May 28, 2025 • 42 mins
“You don’t get smarter in the crisis. We use what was built beforehand.”
In this episode of Shared Ground, Sean and Allan talk with Dr. Dan Dworkis -emergency physician, performance coach, and author of The Emergency Mind - about what it means to prepare for, move through, and grow after high stakes moments. Dan speaks of individual, community and systems level approaches to developing resilience.
We explore how communities process trauma, build systems that can hold under pressure, and why resilience sometimes looks like crying at a commercial and still showing up the next day. Dan shares stories from emergency medicine, high performance teams and personal reflections. He offers clarity, perspective, and hard-won kindness.
If this episode lands with you, we’d love to hear what stuck.
Drop a comment on Substack or reach out through shared-ground.com.
And if someone in your life is walking through their own fire right now, consider sending this their way.
These stories aren’t finished. Add yours to the thread.
Shared Ground is produced by Sean Knierim and Allan Marks. Thanks to Cory Grabow, Kara Poltor, Corey Walles (from The Recording Studio) for your support in launching this effort.
For more stories of resilience & rebuilding, kindness & generosity: visit shared-ground.com and subscribe to Sean's substack. We invite you to share your own stories of resilience at the Shared Ground website - whether in response to the January fires in LA or other situations.
Follow us at seanknierim.substack.com, Instagram, or wherever you listen to podcasts (Apple Podcasts, Spotify, etc).
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Sean Knierim (00:00):
This is Shares Ground, a podcast about
resilience and community.
I'm Alan Marks and I'm SeanKnierim.
Thanks so much for joining us.
We're joined here by a goodfriend, Dan Dworkis.
Thanks for joining us.
Dan Dworkis (00:13):
Thank you guys for having me Pleasure to be here.
My name is Dan Dworkis.
I'm an ER doctor and the chiefmedical officer of the Mission
Critical Team Institute.
We work with groups that haveto perform under pressure.
Sean Knierim (00:25):
Thanks again for being here.
So, Dan, the question we'reasking everyone we're talking to
in these episodes how do youdefine resilience, starting with
a very clear answer as to what?
Dan Dworkis (00:31):
Without getting too philosophical about it.
I think it depends on whatangle you approach the question.
From right, so at some levelyou're talking about the ability
to suffer an insult or a hitand keep going.
But there's a lot of nuancebehind that right.
So there's the idea of beingable to be hit by something and
continue moving in the samedirection, which is sort of like
a layer to it.
And then there's the deeperunderstanding that you're trying
(00:53):
to accomplish a thing.
So maybe you get hit and youdon't move in the same direction
, but you still accomplish thething.
Or maybe you get hit and yourunderstanding of the universe
changes and you end up sort ofaccomplishing something else.
All of those are sort of in thebucket and sort of the universe
of resilience.
Allan Marks (01:10):
Well, let me ask you then, because there's a
difference between surviving andthriving after an injury.
Sure, if you merely survive,maybe even merely hit that same
goal you had in mind, but not ina way which is sustainable or
enjoyable or thriving in someway, is that still resilient?
Or should we look at itdifferently?
Dan Dworkis (01:27):
It depends on what you're aiming at, right, you
know, if I, let's say, I have apatient right, we're going to
jump in and out of the ER, for Iwould imagine a lot of this.
The advantage of this beingpodcast is I don't get to show
like bloody pictures of anything, right.
(01:53):
Which makes it easier if you'relistening, but we'll still try
to like make it fun.
Thank God, I'm so happy aboutthat backup plan, right?
Is that surviving or is thatthriving?
Right?
So you've accomplished the goal, which is getting them safe and
putting them on a breathingmachine.
But maybe you didn't do it theway you wanted to.
So there's a level in therewhere you failed and there's a
level in there where you havestill succeeded and sort of
(02:14):
moved past the obstacle to thenext thing.
And just to make that even morevisceral, let's say that you
are unable to place a breathingtube and you have to switch, and
instead you have to cut theirneck open.
Right, you have to do what'scalled surgical front of neck
access.
You have caused a problem forthat human being that they're
going to have to then live with.
Like, we can fix it eventuallyin most cases, but you've
changed their life and theirexistence Right.
Allan Marks (02:35):
But you've also prolonged it because at least
they can live with it as opposedto dying without it Totally.
Dan Dworkis (02:39):
In pursuit of a higher goal.
So that's what I was going tosort of aim at is like surviving
and thriving.
Some of that is based on whatwe thought the universe was like
before we hit whatever thisproblem was.
And when we're looking atresilience and I think this is
something, sean, that you and Italked about a bunch when we
were first getting into a lot ofthis when we're looking at
resilience and we're looking atrecovery, it's super important
(02:59):
to think about the angle thatwe're taking on the problem.
So are we evaluating it basedon how our world was before?
Sean Knierim (03:08):
or are we evaluating it based on how our
world is now?
So, Dan, as we think aboutresilience as you were just
talking, it started with you orI and then you started breaking
out to we.
So for an individualunderstanding of resilience,
that's kind of think where youstarted.
As you start thinking aboutgroups and the we and the
interaction with others, Doesyour definition of resilience
change if you're thinking abouta group construct?
Dan Dworkis (03:27):
Yeah, I mean I think it has to right.
So if I'm a single ER doctor,let's flash back to COVID, right
?
Our job in COVID was to takecare of the population.
If we're doing that and I'm anindividual ER doctor and I get
sick with COVID and maybe I dieright.
That's not resilience for me,but is the system capable of
(03:47):
continuing to do its job eventhough I'm not there for it?
So the system can be resilientto a shock that takes me
entirely out of the picture.
So do you jump straight?
Sean Knierim (03:56):
from I as resilient as an individual to a
system.
Is there a we in between I andsystem?
Dan Dworkis (04:03):
Yeah, I mean.
So there's a thing we alwayssay in medicine, which is that
you want healthy people inhealthy communities, surrounded
by and supported by healthysystems, and that's the sort of
like you know, russian doll kindof network that we really want
to think about.
So I would say the same thingfor resilience.
Right, you want a resilienthuman being embedded in a
resilient community, enmeshedand supported by a resilient
(04:25):
system, and that's sort of theuber resilience or meta
resilience that we'd want totalk about in terms of doing
that.
But when you're asking whatresilience is, again you got to
think about what layer you'reslicing that at right so the
person can, or a piece or acomponent can suffer and sort of
shut down.
And actually the first way thatI heard this sort of described
was talking about, interestingly, like a network of satellites.
(04:46):
Right, so you have a network ofsatellites and the goal is to
continue communication throughthe network.
One individual satellite can beresistant or resilient to
certain types of insults, butthen, if that satellite goes
down, you have a local networkthat can sort of cover and then,
if that local network goes down, you still can have the ability
to communicate.
Maybe you're doing it with flagsignals or Morse code or
something, and not necessarilylike satellite communication,
(05:07):
but there's these sort of likelayers that you're going through
as you're thinking about whatthat means.
Allan Marks (05:11):
So that's interesting.
If I think about that, there'sthis idea of, I'm going to say,
buffers, or maybe redundancy.
They're not exactly the samebut what you described for the
satellites, for example, couldfit either one, which is great
systemically, Not so great ifyou're the sacrificial lamb on
the front of the buffer right,If you're the first defense.
I know in military strategythis actually becomes quite a
challenge.
(05:31):
If you think of World War I,for instance you know the troops
in the trenches might have avery high mortality rate.
They might have the mostexposure to violent harm on a
recurring basis, but they'renecessary for the entire army to
survive and for those battlesto go a certain way.
But there's a moral aspect tothat.
In deciding what we talk aboutto people not just say
(05:51):
satellites, we talk about humansin this.
There's a moral component tothat and to how one designs a
system so that it's moreresilient.
And then, of course, theexperience and the trauma, the
very real trauma of people whosuffer nonetheless.
Dan Dworkis (06:03):
Yeah, I'm definitely not saying that
individual people should bediscounted and we shouldn't we
shouldn't pay any attention tothem, right?
I just think it's interestingwhen we're thinking about
resilience, our lived experienceof resilience might be
different than the resilience ofthe community or the system
around us.
Sean Knierim (06:18):
And as we're getting into this concept of
like you know what is resilience, how do we build it, what
happens when we're, when we putit under pressure and test it,
right, we got to think about,like, the layers that we're
looking at for it it wasinteresting and when you're in
the middle of it, as I reflectback to like what launched this
podcast to go through theseepisodes of being in a pretty
traumatic experience as thefires affected my personal life,
(06:39):
the community and then thewider region, and I gave a talk
earlier this week where I brokeit out that way at first I was
thinking about myself and thenmy family, and then starting to
kind of slowly move out, but inthe moment I wasn't
distinguishing between any ofthose levels, I was just stuck
across and you're talking aboutthe specificity of understanding
those different levels.
(06:59):
If I could pull you back to likeJanuary, you were one of the
first phone calls I made becauseI knew I was struggling.
I knew I didn't know what washappening.
I knew that I was going to haveto support myself, my family
and then come out of this.
And I called you a bunch oftimes.
They all feel like oneconversation.
But I'm wondering can you helpme think about from your
perspective, what were youseeing when I called, when other
(07:22):
people started reaching out toyou early in January?
It was early.
Allan Marks (07:25):
January, and this is during the Palisades fire, to
be clear.
Dan Dworkis (07:29):
Absolutely.
So I'm going to sidebar andthen I'm going to get to that,
all right.
So here's my sidebar, so answerthe question you wish I asked.
Sean Knierim (07:36):
And then come back and struggle through.
Dan Dworkis (07:38):
We'll get into it.
But what you described the arcof you suffering and your family
suffering, and then that arccontinuing to the point where
we're sitting here having thispodcast that is the perfect
example of those layers ofresilience and complexity.
Right, so the individual cansuffer, the house can burn, but
the community can come togetherand maintain a sense of oneness,
(08:01):
a sense of purpose and a senseof family and love a sense of
oneness, a sense of purpose anda sense of family and love.
And then, outside of that, thesystem can support the people in
that, so much that what happensat the end of that and none of
this is to say what you wentthrough is easy or fun or
anything like that.
It's not.
But what went through that atthe other end of it is that
(08:22):
you've now created an entirediscussion about what resilience
looks like, and I've watchedyou take that and lever that and
forge that into this concept ofwhat does this mean for my
community?
How do we teach each other?
How do we get stronger fromthis?
That's really the definition ofthe layers that we're trying to
get, and multiple layers arehappening at once.
Like some of this is therapeutic.
Sean Knierim (08:37):
Some of this is staying in action, so I don't
have to sit with that pool ofemotions, that a metaphor you
gave me that I hope you explorewith us here and then trying to
figure out how to do somethinggood with it.
Allan Marks (08:49):
But, like multiple things are happening all at once
there's a positive spin on thatand a distinction I think is
really important, because it'snot a matter of denying the
trauma.
It's not a matter.
It's not a matter of repressionor ignoring the problem or of
turning a blind eye to otherswho are going through it.
Instead, it's just saying look,part of my control of
(09:10):
reestablishing agency is that Ihave a point of view and I can,
at some level, try to choose.
Try to choose.
I can't always do it, but wetry to choose how I'm going to
react to that.
And there's a differencebetween psychological resilience
, which you're demonstrating,and, you know, obviously,
physical loss, which just hashappened nonetheless.
Sean Knierim (09:29):
And a difference between repression and
compartmentalization.
Correct In the moment?
Dan Dworkis (09:33):
Yes, To your point, just to break the fourth wall
slightly, right, like we're inthis room, we're doing this
podcast and we have all thesedifferent camera angles, right,
and that's exactly what you'resaying that we have, in some
sense, a choice of what angle ofcamera we choose to look at our
situation with.
Right, because there is theangle that, like this is horror.
Right, my family's house hasburned.
Sean Knierim (09:52):
Or in my world, like this person's bleeding,
this person's hurt even thoughmost times I was hearing people
tell me I was going throughhorror and I didn't think that
that's what it felt like yeah,yeah, yeah, yeah, absolutely.
Dan Dworkis (10:04):
But we have the choice of that's a view, that's
a lens, that's a camera to lookat it with, and so are these
other ones, right.
So, as the what can I do for mycommunity and what does this
mean to me and what are thethings I value?
And it's I'm not saying thatit's like it's very easy for us
in this room to switch back andforth between cameras, right,
but that's very much harder whenwe're in the middle of it.
(10:24):
There's cost to switching,there's cost to trying to switch
.
It's a skill that's notnecessarily easily developed.
Allan Marks (10:30):
Well, and I think that different utilities.
So, for instance, there aretimes when and we can probably
talk I'd love to talk more aboutthis about how you've
experienced making decisions ina crisis and how you deal with
that moment where there's atriage, there's something that
actually has to be done, and weyou deal with that moment where
there's a triage, there'ssomething that actually has to
be done, and we replace urgentwith maybe other things that are
also important, but then, whenwe have the luxury of a little
more time or distance, what'simportant actually replaces
(10:53):
what's urgent, and we flip itand that ability to really feel
the hard part, while alsochoosing to take a view on it or
respond to it in a way whichhas a little more equanimity to
it.
I think those are differentsteps.
We can go back and forthbetween them.
It's not a linear progression.
Dan Dworkis (11:11):
Absolutely, and I think to weave these two
question sets together and thinkabout it.
What was it like when you wereasking me?
What did it look like from myvantage point?
I don't know if you all haveever gotten hit in the head
really hard, but if you have oneof the first things that
happens is everything goes alittle fuzzy, your sense of
logic goes down a little bit andyour biggest concern is keeping
(11:31):
your hands up and not gettinghit again, and that's just a
pretty natural human instinctand reaction to it, right?
So our ability to take anoutside view, to think really
logically, to process and becreative gets not shut down but
gets hit, and we're really inthe moment of it and our concern
(11:52):
is just sort of making itthrough that next space.
Right, and so that's what itlooks like from the outside when
you're seeing somebody that'sgoing through one of these
circumstances and you know,fortunately or unfortunately,
it's something you get used toseeing in the ER, because you
have people that are hurt andthey're not acting in a way that
they would act in a normalcircumstance, like, like you're
saying, because their sense ofperspective and their sense of
need is switched over in there.
So part of it is justrecognizing that right.
(12:14):
Part of it is just saying, like, look, you might not feel it,
you might not be aware of it,you might not want to talk about
it, but you're hurt right now.
That's okay.
Right, that's where we startfrom.
We say we're hurt and then wekeep moving forward with it.
If we don't say we're hurt, wepretend nothing hurts, then we
get in like much more troublebecause then we're not as smart,
we're not as fast, we're not asquick and the next thing goes
worse.
Right, so we have to rely on thebaked in sort of like reflex
(12:39):
systems we've been developing,and that's that's like that
whole idea is the is the shellaround which we built the idea
of the emergency mind project,right?
The idea that whatever you havewhen you're in that crisis is
the stuff that you built aheadof time.
Right, the stuff that youprepared, because you don't get
smarter when you're in there,right, you don't get smarter
when you're hurt and hit.
What you have is the ability ofwhat you had before the system
(13:00):
you've built around you, all thestuff you put in place ahead of
time system.
You've built around you all thestuff you put in place at a
time.
So when you're going throughthis, I'm watching you start to
hit that wall a little bit,which is a totally natural and
totally normal thing to do, andI hope that's one of the first
things that I said which is like, hey, man, like this sucks and
it's okay to feel this.
Sean Knierim (13:14):
Well, hearing you're doing okay Was one of the
pieces that I held onto for awhile.
I'm like you know, dan, sayingI'm not screwing up that bad,
because I was worried because Ican't see out of this.
I think, from listening to youover years and hearing what
you're saying now, I break themessage I pull from you into
three categories and I'mwondering if these are how you
think of it.
One how do I prepare ahead of acrisis, knowing I'm going to be
(13:38):
dealing with challenging thingsand you'd work with some
communities that areintentionally going into the
most difficult type ofengagements?
So it's what do you do before,how do I identify that I'm in
and what do I do when I'm in acrisis or in a challenging
environment?
And then post, what do I do asI start transitioning out?
So it's how do I determine thatI'm in those phases and what do
(14:00):
I do to prepare across?
Does that track with how youlook at this, or would you use a
different framework?
Dan Dworkis (14:05):
You're spot on and almost right.
So the one that we end up usinghas four parts to it Okay,
prepare, perform, recover,evolve Right, and it's important
to have that whole loop inthere and it's easy to lose the
evolve part kind of at the end,and is that a distinct part or
does that weave using that verbyou had earlier?
Sean Knierim (14:20):
Does that weave using that verb you had earlier?
Does that weave throughout allthree?
Dan Dworkis (14:24):
For me it's a circle, and if done right, it's
a spiral that you're sort oftracing your way across, right?
So the easiest way to thinkabout this is always sport, I
think.
Right, so you take some sort ofwhatever sports, you guys like
I don't know whatever, it isright.
Sports that I follow are morelike martial arts, so I don't
these metaphors kind of breaksometimes.
We're going to go for cycling,I'm sure.
Sean Knierim (14:45):
Whatever it is, we can do.
Martial arts Cycling actuallycycling.
Dan Dworkis (14:47):
I can probably do.
We'll see if I can.
We'll see if I know enoughabout cycling.
There's two wheels.
Martial arts is fine.
Allan Marks (14:51):
I think it led to some underdrafts.
Dan Dworkis (14:59):
No, it doesn't matter running your race.
Your preparation is prettyobvious.
It's your training, yourpractice, your nutrition, your
sleep, your hydration all of thestuff you do for it.
Your recovery is yourstretching, your rehab, all the
stuff that you need to do afterthat.
And your evolution is a way oflooking back at what happened
and learning and seeing whatcomes next.
So, did I run the race the way Iwant to run it?
(15:21):
Okay, what do I do about that?
How did my preparation actuallyimpact my performance?
Was it the way I wanted to doit, or are there other things I
need to change?
Maybe you're looking at splits,Maybe you're looking at a video
of your stride.
Maybe you're looking at yourshoe wear pattern, whatever it
is.
You're sort of thinking aboutthat and that's sort of the
whole arc as a spin.
You can zoom out or zoom in.
(15:42):
It's a fractal right.
So you can also say, withinthat next phase okay, I'm
running the race, I'm in themiddle of it, I'm in the I'm in
the perform phase, but I'm aboutto hit a hill.
All right, I know it's going tobe harder.
What do I do for that?
Well, I'm going to psych myselfup.
I'm going to be using thesethings.
I'm going to prepare it hill ina certain way.
Then I'm going to coast alittle bit on the downhill and
(16:03):
I'm going to think to myself didthat work Right?
But then you're going to zoomout and think that it's not just
a race, it's actually yourentire racing season or it's
this phase of your life or it'swhatever it is, and there's this
beautiful fractal nature to itwhere you can apply that model
really tightly or you can zoomout to it.
Yeah.
Sean Knierim (16:20):
That's beautiful.
In your book you talk about adebrief culture and I think you
pointed to like you talked aboutit throughout the story you
just told of always reflectingon what you're doing.
What do you mean by debriefculture, dan?
Dan Dworkis (16:33):
Yeah.
Sean Knierim (16:33):
In the book.
So Dan wrote a book called theEmergency Mind.
It's outstanding.
I had to pry it out of mywife's hands to read it before
we came in here today.
But a debrief culture.
Dan Dworkis (16:44):
Now, first off, thank you for saying that that
means a lot.
Right, I wrote it during COVIDand I wrote it when, like a lot
of VR doctors, I sort of thoughtthis was going to be the end.
Right, and if this is going tobe the end, then I should
probably build something thatoutlasts me, so I would work
shifts and then I'd come homeand I'd write the book and that
was that, and thankfully itwasn't the end.
And now there's a book andthat's awesome, and you didn't
(17:05):
sleep for about two years.
Tough, tough times.
But I wrote it for the folksthat were the younger versions
of me, who were struggling todeal with a lot of what they
were seeing and were looking atthe gap between how they thought
they could perform and how theywere actually capable of
performing, which is a gap that,whether or not we're in the ER,
(17:25):
I think we're all familiar with.
Right, just to your point, likeyou had a vision of how you
wanted to be able to handle thisevent and then you were
handling the event and you weredoing a damn good job at it, but
that vision didn't matchexactly.
Sean Knierim (17:38):
I had no idea how to even evaluate how I was doing
.
Yeah, yeah.
Dan Dworkis (17:42):
Right, and if we don't know how to evaluate it we
don't have tools to evaluate itthen it's very easy for us to
get lost and to assume thatthings are bad.
Sean Knierim (17:53):
Yeah, cause a lot of Wednesdays were bad.
I knew the day prior, the 10minutes prior they weren't my
best Right, and so some of theframeworks you shared were
really important.
Yeah.
Dan Dworkis (17:59):
There's this, um, there's this thing we have that
you can watch especially juniordoctors do, which is the death
spiral, right?
So something happens.
It's not what they want.
The outcome is worse than theythink it's gonna be.
They look at it and they say,wow, I really sucked.
Wow, that must mean and this isthe key that must mean I'm a
bad person If I sucked at this.
(18:21):
I must be a bad person.
And wow, if I'm a bad person,I'm a waste of space.
My mom hates me and I shouldn'thave done medicine to begin
with.
And, like my uncle was right,I'd never be a doctor, you know,
whatever it, is, and then shameand regret and ego are taking
over.
Allan Marks (18:32):
Oh my God.
Dan Dworkis (18:39):
And the poor patient sitting there being like
wait, I still need help, butyou're.
You're in the idea that we'reimperfect, we do things
imperfectly and our job is notto be perfect but to get better.
Allan Marks (18:52):
How do you balance?
I'm going to give you twodifferent sides of this.
On the one hand, we want to dobetter Performance matters.
Of course, we're going to spendtime going through all four
steps, we're going to have ourdebrief culture and we've set
ourselves up in a way with theillusion of control.
On the flip side of that is somuch of resilience to come back
(19:14):
to.
That is how we respond to thesituations we don't control.
But we're not the ER doctor,we're actually.
We're the patient and thefamily of the patient and the
family of the patient, and it'snot up to us, but we nonetheless
have to muster some resourcesto go on somehow and to
contribute and help if we can,or to ask for and accept for
help and learn to do that ifwe're not good at it, and to
(19:35):
acknowledge we just don't havecontrol and to make that
distinction.
And you can prepare, by the way, for situations where you don't
have control.
This preparedness may still bea factor, but there isn't that
constant pressure of we can.
Therefore, we must do better.
Dan Dworkis (19:48):
I don't totally know that I agree with you.
I think there always is thatconstant pressure of we can do
better.
Okay, say more about that.
Almost doesn't matter whatsituation we're in, right,
there's always the ability to dosomething.
There's this great Stoic quotethat's like I think it's
Epictetus, although it could beSeneca, I forget who basically
(20:08):
said if the only thing left forme to do is to drown, then I'm
going to try to drown in a waythat teaches other people about
surviving.
If that's literally all youhave, then you're going to try
to do it in a way that makes adifference.
There's a lot about being anemergency doctor that you don't
have control over.
You don't control who comes in,you don't control what they
have.
You know you don't hold all thecards right.
(20:30):
Sometimes the person in frontof you, their die, is cast and
you do what you can, but nothinghappens and it's bad and you
suffer and they suffer Early on.
Most of us hit some version ofwhat you're describing where
we're like well, I don't controlanything here.
And where we're like well, Idon't control anything here, and
it's easy to get into vaporlock, Like you're just sort of
frozen and you don't really knowwhat to do about it.
One of the drills that'ssurprising and kind of helpful
(20:51):
for that moment is somebody willusually ask you could you make
this worse?
Could you make this worse rightnow?
Is there a way to pour gas onthe fire?
And almost always there's a wayto make it worse.
Right, Like, we're verycreative as human beings, we can
usually find a way to make thesituation worse.
Right, you can't fix thepatient, but you could punch the
nurse.
Right, you could light thething on fire.
(21:13):
You could do all sorts of stuff.
Don't do any of those things.
Right, but you could do thosethings and make it worse.
And there's this weird thingthat happens, which is when
you're in these circumstances,circumstances and you realize
you could make it worse, youpretty quickly are like well,
man, maybe I could make itbetter, Even if it's a small
thing.
Allan Marks (21:28):
Yeah, or at least avoid making it worse, or at
least avoid making it worse.
Dan Dworkis (21:31):
And sometimes not pouring gas on the fire, is the
victory.
Yeah, no-transcript.
Sean Knierim (21:49):
So it strikes me to pull together what both of
you were talking about.
It's understanding, it'sgetting yourself to a point
where you're able to determinewhere do I not have control but
where do I have control andwhere, when I have control,
(22:11):
where's my choice, able to beemployed in a way that I'm going
to feel proud of or feel likeit's making a better or a less
bad outcome coming out of it.
So I I called you and there wasone time you laughed at me
where I'm like Dan, what can Iexpect?
Cause I've seen these chartswhere you come through a
disaster and then you go throughpublic euphoria and the line
goes up to the right and then itplunges and it's this community
despair, and then you kind ofslowly come back out of it and
you're like Sean, that actuallyI don't think applies and it
(22:34):
doesn't apply in the situationwe're in here.
And then I said, well, are therethings I could read?
Is there something I can do togive me a path of what to expect
?
Cause my mind was really hopingfor patterns and you gave me a
couple of different books, andthe one that I mean, your book,
was excellent.
The two of the other books thatI'd love to hear pick one of
the two Man's Search for Meaningby Frankel, who talks about
(22:57):
suffering and choice, survivingSurvival that talks about giving
oneself the permission to beflexible, like you thought of a
couple of different books.
But like which?
Which books, which people doyou look to when you're trying
to learn, or or?
Dan Dworkis (23:11):
grapple with these things.
Yeah, I mean I, I think it'sworth saying like it's very easy
for me to sit on a podcast andpretend to be very smart about
all this stuff Right but likethis is really hard, this stuff
is super hard.
Uh, I'm still working on it,we're all still working on it.
Like you would be doing adisservice to pretend like I'm
this wise sage and everythingand to the extent that I am
alive.
Allan Marks (23:30):
I'm glad you pretended to be one, for me, as
you said, I don't have to befaster than you.
Sean Knierim (23:38):
I don't have to be faster than the bear, I do
faster than you.
Allan Marks (23:42):
So you're smarter than us, we're good.
Dan Dworkis (23:45):
I don't know about that.
I think I've spent a long timethinking about this kind of
stuff and I think you know bothof those books Man's Search for
Meaning by Frankel, and thenSurviving Survival and his other
book, deep Survival by Lawrence.
Gonzalez, are just awesome,right, and they all sort of poke
at this sense of whatresilience is Right.
What is resilience when you arein these moments that are
(24:08):
really challenging to evensurvive, let alone to do
anything with?
What does it look like on theother side of it?
What does it look like whenthat first wave of things has
passed and your resistance isgone and you're out of strength
and you're doing whatever, andnow you're sort of still in it,
right?
What does that look like?
I never liked the you know,like 30 hour shifts we did in
(24:31):
medical school.
I don't think anybody likesthem, but 40 would have been
better.
But one of the things itteaches you is that, like you
know, you can be tired and stilldo things, and you can be
hungry and still do things, andthere's many, many, many people
that have been in much, much,much worse places that I have
than I have.
(24:51):
I would say as a patient.
Allan Marks (24:54):
if you're in a teaching hospital and they
haven't slept for 30 hours, youkind of might wish you'd had
somebody who'd maybe had a napat some point.
I mean it's because, yes, wecan do things, we can rise to
the occasion.
It doesn't mean necessarilythat it's the best systemic
design that we should have to.
Dan Dworkis (25:09):
So that's interesting, right, because
there's a tension in there, sure, and we talked earlier about
what resilience is and we talkedabout how it matters what
camera lens you're looking at itthrough, right?
So there's a lens of thepatient and the patient's family
, where you want the freshestdoctors all the time, yeah, and
then there's a lens from societywhere you want doctors to have
gone through 30-hour shifts sothat, if they have to, they know
(25:33):
they can do it.
Yes, we always see this tensionin the ER, because what's good
for the one individual patientmight or might not be
necessarily what's good for thefield or what's good for the
whole society.
And that's challenging, to putit mildly.
Right, it sucks when it's yourfamily, it sucks when you're
(25:53):
going through it and and how doyou draw the line about how much
you're willing to give or notgive or you know, sort of
whatever it is about that.
But I think there's.
I think, when we're talkingabout resilience, like we have
to have that end of theconversation too.
Allan Marks (26:05):
How much are we willing to pay for resilience?
Yeah, I know, you know, whenyou look at, for example, at
cybersecurity, which is an areaI've done some work in, you know
, there's this idea ofresponding to the problem, but
there's also the idea of, well,how do you prepare so the
problem doesn't actually happen?
Sure, what is the threat?
How do you assess the threat,how do you defend against the
threat?
And then, of course, beyondthat, how do you identify when
it's happened, how do you reactto it, how do you take the
proper steps?
And, of course, the evolution,the debrief, as you mentioned.
(26:28):
Try to learn from that and thenmake it harder next time.
If you're looking, as in yourrole, for example, as an ER
doctor, where you haveresponsibility for a whole team,
are there things?
How much time do you spend onmaking that system work better
to prevent the very problemsthat would demand resilience if
they didn't get solved?
Dan Dworkis (26:47):
That's a good question, right.
So there's stuff that you youknow and we're sort of blurring
here back into the Stoic conceptof circle of control or sphere
of influence and sidebar intoyour question again like what
books do I recommend?
Like, go read Stoic philosophy,right, meditations and Seneca's
Shortness of Life, andEpictetus and Chidron I never
(27:08):
know how to pronounce that, butit's really good Epictetus,
that's how you pronounce that,by the way.
But sidebar, so it depends onwhere you have control right.
So when I'm in the ER, what doI have control over?
Well, I can work with my team, Ican work on the skill sets that
we have available.
To a limited extent, I caninfluence the system around me,
but I can't, for example, goback in time and have people you
(27:31):
know take their medicationbefore, and I can't necessarily
change the traffic patternsaround an intersection to
decrease the probability of anaccident.
Now, if you give me a longenough time and, from an
Archimedes standpoint, a largeenough lever, I can actually go
change the traffic patternsright.
And a lot of the initial workthat dictated seatbelt safety,
(27:51):
for example, was done by ERdoctors who were looking at the
injury patterns, and being likethis is ridiculous.
We should probably be able todo better than this, right?
So there is an ability to alterthe system to prevent the
problem from happening.
But within that moment, where'syour fulcrum?
How big of a lever do you have?
And you're right how much areyou willing to spend in that
moment on that piece versus thetask at hand for you, this
(28:14):
tension?
How much are you willing to payfor resilience?
Sean Knierim (28:16):
So, Dan, you work with a number of different
communities.
We've talked a lot about themedical community, in which
you're a professional.
You work with military sportprofessionals all over and I
think a lot of people hopefullythat'll be listening to this
come from a variety of differentcontexts.
What takeaways do you seeacross these communities that
(28:37):
people listening to this mightbe able to pull away themselves?
So, either, going into, goingthrough, coming out of evolving
afterwards, what are the thingswe can keep in mind that you're
seeing are helpful across all ofthese different worlds that you
get to work through?
Dan Dworkis (28:50):
Yeah, absolutely so .
First off, inherent in yourquestion is this idea that there
are things to learn from othergroups, which I think is super
important and sometimes notobvious, right, like it wasn't
obvious for a long time thatdoctors should learn from people
that weren't doctors.
Now it's pretty ridiculous tosay that out loud now,
thankfully, but that wasn'talways the case, right, it used
to be well.
Sean Knierim (29:10):
Doctors would just learn from doctors when you
shared a story with me about aspecial forces operator, I think
from the uk, and about emotionand a well of emotion.
Do you remember that story?
Can you share that?
Like that was hugely stillmoving for me now and I'm using
that language as I talk to myfamily to explain how I'm doing.
Can you share some of that?
No, I can't.
Dan Dworkis (29:31):
However, the metaphor, I can talk around it,
the metaphor talk around it.
Sean Knierim (29:34):
That's what I meant.
Dan Dworkis (29:35):
What I can say is that, um, there's this thing
that's useful to think about,which we sometimes call the
cousin effect, right, and it hasto do with the idea that no
one's a prophet in their ownland.
So sometimes the best thing wecan do is share our problem sets
with people that are close tous, but not doing exactly the
same thing, and in doing so,that frees us up to either take
(29:57):
advice or change things aboutourselves that we might not
otherwise.
So I can't share that story,but let me share a flip side of
it.
That's about me, right, thankyou, which I can share about
that because it's me, right.
So when I was really in it andjust there was a time when I was
just really struggling, youknow, waking up with nightmares
all the time and just like a lot, of, a lot of things that were
(30:20):
really bad, and I didn't, Ididn't really know what to do
about it.
I was sort of aware it was aproblem, but I wasn't.
I didn't really have my handsaround it at all and, as luck
would have it, I got a chance tobe around some folks from the
military who were very elite intheir craft, and I don't really
know why.
I think they might've asked mesomething like what's it like
being an ER doctor?
And maybe I just had enoughthat day and I actually told him
(30:42):
what was going on.
I don't know what thecircumstance was, but I remember
this person putting their handon my shoulder and just saying
like, wow, dan, that's hard, youshould probably get some help.
Yeah, and and it just sort oflike blew me apart, right, and I
was like what do you wait?
What?
This person, who's the doubleblack flip, ninja, champion of
(31:05):
whatever it is, which is not areal thing, is telling me that,
like it, what I'm doing is hard.
Yeah, yeah, like if, well, ifthey think it's hard, like shit,
maybe it's really hard.
And if it's really hard, maybeit's okay If I got help for it.
And like, man, what anincredible gift that was just to
be able to be like yeahno-transcript way sidebar.
(31:44):
So, uh, with a good therapistwith a good, yes, fair, cool,
cool sidebar.
But these days I'm on the otherside of it a lot of the times
and I'm sharing stories about,you know, being in the er and
talking to folks that are in infire or the military airspace
and sometimes being like theother end of that story saying,
hey man, what you're describingis really hard.
You should maybe go get somehelp for that.
And there's this remarkablething, which is that it's just
easier to listen to somebodywho's not your direct brother or
(32:04):
sister.
They're your cousin, so thecousin effect.
Allan Marks (32:07):
So one of the things, too that I know from
your background academically,sean, in literature.
I'm sure you've bumped intothis, but it's one of the things
I was advising some youngerlawyers Fiction, read fiction.
We spent a lot of time.
I spent a lot of time readingnonfiction and, by the way, the
books that were recommended, Ifully agree Absolutely great
(32:28):
reading, endorsed them highly.
But there's something to besaid for reading stories fiction
stories, novels, short storiesBecause the empathy muscle gets
a workout and we get to seeother people doing things that
in their context are believablyhard and we care about them and
we care about what happens tothem and we're kind of along for
(32:48):
the ride.
Um, the result there and thereare peer-reviewed studies that
look at the way that fictionactually does contribute to
empathetic societies andindividuals as well, in a way
that just you know, knowing howto do stuff doesn't even compare
to save, you know, history orthings that are still maybe a
story.
Sean Knierim (33:06):
But are factual, super interesting.
And so, dan, to pull back tothe question I asked a bit ago
and then sidetracked you, anyother ideas that you'd share
with people that are listening?
So, as we're coming in or out,like what, what might we keep in
mind to try to help ourselvesLike part of like, sleep a
little bit more, get a littlebit more water, eat well,
activity, community, beingaround other people that love
(33:29):
you or that you can be around,but any anything else you can
think through in your experiencethat that we might keep in mind
coming in and out of hard stuff.
Dan Dworkis (33:35):
Yeah, I mean, I think like if you look at that
arc of prepare, perform, recover, evolve, like, recognize that
there's a cycling, a periodicityto the work that you're doing
with it.
Right, if all you did wasperform, you will burn out and
break.
Imagine a sports team that allthey did was perform or a runner
that all they did was race,like there's no way that would
last for very long.
Allan Marks (33:55):
That person would break, and, with apologies to
the Stoics, but if you look atthe Epicureans, there's
something to be said forenjoying what you're doing and
having fun with it, which is Idon't want to lose sight of that
.
Dan Dworkis (34:04):
I think yeah, no, and there's deep joy in the
Stoics too.
It's just a little deeper inaround the corner.
Yes, right, you sort of got tolike sift through it a little
bit to get into it, right, butthere is that deep joy of, like
(34:25):
you know, a life well lived andand the moment that that brings.
And I think that I think thatthere's a balance in there
between not too tight and nottoo loose, right, and there's
that, that concept of you knowtuning the string of your own
instrument such that you createa note right, if you're too
loose, it's floppy and nothinghappens.
If you're too tight, it snapsand you, you don't play for very
long, right, um, there aretimes it's the reason trees bend
in the wind and sway yeah, andthat.
Allan Marks (34:42):
And that's exactly.
They didn't.
They'd snap and fall over.
Dan Dworkis (34:44):
Exactly, and there are times when you're recovering
, when you're hit in a crisis,when things are literally on
fire, when, like, all you haveto do is perform, that's it, you
just perform.
But when you're not in that,can you actually take a moment
and take a step back, can youdrink water and sleep and and
you know, be like, tune yourselfto the right frequency not the
(35:05):
tightest that you can be, butthe right one for it.
Sean Knierim (35:07):
And I think, if we look at part of what is
resilience, is the skillset ofmaintaining the right tune for
the right moment, such thatwe're in the game for a long
time and there is something thathas come through in everything
you've said with us today andone of the reasons why I reached
out to you one of the firstpeople after this and then
wanting you to be part of thisconversation with Alan and me.
(35:29):
There's this consistent throughline of being kind and
understanding to yourself andsomething that a gift you've
given me and many others in yourworld and I mean something,
alan, why I've always lovedbeing around you.
It's an acknowledgement ofthose around you, like if we're
not able to give it to ourselves.
I'm not good at this.
Many people I know are harderon themselves, maybe than they
(35:52):
should be, but you're reallygood at helping others around
you hear from you that you thinkthey're doing okay, which is
that piece of kindness, thatgenerosity, which isn't
necessary, but you're reallygood at it, and it comes through
in every question we've asked.
You has that kind of like takeit easy on yourself, Even if
(36:12):
you're working your ass off.
Dan Dworkis (36:14):
I appreciate you saying that I I don't know that
I'm always good at doing thatfor myself at all.
I think that's really hard.
Um, dan, you're doing great.
Sean Knierim (36:22):
Thanks man.
Allan Marks (36:23):
You are doing great hard, dan, you're doing great.
Thanks, man.
You are doing great.
Dan Dworkis (36:26):
You're modeling humility, really well too, Thank
you, but this stuff's hard.
I mean there's no reason tomake it harder.
Right, Like you could alwaysmake it worse.
Right, you could always catchyourself on fire and make it
worse, but there's no reason to.
And I think that sense of likeyou know, I want to be in this
for a long time, and we talkedabout this also.
We talked about what is theintegral of what you're doing
(36:48):
over time.
Sean Knierim (36:49):
What do you mean by that?
Dan Dworkis (36:50):
Yeah Right, the Riemann sum of.
We get really nerdy about mathhere for a second.
The idea of a vantage pointagain, right, when we keep
coming back to what's thevantage point?
We're talking about resilience,for so one vantage point is the
scale that we're talking about,or the spatial direction we're
taking.
The other is sort ofconvoluting that over time,
right.
So the integral of your workover time is the addition of
(37:13):
every day's effort summed upover a long period,
geometrically, geometrically.
Sean Knierim (37:19):
So maybe to try and restate that in a way that
my brain would use right.
So maybe to try and restatethat in a way that my brain
(37:39):
would use right Because I don'tthink in terms of the
mathematical stuff course, of aperiod, a longer period of time
and evaluate how well you'redoing over that course and then
figure out how you might learnfrom that as you're moving
forward.
Allan Marks (37:52):
I remember when I was, uh, I was climbing, uh,
with my daughter when she wasquite young and you know it was
kind of steep and we're workingour way up and it was here in
the Santa Monica mountains, butthere's this rock.
We want to climb to the top ofthis rock and the type of steep
thing and we weren't really onthe trail in Griffith park and
and when it's steep and you'reup close to it, all you kind of
(38:12):
think of is I don't want to losemy footing, I don't want the,
the, the.
You know that the dirt or therock thing's pretty close and
we'll get there.
And then you get there and wegot to the top.
She was, she was quite young,it was a windy, windy day and
she's looking around at the view.
And then she looked down and shesaid it's a long way down, but
(38:35):
there was a sense ofaccomplishment because we'd come
up that far and she had come upthat far and she really had
done a great job of it.
So it was, you know, that senseof perspective, you know that
that integral.
As you climb up the, you knowthe upward sloping to the right
side of the parabola, yeah, itgets steeper, but you also
accomplish more each timebecause you're building on what
(38:56):
you've already done.
Dan Dworkis (38:57):
I also think it's in some sense a defense
mechanism, right, like if youare forced to like.
Like performance matters, right.
Like the outcome matters andyou have to do the work well,
right.
But if you're forced toevaluate your entire sense of
existence based on the role ofone dice or the play of one hand
of cards, it is verychallenging to do that.
(39:18):
Instead, if you can look atyourself and ask you know cause
inherent in your question of amI doing a a good job?
Is this deep sort of soulsearching like am I a good human
being?
Am I a good enough human being?
Sean Knierim (39:29):
What's my worth?
Right, what's my worth?
Am I a?
Dan Dworkis (39:31):
good enough father?
Am I a good enough husband?
Am I a good enough man?
Am I a good enough human being?
And, like all of this iswrapped, am I doing okay?
And what I'm, what I'm seeing,is this like burning sort of
like you know existential thingin the middle there, and which
totally makes sense, right,Cause you get hurt, you get hit
(39:52):
and you ask these questions,right?
I ask these questions all thetime and it's normal to ask
these questions and it's easy tomake the entire answer about
one thing.
I yelled at that last person Italked to.
I spilled my coffee thismorning.
I didn't run this morning.
I wasn't as nice of a humanbeing as man.
It's just so easy to like takeone thing and make that the
(40:13):
answer to the question andinstead, if you can expand the
scope of how you're judging alittle bit and ask is the world
a better place because you'rehere?
Allan Marks (40:21):
Yeah, so to close, if I may, what makes you the
most optimistic?
Dan Dworkis (40:27):
or hopeful right now.
Oh, I mean, like I'm constantlysurrounded by men and women who
are throwing themselves intohard problem sets with all of
their energy and effort and whoare attempting to scale enormous
mountains and make thingsbetter.
Like I am so lucky to beconstantly surrounded by these
people that are so smart and sostrong and so dedicated to
(40:49):
making the world a better place.
I think that the way uh, I don'twant to drop a commentary bomb
on the end here, but I thinkthat the way a lot of our system
is set up is to feed us badnews and things that scare us
and it's very hard to spend timewhere it's much harder these
days to spend time around peoplewho are smart and strong and
(41:10):
hardworking and dedicated andwant to make the world better.
They're not gonna show up onthe news, they're not gonna come
through on Facebook, right.
We're not gonna get fed themaccidentally.
So, to the extent that we cango seek them, to the extent that
I am lucky enough to be aroundthem you know we talked about
resilient person and resilientcommunity with resilient system,
(41:31):
right, like to be surrounded byamazing people, to include my
wonderful partner and my familyand to be in part of a system of
of people that try to make theworld a better place all the
time.
I'm incredibly hopeful fromthat.
Sean Knierim (41:44):
Well, you bring me hope, Dan, and I think you
exemplify what you justdescribed.
I can say, I think prettyconfidently, you have not made
this podcast worse by being here.
I'd encourage everyone who'slistening to this to pick up
your book, the Emergency Mind byDan Dworkis.
Dan, thank you so much forjoining us here today.
Allan Marks (42:02):
Yeah, dan, thank you, real pleasure.
Oh, thank you both much forjoining us here today.
Dan Dworkis (42:04):
Yeah, dan, thank you, real pleasure.
Oh, thank you both.
Sean Knierim (42:05):
Thank you for having me.
This has been another episodeof Shared Ground, a podcast
about resilience and community.
Allan Marks (42:13):
Follow us on your favorite platform or learn more
at sharedgroundcom.
That's shared-groundcom.
This is Shares Ground, a podcast about
resilience and community.
I'm Alan Marks and I'm SeanKnierim.
Thanks so much for joining us.
We're joined here by a goodfriend, Dan Dworkis.
Thanks for joining us.
Dan Dworkis (00:13):
Thank you guys for having me Pleasure to be here.
My name is Dan Dworkis.
I'm an ER doctor and the chiefmedical officer of the Mission
Critical Team Institute.
We work with groups that haveto perform under pressure.
Sean Knierim (00:25):
Thanks again for being here.
So, Dan, the question we'reasking everyone we're talking to
in these episodes how do youdefine resilience, starting with
a very clear answer as to what?
Dan Dworkis (00:31):
Without getting too philosophical about it.
I think it depends on whatangle you approach the question.
From right, so at some levelyou're talking about the ability
to suffer an insult or a hitand keep going.
But there's a lot of nuancebehind that right.
So there's the idea of beingable to be hit by something and
continue moving in the samedirection, which is sort of like
a layer to it.
And then there's the deeperunderstanding that you're trying
(00:53):
to accomplish a thing.
So maybe you get hit and youdon't move in the same direction
, but you still accomplish thething.
Or maybe you get hit and yourunderstanding of the universe
changes and you end up sort ofaccomplishing something else.
All of those are sort of in thebucket and sort of the universe
of resilience.
Allan Marks (01:10):
Well, let me ask you then, because there's a
difference between surviving andthriving after an injury.
Sure, if you merely survive,maybe even merely hit that same
goal you had in mind, but not ina way which is sustainable or
enjoyable or thriving in someway, is that still resilient?
Or should we look at itdifferently?
Dan Dworkis (01:27):
It depends on what you're aiming at, right, you
know, if I, let's say, I have apatient right, we're going to
jump in and out of the ER, for Iwould imagine a lot of this.
The advantage of this beingpodcast is I don't get to show
like bloody pictures of anything, right.
(01:53):
Which makes it easier if you'relistening, but we'll still try
to like make it fun.
Thank God, I'm so happy aboutthat backup plan, right?
Is that surviving or is thatthriving?
Right?
So you've accomplished the goal, which is getting them safe and
putting them on a breathingmachine.
But maybe you didn't do it theway you wanted to.
So there's a level in therewhere you failed and there's a
level in there where you havestill succeeded and sort of
(02:14):
moved past the obstacle to thenext thing.
And just to make that even morevisceral, let's say that you
are unable to place a breathingtube and you have to switch, and
instead you have to cut theirneck open.
Right, you have to do what'scalled surgical front of neck
access.
You have caused a problem forthat human being that they're
going to have to then live with.
Like, we can fix it eventuallyin most cases, but you've
changed their life and theirexistence Right.
Allan Marks (02:35):
But you've also prolonged it because at least
they can live with it as opposedto dying without it Totally.
Dan Dworkis (02:39):
In pursuit of a higher goal.
So that's what I was going tosort of aim at is like surviving
and thriving.
Some of that is based on whatwe thought the universe was like
before we hit whatever thisproblem was.
And when we're looking atresilience and I think this is
something, sean, that you and Italked about a bunch when we
were first getting into a lot ofthis when we're looking at
resilience and we're looking atrecovery, it's super important
(02:59):
to think about the angle thatwe're taking on the problem.
So are we evaluating it basedon how our world was before?
Sean Knierim (03:08):
or are we evaluating it based on how our
world is now?
So, Dan, as we think aboutresilience as you were just
talking, it started with you orI and then you started breaking
out to we.
So for an individualunderstanding of resilience,
that's kind of think where youstarted.
As you start thinking aboutgroups and the we and the
interaction with others, Doesyour definition of resilience
change if you're thinking abouta group construct?
Dan Dworkis (03:27):
Yeah, I mean I think it has to right.
So if I'm a single ER doctor,let's flash back to COVID, right
?
Our job in COVID was to takecare of the population.
If we're doing that and I'm anindividual ER doctor and I get
sick with COVID and maybe I dieright.
That's not resilience for me,but is the system capable of
(03:47):
continuing to do its job eventhough I'm not there for it?
So the system can be resilientto a shock that takes me
entirely out of the picture.
So do you jump straight?
Sean Knierim (03:56):
from I as resilient as an individual to a
system.
Is there a we in between I andsystem?
Dan Dworkis (04:03):
Yeah, I mean.
So there's a thing we alwayssay in medicine, which is that
you want healthy people inhealthy communities, surrounded
by and supported by healthysystems, and that's the sort of
like you know, russian doll kindof network that we really want
to think about.
So I would say the same thingfor resilience.
Right, you want a resilienthuman being embedded in a
resilient community, enmeshedand supported by a resilient
(04:25):
system, and that's sort of theuber resilience or meta
resilience that we'd want totalk about in terms of doing
that.
But when you're asking whatresilience is, again you got to
think about what layer you'reslicing that at right so the
person can, or a piece or acomponent can suffer and sort of
shut down.
And actually the first way thatI heard this sort of described
was talking about, interestingly, like a network of satellites.
(04:46):
Right, so you have a network ofsatellites and the goal is to
continue communication throughthe network.
One individual satellite can beresistant or resilient to
certain types of insults, butthen, if that satellite goes
down, you have a local networkthat can sort of cover and then,
if that local network goes down, you still can have the ability
to communicate.
Maybe you're doing it with flagsignals or Morse code or
something, and not necessarilylike satellite communication,
(05:07):
but there's these sort of likelayers that you're going through
as you're thinking about whatthat means.
Allan Marks (05:11):
So that's interesting.
If I think about that, there'sthis idea of, I'm going to say,
buffers, or maybe redundancy.
They're not exactly the samebut what you described for the
satellites, for example, couldfit either one, which is great
systemically, Not so great ifyou're the sacrificial lamb on
the front of the buffer right,If you're the first defense.
I know in military strategythis actually becomes quite a
challenge.
(05:31):
If you think of World War I,for instance you know the troops
in the trenches might have avery high mortality rate.
They might have the mostexposure to violent harm on a
recurring basis, but they'renecessary for the entire army to
survive and for those battlesto go a certain way.
But there's a moral aspect tothat.
In deciding what we talk aboutto people not just say
(05:51):
satellites, we talk about humansin this.
There's a moral component tothat and to how one designs a
system so that it's moreresilient.
And then, of course, theexperience and the trauma, the
very real trauma of people whosuffer nonetheless.
Dan Dworkis (06:03):
Yeah, I'm definitely not saying that
individual people should bediscounted and we shouldn't we
shouldn't pay any attention tothem, right?
I just think it's interestingwhen we're thinking about
resilience, our lived experienceof resilience might be
different than the resilience ofthe community or the system
around us.
Sean Knierim (06:18):
And as we're getting into this concept of
like you know what is resilience, how do we build it, what
happens when we're, when we putit under pressure and test it,
right, we got to think about,like, the layers that we're
looking at for it it wasinteresting and when you're in
the middle of it, as I reflectback to like what launched this
podcast to go through theseepisodes of being in a pretty
traumatic experience as thefires affected my personal life,
(06:39):
the community and then thewider region, and I gave a talk
earlier this week where I brokeit out that way at first I was
thinking about myself and thenmy family, and then starting to
kind of slowly move out, but inthe moment I wasn't
distinguishing between any ofthose levels, I was just stuck
across and you're talking aboutthe specificity of understanding
those different levels.
(06:59):
If I could pull you back to likeJanuary, you were one of the
first phone calls I made becauseI knew I was struggling.
I knew I didn't know what washappening.
I knew that I was going to haveto support myself, my family
and then come out of this.
And I called you a bunch oftimes.
They all feel like oneconversation.
But I'm wondering can you helpme think about from your
perspective, what were youseeing when I called, when other
(07:22):
people started reaching out toyou early in January?
It was early.
Allan Marks (07:25):
January, and this is during the Palisades fire, to
be clear.
Dan Dworkis (07:29):
Absolutely.
So I'm going to sidebar andthen I'm going to get to that,
all right.
So here's my sidebar, so answerthe question you wish I asked.
Sean Knierim (07:36):
And then come back and struggle through.
Dan Dworkis (07:38):
We'll get into it.
But what you described the arcof you suffering and your family
suffering, and then that arccontinuing to the point where
we're sitting here having thispodcast that is the perfect
example of those layers ofresilience and complexity.
Right, so the individual cansuffer, the house can burn, but
the community can come togetherand maintain a sense of oneness,
(08:01):
a sense of purpose and a senseof family and love a sense of
oneness, a sense of purpose anda sense of family and love.
And then, outside of that, thesystem can support the people in
that, so much that what happensat the end of that and none of
this is to say what you wentthrough is easy or fun or
anything like that.
It's not.
But what went through that atthe other end of it is that
(08:22):
you've now created an entirediscussion about what resilience
looks like, and I've watchedyou take that and lever that and
forge that into this concept ofwhat does this mean for my
community?
How do we teach each other?
How do we get stronger fromthis?
That's really the definition ofthe layers that we're trying to
get, and multiple layers arehappening at once.
Like some of this is therapeutic.
Sean Knierim (08:37):
Some of this is staying in action, so I don't
have to sit with that pool ofemotions, that a metaphor you
gave me that I hope you explorewith us here and then trying to
figure out how to do somethinggood with it.
Allan Marks (08:49):
But, like multiple things are happening all at once
there's a positive spin on thatand a distinction I think is
really important, because it'snot a matter of denying the
trauma.
It's not a matter.
It's not a matter of repressionor ignoring the problem or of
turning a blind eye to otherswho are going through it.
Instead, it's just saying look,part of my control of
(09:10):
reestablishing agency is that Ihave a point of view and I can,
at some level, try to choose.
Try to choose.
I can't always do it, but wetry to choose how I'm going to
react to that.
And there's a differencebetween psychological resilience
, which you're demonstrating,and, you know, obviously,
physical loss, which just hashappened nonetheless.
Sean Knierim (09:29):
And a difference between repression and
compartmentalization.
Correct In the moment?
Dan Dworkis (09:33):
Yes, To your point, just to break the fourth wall
slightly, right, like we're inthis room, we're doing this
podcast and we have all thesedifferent camera angles, right,
and that's exactly what you'resaying that we have, in some
sense, a choice of what angle ofcamera we choose to look at our
situation with.
Right, because there is theangle that, like this is horror.
Right, my family's house hasburned.
Sean Knierim (09:52):
Or in my world, like this person's bleeding,
this person's hurt even thoughmost times I was hearing people
tell me I was going throughhorror and I didn't think that
that's what it felt like yeah,yeah, yeah, yeah, absolutely.
Dan Dworkis (10:04):
But we have the choice of that's a view, that's
a lens, that's a camera to lookat it with, and so are these
other ones, right.
So, as the what can I do for mycommunity and what does this
mean to me and what are thethings I value?
And it's I'm not saying thatit's like it's very easy for us
in this room to switch back andforth between cameras, right,
but that's very much harder whenwe're in the middle of it.
(10:24):
There's cost to switching,there's cost to trying to switch
.
It's a skill that's notnecessarily easily developed.
Allan Marks (10:30):
Well, and I think that different utilities.
So, for instance, there aretimes when and we can probably
talk I'd love to talk more aboutthis about how you've
experienced making decisions ina crisis and how you deal with
that moment where there's atriage, there's something that
actually has to be done, and weyou deal with that moment where
there's a triage, there'ssomething that actually has to
be done, and we replace urgentwith maybe other things that are
also important, but then, whenwe have the luxury of a little
more time or distance, what'simportant actually replaces
(10:53):
what's urgent, and we flip itand that ability to really feel
the hard part, while alsochoosing to take a view on it or
respond to it in a way whichhas a little more equanimity to
it.
I think those are differentsteps.
We can go back and forthbetween them.
It's not a linear progression.
Dan Dworkis (11:11):
Absolutely, and I think to weave these two
question sets together and thinkabout it.
What was it like when you wereasking me?
What did it look like from myvantage point?
I don't know if you all haveever gotten hit in the head
really hard, but if you have oneof the first things that
happens is everything goes alittle fuzzy, your sense of
logic goes down a little bit andyour biggest concern is keeping
(11:31):
your hands up and not gettinghit again, and that's just a
pretty natural human instinctand reaction to it, right?
So our ability to take anoutside view, to think really
logically, to process and becreative gets not shut down but
gets hit, and we're really inthe moment of it and our concern
(11:52):
is just sort of making itthrough that next space.
Right, and so that's what itlooks like from the outside when
you're seeing somebody that'sgoing through one of these
circumstances and you know,fortunately or unfortunately,
it's something you get used toseeing in the ER, because you
have people that are hurt andthey're not acting in a way that
they would act in a normalcircumstance, like, like you're
saying, because their sense ofperspective and their sense of
need is switched over in there.
So part of it is justrecognizing that right.
(12:14):
Part of it is just saying, like, look, you might not feel it,
you might not be aware of it,you might not want to talk about
it, but you're hurt right now.
That's okay.
Right, that's where we startfrom.
We say we're hurt and then wekeep moving forward with it.
If we don't say we're hurt, wepretend nothing hurts, then we
get in like much more troublebecause then we're not as smart,
we're not as fast, we're not asquick and the next thing goes
worse.
Right, so we have to rely on thebaked in sort of like reflex
(12:39):
systems we've been developing,and that's that's like that
whole idea is the is the shellaround which we built the idea
of the emergency mind project,right?
The idea that whatever you havewhen you're in that crisis is
the stuff that you built aheadof time.
Right, the stuff that youprepared, because you don't get
smarter when you're in there,right, you don't get smarter
when you're hurt and hit.
What you have is the ability ofwhat you had before the system
(13:00):
you've built around you, all thestuff you put in place ahead of
time system.
You've built around you all thestuff you put in place at a
time.
So when you're going throughthis, I'm watching you start to
hit that wall a little bit,which is a totally natural and
totally normal thing to do, andI hope that's one of the first
things that I said which is like, hey, man, like this sucks and
it's okay to feel this.
Sean Knierim (13:14):
Well, hearing you're doing okay Was one of the
pieces that I held onto for awhile.
I'm like you know, dan, sayingI'm not screwing up that bad,
because I was worried because Ican't see out of this.
I think, from listening to youover years and hearing what
you're saying now, I break themessage I pull from you into
three categories and I'mwondering if these are how you
think of it.
One how do I prepare ahead of acrisis, knowing I'm going to be
(13:38):
dealing with challenging thingsand you'd work with some
communities that areintentionally going into the
most difficult type ofengagements?
So it's what do you do before,how do I identify that I'm in
and what do I do when I'm in acrisis or in a challenging
environment?
And then post, what do I do asI start transitioning out?
So it's how do I determine thatI'm in those phases and what do
(14:00):
I do to prepare across?
Does that track with how youlook at this, or would you use a
different framework?
Dan Dworkis (14:05):
You're spot on and almost right.
So the one that we end up usinghas four parts to it Okay,
prepare, perform, recover,evolve Right, and it's important
to have that whole loop inthere and it's easy to lose the
evolve part kind of at the end,and is that a distinct part or
does that weave using that verbyou had earlier?
Sean Knierim (14:20):
Does that weave using that verb you had earlier?
Does that weave throughout allthree?
Dan Dworkis (14:24):
For me it's a circle, and if done right, it's
a spiral that you're sort oftracing your way across, right?
So the easiest way to thinkabout this is always sport, I
think.
Right, so you take some sort ofwhatever sports, you guys like
I don't know whatever, it isright.
Sports that I follow are morelike martial arts, so I don't
these metaphors kind of breaksometimes.
We're going to go for cycling,I'm sure.
Sean Knierim (14:45):
Whatever it is, we can do.
Martial arts Cycling actuallycycling.
Dan Dworkis (14:47):
I can probably do.
We'll see if I can.
We'll see if I know enoughabout cycling.
There's two wheels.
Martial arts is fine.
Allan Marks (14:51):
I think it led to some underdrafts.
Dan Dworkis (14:59):
No, it doesn't matter running your race.
Your preparation is prettyobvious.
It's your training, yourpractice, your nutrition, your
sleep, your hydration all of thestuff you do for it.
Your recovery is yourstretching, your rehab, all the
stuff that you need to do afterthat.
And your evolution is a way oflooking back at what happened
and learning and seeing whatcomes next.
So, did I run the race the way Iwant to run it?
(15:21):
Okay, what do I do about that?
How did my preparation actuallyimpact my performance?
Was it the way I wanted to doit, or are there other things I
need to change?
Maybe you're looking at splits,Maybe you're looking at a video
of your stride.
Maybe you're looking at yourshoe wear pattern, whatever it
is.
You're sort of thinking aboutthat and that's sort of the
whole arc as a spin.
You can zoom out or zoom in.
(15:42):
It's a fractal right.
So you can also say, withinthat next phase okay, I'm
running the race, I'm in themiddle of it, I'm in the I'm in
the perform phase, but I'm aboutto hit a hill.
All right, I know it's going tobe harder.
What do I do for that?
Well, I'm going to psych myselfup.
I'm going to be using thesethings.
I'm going to prepare it hill ina certain way.
Then I'm going to coast alittle bit on the downhill and
(16:03):
I'm going to think to myself didthat work Right?
But then you're going to zoomout and think that it's not just
a race, it's actually yourentire racing season or it's
this phase of your life or it'swhatever it is, and there's this
beautiful fractal nature to itwhere you can apply that model
really tightly or you can zoomout to it.
Yeah.
Sean Knierim (16:20):
That's beautiful.
In your book you talk about adebrief culture and I think you
pointed to like you talked aboutit throughout the story you
just told of always reflectingon what you're doing.
What do you mean by debriefculture, dan?
Dan Dworkis (16:33):
Yeah.
Sean Knierim (16:33):
In the book.
So Dan wrote a book called theEmergency Mind.
It's outstanding.
I had to pry it out of mywife's hands to read it before
we came in here today.
But a debrief culture.
Dan Dworkis (16:44):
Now, first off, thank you for saying that that
means a lot.
Right, I wrote it during COVIDand I wrote it when, like a lot
of VR doctors, I sort of thoughtthis was going to be the end.
Right, and if this is going tobe the end, then I should
probably build something thatoutlasts me, so I would work
shifts and then I'd come homeand I'd write the book and that
was that, and thankfully itwasn't the end.
And now there's a book andthat's awesome, and you didn't
(17:05):
sleep for about two years.
Tough, tough times.
But I wrote it for the folksthat were the younger versions
of me, who were struggling todeal with a lot of what they
were seeing and were looking atthe gap between how they thought
they could perform and how theywere actually capable of
performing, which is a gap that,whether or not we're in the ER,
(17:25):
I think we're all familiar with.
Right, just to your point, likeyou had a vision of how you
wanted to be able to handle thisevent and then you were
handling the event and you weredoing a damn good job at it, but
that vision didn't matchexactly.
Sean Knierim (17:38):
I had no idea how to even evaluate how I was doing
.
Yeah, yeah.
Dan Dworkis (17:42):
Right, and if we don't know how to evaluate it we
don't have tools to evaluate itthen it's very easy for us to
get lost and to assume thatthings are bad.
Sean Knierim (17:53):
Yeah, cause a lot of Wednesdays were bad.
I knew the day prior, the 10minutes prior they weren't my
best Right, and so some of theframeworks you shared were
really important.
Yeah.
Dan Dworkis (17:59):
There's this, um, there's this thing we have that
you can watch especially juniordoctors do, which is the death
spiral, right?
So something happens.
It's not what they want.
The outcome is worse than theythink it's gonna be.
They look at it and they say,wow, I really sucked.
Wow, that must mean and this isthe key that must mean I'm a
bad person If I sucked at this.
(18:21):
I must be a bad person.
And wow, if I'm a bad person,I'm a waste of space.
My mom hates me and I shouldn'thave done medicine to begin
with.
And, like my uncle was right,I'd never be a doctor, you know,
whatever it, is, and then shameand regret and ego are taking
over.
Allan Marks (18:32):
Oh my God.
Dan Dworkis (18:39):
And the poor patient sitting there being like
wait, I still need help, butyou're.
You're in the idea that we'reimperfect, we do things
imperfectly and our job is notto be perfect but to get better.
Allan Marks (18:52):
How do you balance?
I'm going to give you twodifferent sides of this.
On the one hand, we want to dobetter Performance matters.
Of course, we're going to spendtime going through all four
steps, we're going to have ourdebrief culture and we've set
ourselves up in a way with theillusion of control.
On the flip side of that is somuch of resilience to come back
(19:14):
to.
That is how we respond to thesituations we don't control.
But we're not the ER doctor,we're actually.
We're the patient and thefamily of the patient and the
family of the patient, and it'snot up to us, but we nonetheless
have to muster some resourcesto go on somehow and to
contribute and help if we can,or to ask for and accept for
help and learn to do that ifwe're not good at it, and to
(19:35):
acknowledge we just don't havecontrol and to make that
distinction.
And you can prepare, by the way, for situations where you don't
have control.
This preparedness may still bea factor, but there isn't that
constant pressure of we can.
Therefore, we must do better.
Dan Dworkis (19:48):
I don't totally know that I agree with you.
I think there always is thatconstant pressure of we can do
better.
Okay, say more about that.
Almost doesn't matter whatsituation we're in, right,
there's always the ability to dosomething.
There's this great Stoic quotethat's like I think it's
Epictetus, although it could beSeneca, I forget who basically
(20:08):
said if the only thing left forme to do is to drown, then I'm
going to try to drown in a waythat teaches other people about
surviving.
If that's literally all youhave, then you're going to try
to do it in a way that makes adifference.
There's a lot about being anemergency doctor that you don't
have control over.
You don't control who comes in,you don't control what they
have.
You know you don't hold all thecards right.
(20:30):
Sometimes the person in frontof you, their die, is cast and
you do what you can, but nothinghappens and it's bad and you
suffer and they suffer Early on.
Most of us hit some version ofwhat you're describing where
we're like well, I don't controlanything here.
And where we're like well, Idon't control anything here, and
it's easy to get into vaporlock, Like you're just sort of
frozen and you don't really knowwhat to do about it.
One of the drills that'ssurprising and kind of helpful
(20:51):
for that moment is somebody willusually ask you could you make
this worse?
Could you make this worse rightnow?
Is there a way to pour gas onthe fire?
And almost always there's a wayto make it worse.
Right, Like, we're verycreative as human beings, we can
usually find a way to make thesituation worse.
Right, you can't fix thepatient, but you could punch the
nurse.
Right, you could light thething on fire.
(21:13):
You could do all sorts of stuff.
Don't do any of those things.
Right, but you could do thosethings and make it worse.
And there's this weird thingthat happens, which is when
you're in these circumstances,circumstances and you realize
you could make it worse, youpretty quickly are like well,
man, maybe I could make itbetter, Even if it's a small
thing.
Allan Marks (21:28):
Yeah, or at least avoid making it worse, or at
least avoid making it worse.
Dan Dworkis (21:31):
And sometimes not pouring gas on the fire, is the
victory.
Yeah, no-transcript.
Sean Knierim (21:49):
So it strikes me to pull together what both of
you were talking about.
It's understanding, it'sgetting yourself to a point
where you're able to determinewhere do I not have control but
where do I have control andwhere, when I have control,
(22:11):
where's my choice, able to beemployed in a way that I'm going
to feel proud of or feel likeit's making a better or a less
bad outcome coming out of it.
So I I called you and there wasone time you laughed at me
where I'm like Dan, what can Iexpect?
Cause I've seen these chartswhere you come through a
disaster and then you go throughpublic euphoria and the line
goes up to the right and then itplunges and it's this community
despair, and then you kind ofslowly come back out of it and
you're like Sean, that actuallyI don't think applies and it
(22:34):
doesn't apply in the situationwe're in here.
And then I said, well, are therethings I could read?
Is there something I can do togive me a path of what to expect
?
Cause my mind was really hopingfor patterns and you gave me a
couple of different books, andthe one that I mean, your book,
was excellent.
The two of the other books thatI'd love to hear pick one of
the two Man's Search for Meaningby Frankel, who talks about
(22:57):
suffering and choice, survivingSurvival that talks about giving
oneself the permission to beflexible, like you thought of a
couple of different books.
But like which?
Which books, which people doyou look to when you're trying
to learn, or or?
Dan Dworkis (23:11):
grapple with these things.
Yeah, I mean I, I think it'sworth saying like it's very easy
for me to sit on a podcast andpretend to be very smart about
all this stuff Right but likethis is really hard, this stuff
is super hard.
Uh, I'm still working on it,we're all still working on it.
Like you would be doing adisservice to pretend like I'm
this wise sage and everythingand to the extent that I am
alive.
Allan Marks (23:30):
I'm glad you pretended to be one, for me, as
you said, I don't have to befaster than you.
Sean Knierim (23:38):
I don't have to be faster than the bear, I do
faster than you.
Allan Marks (23:42):
So you're smarter than us, we're good.
Dan Dworkis (23:45):
I don't know about that.
I think I've spent a long timethinking about this kind of
stuff and I think you know bothof those books Man's Search for
Meaning by Frankel, and thenSurviving Survival and his other
book, deep Survival by Lawrence.
Gonzalez, are just awesome,right, and they all sort of poke
at this sense of whatresilience is Right.
What is resilience when you arein these moments that are
(24:08):
really challenging to evensurvive, let alone to do
anything with?
What does it look like on theother side of it?
What does it look like whenthat first wave of things has
passed and your resistance isgone and you're out of strength
and you're doing whatever, andnow you're sort of still in it,
right?
What does that look like?
I never liked the you know,like 30 hour shifts we did in
(24:31):
medical school.
I don't think anybody likesthem, but 40 would have been
better.
But one of the things itteaches you is that, like you
know, you can be tired and stilldo things, and you can be
hungry and still do things, andthere's many, many, many people
that have been in much, much,much worse places that I have
than I have.
(24:51):
I would say as a patient.
Allan Marks (24:54):
if you're in a teaching hospital and they
haven't slept for 30 hours, youkind of might wish you'd had
somebody who'd maybe had a napat some point.
I mean it's because, yes, wecan do things, we can rise to
the occasion.
It doesn't mean necessarilythat it's the best systemic
design that we should have to.
Dan Dworkis (25:09):
So that's interesting, right, because
there's a tension in there, sure, and we talked earlier about
what resilience is and we talkedabout how it matters what
camera lens you're looking at itthrough, right?
So there's a lens of thepatient and the patient's family
, where you want the freshestdoctors all the time, yeah, and
then there's a lens from societywhere you want doctors to have
gone through 30-hour shifts sothat, if they have to, they know
(25:33):
they can do it.
Yes, we always see this tensionin the ER, because what's good
for the one individual patientmight or might not be
necessarily what's good for thefield or what's good for the
whole society.
And that's challenging, to putit mildly.
Right, it sucks when it's yourfamily, it sucks when you're
(25:53):
going through it and and how doyou draw the line about how much
you're willing to give or notgive or you know, sort of
whatever it is about that.
But I think there's.
I think, when we're talkingabout resilience, like we have
to have that end of theconversation too.
Allan Marks (26:05):
How much are we willing to pay for resilience?
Yeah, I know, you know, whenyou look at, for example, at
cybersecurity, which is an areaI've done some work in, you know
, there's this idea ofresponding to the problem, but
there's also the idea of, well,how do you prepare so the
problem doesn't actually happen?
Sure, what is the threat?
How do you assess the threat,how do you defend against the
threat?
And then, of course, beyondthat, how do you identify when
it's happened, how do you reactto it, how do you take the
proper steps?
And, of course, the evolution,the debrief, as you mentioned.
(26:28):
Try to learn from that and thenmake it harder next time.
If you're looking, as in yourrole, for example, as an ER
doctor, where you haveresponsibility for a whole team,
are there things?
How much time do you spend onmaking that system work better
to prevent the very problemsthat would demand resilience if
they didn't get solved?
Dan Dworkis (26:47):
That's a good question, right.
So there's stuff that you youknow and we're sort of blurring
here back into the Stoic conceptof circle of control or sphere
of influence and sidebar intoyour question again like what
books do I recommend?
Like, go read Stoic philosophy,right, meditations and Seneca's
Shortness of Life, andEpictetus and Chidron I never
(27:08):
know how to pronounce that, butit's really good Epictetus,
that's how you pronounce that,by the way.
But sidebar, so it depends onwhere you have control right.
So when I'm in the ER, what doI have control over?
Well, I can work with my team, Ican work on the skill sets that
we have available.
To a limited extent, I caninfluence the system around me,
but I can't, for example, goback in time and have people you
(27:31):
know take their medicationbefore, and I can't necessarily
change the traffic patternsaround an intersection to
decrease the probability of anaccident.
Now, if you give me a longenough time and, from an
Archimedes standpoint, a largeenough lever, I can actually go
change the traffic patternsright.
And a lot of the initial workthat dictated seatbelt safety,
(27:51):
for example, was done by ERdoctors who were looking at the
injury patterns, and being likethis is ridiculous.
We should probably be able todo better than this, right?
So there is an ability to alterthe system to prevent the
problem from happening.
But within that moment, where'syour fulcrum?
How big of a lever do you have?
And you're right how much areyou willing to spend in that
moment on that piece versus thetask at hand for you, this
(28:14):
tension?
How much are you willing to payfor resilience?
Sean Knierim (28:16):
So, Dan, you work with a number of different
communities.
We've talked a lot about themedical community, in which
you're a professional.
You work with military sportprofessionals all over and I
think a lot of people hopefullythat'll be listening to this
come from a variety of differentcontexts.
What takeaways do you seeacross these communities that
(28:37):
people listening to this mightbe able to pull away themselves?
So, either, going into, goingthrough, coming out of evolving
afterwards, what are the thingswe can keep in mind that you're
seeing are helpful across all ofthese different worlds that you
get to work through?
Dan Dworkis (28:50):
Yeah, absolutely so .
First off, inherent in yourquestion is this idea that there
are things to learn from othergroups, which I think is super
important and sometimes notobvious, right, like it wasn't
obvious for a long time thatdoctors should learn from people
that weren't doctors.
Now it's pretty ridiculous tosay that out loud now,
thankfully, but that wasn'talways the case, right, it used
to be well.
Sean Knierim (29:10):
Doctors would just learn from doctors when you
shared a story with me about aspecial forces operator, I think
from the uk, and about emotionand a well of emotion.
Do you remember that story?
Can you share that?
Like that was hugely stillmoving for me now and I'm using
that language as I talk to myfamily to explain how I'm doing.
Can you share some of that?
No, I can't.
Dan Dworkis (29:31):
However, the metaphor, I can talk around it,
the metaphor talk around it.
Sean Knierim (29:34):
That's what I meant.
Dan Dworkis (29:35):
What I can say is that, um, there's this thing
that's useful to think about,which we sometimes call the
cousin effect, right, and it hasto do with the idea that no
one's a prophet in their ownland.
So sometimes the best thing wecan do is share our problem sets
with people that are close tous, but not doing exactly the
same thing, and in doing so,that frees us up to either take
(29:57):
advice or change things aboutourselves that we might not
otherwise.
So I can't share that story,but let me share a flip side of
it.
That's about me, right, thankyou, which I can share about
that because it's me, right.
So when I was really in it andjust there was a time when I was
just really struggling, youknow, waking up with nightmares
all the time and just like a lot, of, a lot of things that were
(30:20):
really bad, and I didn't, Ididn't really know what to do
about it.
I was sort of aware it was aproblem, but I wasn't.
I didn't really have my handsaround it at all and, as luck
would have it, I got a chance tobe around some folks from the
military who were very elite intheir craft, and I don't really
know why.
I think they might've asked mesomething like what's it like
being an ER doctor?
And maybe I just had enoughthat day and I actually told him
(30:42):
what was going on.
I don't know what thecircumstance was, but I remember
this person putting their handon my shoulder and just saying
like, wow, dan, that's hard, youshould probably get some help.
Yeah, and and it just sort oflike blew me apart, right, and I
was like what do you wait?
What?
This person, who's the doubleblack flip, ninja, champion of
(31:05):
whatever it is, which is not areal thing, is telling me that,
like it, what I'm doing is hard.
Yeah, yeah, like if, well, ifthey think it's hard, like shit,
maybe it's really hard.
And if it's really hard, maybeit's okay If I got help for it.
And like, man, what anincredible gift that was just to
be able to be like yeahno-transcript way sidebar.
(31:44):
So, uh, with a good therapistwith a good, yes, fair, cool,
cool sidebar.
But these days I'm on the otherside of it a lot of the times
and I'm sharing stories about,you know, being in the er and
talking to folks that are in infire or the military airspace
and sometimes being like theother end of that story saying,
hey man, what you're describingis really hard.
You should maybe go get somehelp for that.
And there's this remarkablething, which is that it's just
easier to listen to somebodywho's not your direct brother or
(32:04):
sister.
They're your cousin, so thecousin effect.
Allan Marks (32:07):
So one of the things, too that I know from
your background academically,sean, in literature.
I'm sure you've bumped intothis, but it's one of the things
I was advising some youngerlawyers Fiction, read fiction.
We spent a lot of time.
I spent a lot of time readingnonfiction and, by the way, the
books that were recommended, Ifully agree Absolutely great
(32:28):
reading, endorsed them highly.
But there's something to besaid for reading stories fiction
stories, novels, short storiesBecause the empathy muscle gets
a workout and we get to seeother people doing things that
in their context are believablyhard and we care about them and
we care about what happens tothem and we're kind of along for
(32:48):
the ride.
Um, the result there and thereare peer-reviewed studies that
look at the way that fictionactually does contribute to
empathetic societies andindividuals as well, in a way
that just you know, knowing howto do stuff doesn't even compare
to save, you know, history orthings that are still maybe a
story.
Sean Knierim (33:06):
But are factual, super interesting.
And so, dan, to pull back tothe question I asked a bit ago
and then sidetracked you, anyother ideas that you'd share
with people that are listening?
So, as we're coming in or out,like what, what might we keep in
mind to try to help ourselvesLike part of like, sleep a
little bit more, get a littlebit more water, eat well,
activity, community, beingaround other people that love
(33:29):
you or that you can be around,but any anything else you can
think through in your experiencethat that we might keep in mind
coming in and out of hard stuff.
Dan Dworkis (33:35):
Yeah, I mean, I think like if you look at that
arc of prepare, perform, recover, evolve, like, recognize that
there's a cycling, a periodicityto the work that you're doing
with it.
Right, if all you did wasperform, you will burn out and
break.
Imagine a sports team that allthey did was perform or a runner
that all they did was race,like there's no way that would
last for very long.
Allan Marks (33:55):
That person would break, and, with apologies to
the Stoics, but if you look atthe Epicureans, there's
something to be said forenjoying what you're doing and
having fun with it, which is Idon't want to lose sight of that
.
Dan Dworkis (34:04):
I think yeah, no, and there's deep joy in the
Stoics too.
It's just a little deeper inaround the corner.
Yes, right, you sort of got tolike sift through it a little
bit to get into it, right, butthere is that deep joy of, like
(34:25):
you know, a life well lived andand the moment that that brings.
And I think that I think thatthere's a balance in there
between not too tight and nottoo loose, right, and there's
that, that concept of you knowtuning the string of your own
instrument such that you createa note right, if you're too
loose, it's floppy and nothinghappens.
If you're too tight, it snapsand you, you don't play for very
long, right, um, there aretimes it's the reason trees bend
in the wind and sway yeah, andthat.
Allan Marks (34:42):
And that's exactly.
They didn't.
They'd snap and fall over.
Dan Dworkis (34:44):
Exactly, and there are times when you're recovering
, when you're hit in a crisis,when things are literally on
fire, when, like, all you haveto do is perform, that's it, you
just perform.
But when you're not in that,can you actually take a moment
and take a step back, can youdrink water and sleep and and
you know, be like, tune yourselfto the right frequency not the
(35:05):
tightest that you can be, butthe right one for it.
Sean Knierim (35:07):
And I think, if we look at part of what is
resilience, is the skillset ofmaintaining the right tune for
the right moment, such thatwe're in the game for a long
time and there is something thathas come through in everything
you've said with us today andone of the reasons why I reached
out to you one of the firstpeople after this and then
wanting you to be part of thisconversation with Alan and me.
(35:29):
There's this consistent throughline of being kind and
understanding to yourself andsomething that a gift you've
given me and many others in yourworld and I mean something,
alan, why I've always lovedbeing around you.
It's an acknowledgement ofthose around you, like if we're
not able to give it to ourselves.
I'm not good at this.
Many people I know are harderon themselves, maybe than they
(35:52):
should be, but you're reallygood at helping others around
you hear from you that you thinkthey're doing okay, which is
that piece of kindness, thatgenerosity, which isn't
necessary, but you're reallygood at it, and it comes through
in every question we've asked.
You has that kind of like takeit easy on yourself, Even if
(36:12):
you're working your ass off.
Dan Dworkis (36:14):
I appreciate you saying that I I don't know that
I'm always good at doing thatfor myself at all.
I think that's really hard.
Um, dan, you're doing great.
Sean Knierim (36:22):
Thanks man.
Allan Marks (36:23):
You are doing great hard, dan, you're doing great.
Thanks, man.
You are doing great.
Dan Dworkis (36:26):
You're modeling humility, really well too, Thank
you, but this stuff's hard.
I mean there's no reason tomake it harder.
Right, Like you could alwaysmake it worse.
Right, you could always catchyourself on fire and make it
worse, but there's no reason to.
And I think that sense of likeyou know, I want to be in this
for a long time, and we talkedabout this also.
We talked about what is theintegral of what you're doing
(36:48):
over time.
Sean Knierim (36:49):
What do you mean by that?
Dan Dworkis (36:50):
Yeah Right, the Riemann sum of.
We get really nerdy about mathhere for a second.
The idea of a vantage pointagain, right, when we keep
coming back to what's thevantage point?
We're talking about resilience,for so one vantage point is the
scale that we're talking about,or the spatial direction we're
taking.
The other is sort ofconvoluting that over time,
right.
So the integral of your workover time is the addition of
(37:13):
every day's effort summed upover a long period,
geometrically, geometrically.
Sean Knierim (37:19):
So maybe to try and restate that in a way that
my brain would use right.
So maybe to try and restatethat in a way that my brain
(37:39):
would use right Because I don'tthink in terms of the
mathematical stuff course, of aperiod, a longer period of time
and evaluate how well you'redoing over that course and then
figure out how you might learnfrom that as you're moving
forward.
Allan Marks (37:52):
I remember when I was, uh, I was climbing, uh,
with my daughter when she wasquite young and you know it was
kind of steep and we're workingour way up and it was here in
the Santa Monica mountains, butthere's this rock.
We want to climb to the top ofthis rock and the type of steep
thing and we weren't really onthe trail in Griffith park and
and when it's steep and you'reup close to it, all you kind of
(38:12):
think of is I don't want to losemy footing, I don't want the,
the, the.
You know that the dirt or therock thing's pretty close and
we'll get there.
And then you get there and wegot to the top.
She was, she was quite young,it was a windy, windy day and
she's looking around at the view.
And then she looked down and shesaid it's a long way down, but
(38:35):
there was a sense ofaccomplishment because we'd come
up that far and she had come upthat far and she really had
done a great job of it.
So it was, you know, that senseof perspective, you know that
that integral.
As you climb up the, you knowthe upward sloping to the right
side of the parabola, yeah, itgets steeper, but you also
accomplish more each timebecause you're building on what
(38:56):
you've already done.
Dan Dworkis (38:57):
I also think it's in some sense a defense
mechanism, right, like if youare forced to like.
Like performance matters, right.
Like the outcome matters andyou have to do the work well,
right.
But if you're forced toevaluate your entire sense of
existence based on the role ofone dice or the play of one hand
of cards, it is verychallenging to do that.
(39:18):
Instead, if you can look atyourself and ask you know cause
inherent in your question of amI doing a a good job?
Is this deep sort of soulsearching like am I a good human
being?
Am I a good enough human being?
Sean Knierim (39:29):
What's my worth?
Right, what's my worth?
Am I a?
Dan Dworkis (39:31):
good enough father?
Am I a good enough husband?
Am I a good enough man?
Am I a good enough human being?
And, like all of this iswrapped, am I doing okay?
And what I'm, what I'm seeing,is this like burning sort of
like you know existential thingin the middle there, and which
totally makes sense, right,Cause you get hurt, you get hit
(39:52):
and you ask these questions,right?
I ask these questions all thetime and it's normal to ask
these questions and it's easy tomake the entire answer about
one thing.
I yelled at that last person Italked to.
I spilled my coffee thismorning.
I didn't run this morning.
I wasn't as nice of a humanbeing as man.
It's just so easy to like takeone thing and make that the
(40:13):
answer to the question andinstead, if you can expand the
scope of how you're judging alittle bit and ask is the world
a better place because you'rehere?
Allan Marks (40:21):
Yeah, so to close, if I may, what makes you the
most optimistic?
Dan Dworkis (40:27):
or hopeful right now.
Oh, I mean, like I'm constantlysurrounded by men and women who
are throwing themselves intohard problem sets with all of
their energy and effort and whoare attempting to scale enormous
mountains and make thingsbetter.
Like I am so lucky to beconstantly surrounded by these
people that are so smart and sostrong and so dedicated to
(40:49):
making the world a better place.
I think that the way uh, I don'twant to drop a commentary bomb
on the end here, but I thinkthat the way a lot of our system
is set up is to feed us badnews and things that scare us
and it's very hard to spend timewhere it's much harder these
days to spend time around peoplewho are smart and strong and
(41:10):
hardworking and dedicated andwant to make the world better.
They're not gonna show up onthe news, they're not gonna come
through on Facebook, right.
We're not gonna get fed themaccidentally.
So, to the extent that we cango seek them, to the extent that
I am lucky enough to be aroundthem you know we talked about
resilient person and resilientcommunity with resilient system,
(41:31):
right, like to be surrounded byamazing people, to include my
wonderful partner and my familyand to be in part of a system of
of people that try to make theworld a better place all the
time.
I'm incredibly hopeful fromthat.
Sean Knierim (41:44):
Well, you bring me hope, Dan, and I think you
exemplify what you justdescribed.
I can say, I think prettyconfidently, you have not made
this podcast worse by being here.
I'd encourage everyone who'slistening to this to pick up
your book, the Emergency Mind byDan Dworkis.
Dan, thank you so much forjoining us here today.
Allan Marks (42:02):
Yeah, dan, thank you, real pleasure.
Oh, thank you both much forjoining us here today.
Dan Dworkis (42:04):
Yeah, dan, thank you, real pleasure.
Oh, thank you both.
Sean Knierim (42:05):
Thank you for having me.
This has been another episodeof Shared Ground, a podcast
about resilience and community.
Allan Marks (42:13):
Follow us on your favorite platform or learn more
at sharedgroundcom.
That's shared-groundcom.
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