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Medical Humanities

Ski Racing: Training for Medicine

Michael Chen

April 20, 2015

I felt the crisp air against my cheek as the chairlift moved up the silent mountain. The clouds above reflected a fiery glow from the rising sun. When the chairlift reached the summit I pushed off, tightened my boots, and assessed the conditions on the empty slope below. 

Chairlifts do not open to the public until 9:00AM. However, as a ski racer I started training at the crack of dawn, finding early morning solitude and escape from the ruckus of school and the city. I skied about 3,000 runs a year, getting up and pushing forward even after hundreds of crashes. No matter how much my muscles burned or how freezing the temperatures were, I did not give up in the face of obstacles.  Reflecting on past experiences helped me learn from my mistakes and try until I succeeded.

I have competed for the Snowbird Ski Team since I was six years old and represented the Chinese-Taipei National Ski Team in college, placing in the top 10 at the 2010 World Alpine Junior Championships and the 2011 Asian Winter Games. I continue to be a ski coach, working with children to cultivate a lifelong love of skiing while developing confidence and self-worth. While I am proud of my personal accomplishments in skiing, I have learned the most about myself while coaching.

One memory of working with five young ski racers has been particularly ingrained in my memory. That day, a dense fog settled onto the mountain, obscuring a run that is only safe during small durations of the year. After gauging the comfort level of my group, I determined it was safe and diagrammed the jump in the snow for them. My next challenge was to gain their trust. Only one of them had skied the run before, so the idea of jumping the cliff was intimidating. I sent the experienced racer down first, so the others could see her execute the jump successfully. One-by-one, the racers jumped. 

From the bottom of the cliff, the group looked up in awe of what they had accomplished. They were cheered by a group of snowboarders from the top of the cliff. That experience provided a confidence boost for both the young kids and me. I had earned their trust and patiently answered their questions to alleviate their fears. 

I am grateful that I have had the opportunity to be involved in ski racing and coaching. Turning apprehension into excitement sparked my love for both and has made me respect the responsibility of earning others’ trust. I have learned many lessons, including some that apply to my future career as a physician:

Collegiality – Ski racing is unique in that it is both an individual and team sport. There are only individual results at races. Utah’s resort team lines blur as we often compete together as a “team” when representing the Intermountain Division or even the West at Junior Olympics and other national races. No matter the team, any racer who needs someone to carry their jacket down to the bottom of the course knows that someone is happy to help. While on the course, you are competing for yourself. But beyond that, ski racing is quite a tight-knit community. 

As healthcare moves towards becoming more and more patient-centered, the necessity of camaraderie will only increase. My experiences during my pediatric rotation demonstrated this well. On a team of 4 medical students, a senior resident, and one attending, we 3rd years were allowed to act as interns. We wrote orders, consulted specialists, and were the first page for our patients. Having this type of responsibility showed me just how important collegiality is in healthcare and in achieving the Hippocratic Oath mantra “do no harm.” Be it discussing alternatives for a timentin allergy in a cystic fibrosis patient with pharmacists, consulting the Department of Child & Family Services for unfortunate social situations, or requesting pet and art therapy for a patient on hospital day 20, our common goal was the same – the best care for our patient. While the entire healthcare team was necessary for well-rounded care, quality of care came down to individual responsibility. Just as in skiing, every person was responsible for their own duties. A forgotten order or delayed phone call delayed patient care and slowed the whole team down. Because of this, it was essential for us to perform at the top of our abilities. And as with helping each other on the ski hill, we helped each other prepare discharge summaries and follow-up with primary care providers.

Discipline – Ski racing takes massive amounts of time. Whether it was training six days a week in the winter or only going to every other week of school due to ski race schedules, time management was an essential skill to develop. Learning to coordinate ski race schedules and assignments/exams with teachers was complicated. It was not a question of if, but when, I would miss an exam. 

I had one experience at a Downhill race in which the athlete before me crashed and was lifted off the course via helicopter. This was quite unsettling as I was the next racer to go down the “safe” course. Experiences like this form the ability to maintain discipline even in uncontrollable circumstances. This has helped me learn to accept situations as they arise and maintain discipline instead of stressing.

Physicians constantly have to balance different aspects of their lives whether it be catching up on notes, attending a child’s piano recital, or answering phone calls of frantic patients. Life happens and learning to stay disciplined is a valuable life lesson. Discipline in focusing on the task at hand such as interviewing a patient in clinic with his 6 siblings causing chaos in the room is important for attaining the all-important history to lead to a diagnosis. Discipline also comes in the form of organization: I remember on my first 30-hour call, I had 3 admissions overnight with enough pages that I needed to clear my pager 4 times. Before I was able to gather my thoughts and staff a patient with an attending, I was paged to check on one of my patients who had just spiked a fever. Then while writing orders for cultures for that patient, I was paged to do another admit. The night continued like that and staying disciplined throughout the onslaught of tasks was essential to making it through the night. Before I knew it, it was morning and my allowed time in the hospital was coming to an end, but I still had many notes to write. Staying disciplined throughout the night in scribbling down what orders I had written for patients on my tracker and keeping H&Ps separated allowed me to write accurate notes. While I did not realize it before, “do no harm” has been a part of my life for quite a while and staying disciplined is important to keeping to that mantra. Be it losing focus while going off a jump at 75 mph or writing an order for the wrong patient, discipline plays a large role in not doing harm and ski racing helped train me for my career of doing no harm. 

Adaptability – Whether it is torn ACLs, broken legs, or even death, injuries are seen quite often in the ski racing world. Risk assessment is embedded in the brain of every ski racer from a young age. Every turn could lead to a season-ending injury. Adaptability is crucial to making it to the bottom of the hill. I once had a squirrel run right across my path as I was bombing down the hill at highway speeds. Race runs become a blur of subconscious decisions, as there is no way I could make the thousands of tiny adjustments consciously. The ability to adapt to numerous changes takes training and was a valuable experience learned from ski racing.

Physicians must also stay adaptable. We can make plans, but it would be naïve to think that everything will go as intended. From patients who forget to take medicine to errors in medical records, there will always be unforeseen events that a physician must deal with gracefully. As one of my attendings said, “I enjoy practicing proactive medicine, but sometimes we must practice reactive medicine.” I will never forget the first exploratory laparotomy that I scrubbed in on. We had a strong suspicion of a perforated bowel. Having never seen an open abdomen, I stood there unsure of what to do as the resident and attending were pulling out loops of bowel. My only experience with bowels had been in a cadaver 2 years ago. However, realizing that acting as a statue was not going to serve anyone well, I jumped in moving bowel out of the way, retracting abdominal wall, and helping to suction. Adaptability also is important in communicating with patients. Being in outpatient clinics in the fall, I asked every patient if they had received a flu vaccination yet that year. I received a wide variety of responses to this question from “My culture doesn’t allow shots” to “Don’t those cause autism?” to “Who wouldn’t get one?” Learning to adapt my communication style and presentation of evidence-based medicine came into play. Like in skiing, where a snow patch can actually be a surprising ice patch, having an attitude towards me completely change when I ask about flu shots was surprising. However, I have used adaptability to figure out how to solve problems: be it skiing the rest of a turn on one ski or presenting a patient with information about how flu shots don’t cause the flu. As many residents have told me, being flexible is a part of medicine, and I will constantly need to learn how to work with patients of all backgrounds and styles of communication.

In a few years I will graduate from the University of Utah School of Medicine. I will take my experiences and everything that I develop, such as interpersonal skills and organizational skills, into my future career. I will use all my successes and failures to better myself as a person and hopefully as a physician. My lessons and experiences from ski racing will continue to guide me throughout life and make me a better physician. 

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