Answering the call for stoicism

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Dealing with the daily disruptions.

As we navigate these and future turbulent times, it’s essential to remain calm, alert and stoic. Whether you’re a busy ER physician, stressed out resident or med-student, we all are facing adversity and disruption in our daily lives.


In these times, it is essential to remember the words of the philosopher Epictetus —“We suffer not from the events in our lives, but from our judgment about them.” We often attribute the term ‘stoic’ to calm and collected individuals under pressure, avoiding emotional extremes to keep things in perspective. Those people who turn an obstacle into a positive.

Stoicism is more than just a philosophic term — it’s a call to action that can influence how we interact with the world around us. Stoicism allows us to apply principles that guide our decision making in times of adversity.

Modern-day philosopher, Nassim Nicholas Taleb, defines a stoic as someone who “transforms fear into prudence, pain into information, mistakes into initiation and desire into undertaking.”


Pillars of Stoicism:

The dichotomy of Control:   Historically, stoics believed that everything around them worked together in a cause-effect relationship. They thought that while we don’t always control the things around us, we do have control over how we react to them.

Example: We don’t have control of the patient before they enter the emergency department, their prior health management, the way EMS transported the patient or even some the actions of the ED staff. But we do have control over how we react to their condition upon arrival, interact with the EMS and ER staff during the resuscitation, and the decisions we make to treat this patient.

Cardinal Virtues:  Instead of imagining the “perfect” world, a stoic views the world as it is while pursuing self-improvement through the practice of the four virtues.


  • Practical Wisdom – differentiating the good from the bad. Ability to navigate complex situations in a logical, calm and informed manner.
  • Justice – knowing the right thing to do. They are treating others with fairness, even when they have done wrong.
  • Courage – standing up, physically and morally, for what you believe is right. Approaching daily circumstances with clarity and integrity.
  • Temperance – personifying self-restraint and moderation in all aspects of life.

Example: Calling for a consult on a patient; however, the consulting physician appears angry and disinterested in helping you or the patient. This is a problematic situation, but channeling the virtues above can be helpful.

We have no idea what situation others just walked out of when we interact with them. If they are treating you poorly, you don’t need to treat them the same way, can be silent, listen and maintain stoicism.

Understand that you are doing the best thing for the patient, being calm and firm in your medical discretion for this necessary consult. Temperance can be difficult but can help diffuse a negative situation.

So what do we do with this info?

  • Write: sit down and take time to process what is going on around you. Write down what you have control over and what you don’t. Write down a stoic quote that speaks to you, and then write down why it speaks to you.
  • Reflect: The next time you are worried about something, take a moment to reflect on if you have control over what you are concerned about. Are you worried it’s going to rain and ruin your event outside? If so, perhaps remember that you have no control over whether it rains or not. This will help you realize that worrying about it does nothing but hurt you and won’t change anything.

Only those who have internally cultivated virtue and self-control can influence others and create change. By applying dichotomy of control and the cardinal virtues to our daily practice, hopefully, they will lead us to be happier, healthier and subsequently impact the world for the better.

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EM OVER EASY is a podcast by three EM physicians, Andy Little, Tanner Gronoowski and Drew Kalnow, with a focus on #MoreThanMedicine. The podcast can be found on Apple Podcasts, Stitcher and more. For more about the content and hosts, visit and follow them on twitter @emovereasy.

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