Dr. Martin Kuuskne is an Emergency Medicine Physician at Brampton Civic Hospital. He received both his Bachelor of Health Sciences and M.D. from McMaster University, Ontario. He then completed his residency in Emergency Medicine through the Royal College of Physicians and Surgeons at McGill University in Montreal, Quebec. During his residency, he became interested in and completed a fellowship in medical education specializing in simulation and its role in training and assessment. He was one of the two founders of EMSimCases.com, an open access, peer-reviewed repository of emergency medicine simulation cases. He currently applies his fellowship experience towards interprofessional in-situ simulation exercises where he both leads and debriefs his colleagues through various cases. When not in the emergency department, Martin finds himself enjoying music through playing the piano and exploring the world’s greatest reefs through scuba diving. He is currently also a ringside physician for the Ontario Ministry of Tourism, Culture and Sport for professional boxing events in the province. Most recently, Martin was asked to participate in the 2nd Royal Hospital International Conference in Muscat, Oman where he lectured on the diagnosis and management of acute subarachnoid hemorrhage. He currently resides in Toronto, Ontario.
Where did the idea for a career in emergency medicine come from?
I spent the majority of my formative elementary and secondary school studying music at St. Michael’s Choir School in Toronto. Being a part of a world-wide touring choir and gaining expertise in performance piano, I was initially aiming for a career in music. While I progressed in my musical studies, I also found myself not only excelling but also enjoying math and sciences which continued through university. One day, I found myself in an emergency situation where I had to apply basic first aid airway principles to a person in distress. This scenario led to a shift in my professional direction as I realized I could use my passion for the sciences towards saving lives. It then became clear that I wanted to become an emergency physician.
What does your typical day look like and how do you make it productive?
Working in the busiest emergency department in Canada, no two days are ever the same. Because of this, it is important for me to have processes and routines that I use on a daily basis. In order to keep track of the large volume of patients that need to be seen, I use a tracking system that I personally developed. This allows me to create a snapshot of what is needed to most efficiently make a disposition for each patient. Teamwork in the emergency department is absolutely pivotal. Every day I foster my relationships with our emergency team which includes nurses, administrative staff, allied health professionals and specialists by conducting team huddles at the beginning of each shift and debriefing especially difficult and emotionally trying cases. This leads to a supportive and communicative dynamic between each team member creating a productive atmosphere.
How do you bring ideas to life?
In my experience, planning and fully educating myself around the idea before starting allows me to more successfully bring it to life. Speaking with experts, doing self-directed learning, seeking non-biased opinions and gathering as much information on the topic as possible allows me to confidently start a project or idea while executing it in my own vision.
What’s one trend that excites you?
Point of care ultrasound has made giant strides in emergency medicine in the last few years. The use of ultrasound has greatly impacted the care of my patients from FAST scans for abdominal trauma to ocular ultrasound for retinal detachment. As an accurate, visual extension of our physical examination, the use of ultrasound helps me make real-time decisions about further care. I am very excited for the arrival of hand-held portable ultrasound probes that we can pair with our personal smartphone devices. This will eliminate the restrictions of the larger ultrasound machines that we currently use.
What is one habit of yours that makes you more productive as an emergency medicine physician?
Reassessing patients that I have seen is a key to my productivity in the emergency department. This has to be balanced with continuing to see new patients as the shift progresses. I make it a habit to revisit my full list of previous cases at least every hour and make sure all the relevant laboratory testing and imaging has been completed in order to keep the flow of patients moving. These periods of review allow for disposition decisions and micromanagement of occasional systems errors that would otherwise delay care or increase the patients’ length of stay.
What advice would you give your younger self?
You will learn something from every case. Patients manifest the same diagnoses differently so no two patients are ever the same. From the way a patient verbalizes their pain to the degree of ptosis present in a Bell’s Palsy; each clinical encounter will improve your diagnostic skills. Pattern recognition and good history taking are as important as the latest, evidence-based treatment.
Tell us something that’s true that almost nobody agrees with you on?
The field of emergency medicine in constantly changing due to modern research and development in diagnosis and treatment. Opinions will always vary due to the plethora of information and data that can support both sides of an argument. The key in these situations is to use good communication to find a balance between patient centered care and evidence based medicine. Only through receptive and thoughtful communication with colleagues and the patient can we create the best path towards health and healing.
As a medical professional, what is the one thing you do over and over and recommend everyone else do?
I make a note of each case that was difficult from either a diagnostic, treatment, emotional, or systematic perspective. In my free time, I reflect upon these cases and either read up on the condition or discuss the case with colleagues. I recommend this because it allows me to grow professionally through the difficult situation and become an expert should such a situation come up again.
What is one strategy that has helped you grow your career? Please explain.
The emergency medicine community in Canada and even globally is surprisingly tightly knit. Networking at both national and international conferences has proved vital in growing my career. Opportunities that I have gained through networking have shaped my clinical and non-clinical practice and it forms a community of practice.
What is one failure you had in your career, and how did you overcome it?
I think I am unique in the sense that I view failure much differently than most. People experience some level of failure every day, whether minuscule or significant, it is an aspect of daily life. In my opinion these “failures” that people experience should never be seen as failure, instead I choose to view these as learning opportunities from which one can grow. Each lesson teaches me where I can develop both professionally and personally, and shows me how I can better prepare myself for the next challenge. As Thomas Edison famously said, “I didn’t fail 1,000 times… the light bulb was an invention with 1,000 steps.” This quote perfectly summarizes that failure is a necessary stepping stone to success.
What is one business idea that you’re willing to give away to our readers?
I find the technology in some of the most basic medical equipment light years behind the technological advancements in other industries. I’m sure someone could drastically improve something as basic as stretchers; add in touchscreen monitors and a defibrillator, change the whole structure of a stretcher to allow for rapid automatic transformation from supine to sitting to supported standing position, and add in autonomous transport capabilities. That would be great!
What is the best $100 you recently spent? What and why?
I always say that there are two types of emergency doctors: those with scissors and those who ask for scissors. I recently bought a pair of black oxidized trauma shears and they cut through anything with ease. Also, a pair of alligator forceps are absolutely essential for the emergency doctor on the move: that foreign body won’t stand a chance and you’ll save the time it takes getting it delivered from the OR.
What is one piece of software or a web service that helps you be productive? How do you use it?
The app “Evernote” is something I use on a daily basis. I keep all of our new hospital guidelines and policies as well as treatment algorithms on there for quick access. If I need to remind myself of something, I can quickly open the app and search for the file that I need. It saves files of all types which can be edited and synced between all of your devices.
What is the one book that you recommend our readers should read and why?
I recently read the biography of Elon Musk: Tesla, SpaceX, and the Quest for a Fantastic Future by Ashlee Vance. I found it inspiring from both a technological and also from a personal perspective as you learn about the incredible odds that Elon Musk faced and the obstacles that he overcame as he created and managed his various companies. A greater picture and a larger vision for the future emerges throughout the book and it emphasized the importance of decision making on seemingly smaller events on the outcome of larger personal goals. This has been something that I’ve taken to heart in my own life.
What is your favorite quote?
Well, continuing with the Elon Musk Theme: “When something is important enough, you do it even if the odds are not in your favor.” – Elon Musk