TLP434: Lessons Learned from the Trauma Room on the Front Lines with Dr. Melissa Givens

Dr. Melissa Givens is a retired colonel with over 25 years of service in the U.S. Army, specializing in emergency and disaster medicine. She holds both an MD and an MPH (Master of Public Health) and is experienced in military and special operations medicine. Dr. Melissa also served as the medical director of the Ryan Larkin Field Hospital, established during the COVID-19 pandemic at Columbia University’s Baker Athletic Complex. She reflects on her time as a military physician in Iraq, highlighting the challenges of maintaining order in high-stress environments and the importance of collaboration over ego. She discusses how tone, energy, and non-verbal communication are crucial in trauma situations, and how breaking down hierarchies can improve teamwork and patient care. Melissa recalls how the anonymity of full protective gear during COVID-19 reduced posturing and fostered greater collaboration. Addressing leadership development, she encourages medical students to embrace leadership early, make decisions with incomplete information, and overcome their desire for certainty. She also emphasizes creating an open environment within all teams, allowing for dissent and input from all members.      Key Takeaways [01:33] Melissa, a mother and experienced leader, talks about balancing professional and personal life. She emphasizes how important it is to be a parent her kids can be proud of, which serves as a grounding principle in her life. [03:21] She reflects on her experiences as a military physician in Iraq, dealing with a unique "red line" designed to separate emergency doctors from trauma surgeons in high-stress environments. The goal was to create order but often exacerbated tensions, highlighting the importance of collaboration over ego. [07:17] Melissa describes the critical importance of energy, tone, and non-verbal communication in trauma situations. Being aware of how these factors impact both patients and medical teams is crucial, as is creating an environment of trust and clear communication. [12:40] She discusses how breaking down hierarchies in medical settings, such as addressing colleagues by first names rather than titles, can foster better teamwork and communication, leading to improved patient care. [09:15] Melissa recounts a fascinating experience during COVID-19 in a field hospital. The anonymity created by full protective gear eliminated the usual posturing and egos that can sometimes dominate medical teams, fostering greater collaboration and a singular focus on patient care. [18:30] When discussing gaps in leadership development, Missy mentions the importance of encouraging medical students to embrace leadership roles early, avoid hesitation, and overcome their desire for certainty. She emphasizes the value of making decisions with incomplete information—an essential skill in medicine and leadership. [20:35] Melissa shares an entertaining story about leadership and problem-solving under pressure, involving a boat trip to see hippos in Africa. When the motor failed, she had to think quickly to save the team from an approaching hippo, using nothing but the boat’s floorboards to row. This story highlights the importance of being accountable and prepared for the unexpected in any leadership situation. [24:11] Melissa emphasizes how creating a welcoming environment for a trauma team, allowing for dissent and encouraging open dialogue, leads to the best outcomes. She believes clear roles, articulation of plans, and encouraging input from all team members are critical to effective collaboration. [31:48] Melissa advises that leaders approach situations with curiosity rather than judgment, especially when being second-guessed or dealing with Monday-morning quarterbacks. This open mindset fosters trust and continuous improvement through after-action reviews. [33:20] Reflecting on work-life balance, Melissa shares her motto, inspired by her college powerlifting coach: "If you're nothing sore every day for the rest of your life, you're not working hard enough." She encourages leaders to challenge themselves in various aspects of life but also emphasizes the importance of rest and recovery for growth and balance. [35:37] Closing quote: "When we long for life without difficulties, remind us that oaks grow strong in contrary winds, and diamonds are made under pressure." – Peter Marshall.   Quotable Quotes "If you're not sore every day for the rest of your life, you're not working hard enough."  "Approach all things with curiosity." "Check your ego at the door and act accordingly."  "Creating that welcoming environment where there is room for either dissent or insertion of new ideas is really what I've seen make the most successful trauma teams."  “Don’t make these assumptions. Be accountable." "You need to challenge yourself intellectually, emotionally, cognitively, and physically, and always be aspiring for that growth state."   "When we long for life without difficulties, remind us that oaks grow strong in contrary winds, and diamonds are made under pressure." – Peter Marshall.   Resources Mentioned The Leadership Podcast | Sponsored by | Rafti Advisors. LLC | Self-Reliant Leadership. LLC | Missy Given’s LinkedIn | Missy Given’s Website |