. We need to master operating in first or second gear to allow us to safely and expertly handle the 75 mph speeds our jobs daily demand without falling off cliffs.

Our EM Well-being Committee is just over a year old and I am proud of our accomplishments. We, however, have a long road to travel and we are working hard to make significant advances to improve the well-being for all. This work requires patience, practice, and perseverance in order to facilitate the necessary cultural shift of slowing down to allow all of us to have a long, rewarding career in the fast lane.

Well-being Initiative Ideas:

• Shift Breaks to eat, refresh, or take a walk out of the department
• Guidelines around aging and overnight shifts
• Guidelines regarding third trimester pregnancy and overnight shifts
• Eating and Drinking guidelines with the Emergency Department

Jenny Castillo Cato, M.D.