EM Collective Wisdom: Megan Fix

Author: Megan Fix, MD (Director of Education, Division of Emergency Medicine, University of Utah, Salt Lake City, UT) // Edited by: Alex Koyfman, MD (@EMHighAK) and Brit Long, MD (@long_brit)

1) Why still Emergency Medicine? 

Taking care of patients in the ED is a great privilege and honor for me.  I’m so thankful to have the opportunity to connect with patients at their time of crisis – whatever that may be.  EM allows for constant learning and variety, which keeps me interested, engaged, and excited about our amazing profession.

I am also very fortunate to work with students and residents, which keeps me balanced.

2) Most impactful case?

There are so many cases that have shaped me into who I am today, but the most impactful of these was a young woman I took care of when I was a new attending.  She was mid-40s, beautiful, and had a large DVT. She was transferred from an outside facility to be admitted to our vascular service.  While waiting for admission, she walked to the bathroom and collapsed… presumably from a massive PE.  She was brought into the resus bay still awake and alert and looked up at me with beautiful blue eyes and said “I’m dying”.  We resuscitated her the best we could. Intubated.  tPA.  ACLS. Consult with CT surgery for possible thrombectomy.  Almost an hour of CPR.  I brought her family in for the code and found it to be very powerful.  They were on board with everything we were doing. It was incredibly hard on everyone. I invited them to see the ultrasound that showed no cardiac activity, and I cried with them when we called the code. I will never forget her eyes and how I couldn’t save her.

This case reminded me that everyone we care for in the ED is a human being.  We, too, are human beings and our depth of experience both physically and emotionally that makes us better physicians.  As painfully hard as this was, I am thankful to have shared this depth of the human experience.

3) Most important career decision leading to satisfaction?

I have a two-part answer here.  First, I was fortunate in residency to be forced into a process of self-discovery. I was actually quite depressed at this time in my life, and with the help of my loving friends and colleagues (and my PD and chief resident) I was able to take a look inside myself and make some decisions about how I was going to live my life.  I made a commitment to my relationship with me and to self-care. By doing that I was freer to really enjoy my career and had much more to give.  I became truly happier and was able to focus on my career strengths – which are in teaching and working with others.  Through this self-realization process I have become a person who is authentic and dedicated to being the best human I can be. This also involves honesty.

The second part of my answer is hands down being involved in education.  From my roles with medical students to residents to other faculty members, the rewards of education are unparalleled.  I gain joy from having a balance of clinical work and education, and it’s allowed me to be super satisfied with my life – both in and out of my career.

4) What does future of EM look like?

So bright!  When I look around the community of EM I see incredible people.  From the EM docs at my institution to the international community of EM, I see extremely capable, motivated, intelligent people who deeply care about our specialty and our future.  Our residents are getting better and better, and they have amazing ideas for the future. Although the world is always changing, who is best equipped to adapt to change?  EM folks are because that is what we do every day.

5) Greatest achievement / why giving back is important?

Although I am very proud of my achievements in medical education, I must say that my greatest achievement in life is being authentic with who I am.  I am a wife and mother, and this comes first.  Then I am a clinician educator.  All of these roles work together, and I could not be my best physician without being true to my values of being a wife and a mom first.  I feel great joy when I’m teaching because of the connection I make with learners.  This ranges from medical students, to residents, to faculty in the different CME courses that I teach.  Last night, we had a mentor mixer for the medical students, and I mentioned to them that we faculty love mentoring because we like students… and that we once were students.  I feel that mentoring is one of the best ways for me to give back, because I have relied on so many mentors throughout my own career.  Connecting with students and residents allows me to be authentic – I share with them my struggles in life in the hopes that they can find some wisdom there that will help them with their own journey.  That is what my mentors gave to me, and it helped me become who I am.

6) Favorite failure?

Being wrong!  I love it when our amazingly smart residents call me out on my areas of ignorance.  They are always bringing up new ideas or papers that were recently published.  This is one of the best things about academic medicine – your learners oftentimes know more than you and can teach you so much.

7) One thing you would change about our field?

I mentor a lot of medical students, and one thing they seem to always bring up is, “I’ve heard that you will burnout if you go into EM”.  We know this.  It’s in all of the surveys.  I’m not sure how I would change this, but truly this is not my experience of EM.  I have great joy in what I do, and probably part of that is due to framing, my self-work, having an academic career, etc. I look around my faculty group and see very few who are currently burnt out, but I do see colleagues who are experiencing this and have even left the specialty.  As are most things, burnout is multi-factorial, but I would love for the EM community to have this more figured out so it’s not such a stamp on our specialty.

8) Something that you love that has indirectly impacted your EM career?

My husband and 3 boys. They make me a better person by being their amazing selves.  I also have found outdoor activities (and sometimes competing in triathlons, swim races, etc) and cooking amazingly healing.  Authentic friendships are also truly magical and inspiring.

3 people you’d like to see fill this out

1) Amal Mattu

2) Mike Gibbs

3) Loice Swisher