when the organizer of today invited me
to be Speaker the same moment I said yes
sure I can make it I didn’t think too
much maybe the funny thing came to my
mind that I will become more famous and
people can find me easily I know I used
to give a medical talk easy for me to
practice but this is the first time to
be speaker for TEDx I never know how to
process I never know the details you
asked it earlier yes I am one of the
people who doesn’t know before and I
never asked I didn’t expect I have to
spend a lot of time and effort to
prepare for that and also I wasn’t sure
that I can make it tonight today by
right I supposed to be overseas now but
I managed to change my flight for next
week to keep my promise and to be with
you today and fortunately everything
went well but when I go back and think
about I found that I was a rush to say
yes I know that usually we do that
usually we can say yes or no routinely
right subconsciously but usually we do
that for the routine think we used to do
so I think I should ask about some
details before yes or no sometimes we
say yes it works sometimes it doesn’t
work sometimes even can put us in such
critical situations and can add some
commitment to us as I have today so this
is Alexandria my lovely hometown from
actually the second capital of Egypt
from where I came from I’m here 14 years
and then 14 years ago they offered me to
come to work as a physician in Malaysia
Malaysia at the time I know it from this
just made in Malaysia when I buy any
imported item militia the time which I
know from people who visit Malaysia and
come back tell me wow you are going to
Malaysia you will enjoy in Kuala Lumpur
getting but I know that the place you
are going to visit sometimes in fact
most of the time is different from the
place you are going to work so sometimes
I have to collect more information I
have to check about Asian culture about
Asian food because a Middle East man I
have to think about that my future
career here I have to think about my
family I have to collect more
information and I had the time for that
it was not that easy decision to come
and to travel more than 12 hours
directly which I never travelled before
most of the time I go to Europe or
Middle East is just two or three hour
and I feel bored
nowadays when across I said oh I am over
the India now is good for me so the
situation done I’m here 14 years I’m
very happy me and my family to be here
back to 1979 when I finished my second
school so you can know now roughly how
old am I when I got a high mark to go
any college which I want I know that I
like mathematics but I never get high
mark I usually believe in biology so I
said let me to think either medical
college or pharmacy at the time I have
to think carefully because it’s my
future career and I have to collect all
the information needed not only that
there is a big difference between the
things you like and the think you
success
not everything we like we can success
right so I collected more information
and I decided to be a doctor once I told
my friends and my parents that I want to
be a doctor everyone jealous and said oh
you want to be a doctor to make bunny
doctors always make money you know I go
to see the doctor but usually it’s Wendy
with me five times not very fast
charge me a lot no one knows that
doctors always under stress I think some
of you are doctors we can be even more
than that but you don t feel it we feel
it so in fact the doctor you see in the
front of you in the clinic smiling cool
down easy and relaxed discussing
everything you never know that they are
the same doctors who are behind the door
behind the ICU and CCU facing a lot of a
challenging situation in particular when
we face unpredicted risk doctors usually
they can predict the risk when we do for
elective operation and even we ask the
patient about his acceptance and consent
that we explain to him everything but
sometimes out of prediction will have
some risk and this risk actually has to
be solve it and prevent it by fast and
wise decision this is the really
challenge how do you think wise how do
you think fast
in fact doctors behind the door you
don’t you know it because you always in
the front of the water unless you are a
doctors we are doing our best to save
our patients our concern is patient
safety we feel guilty when we do
anything shall a
affect the patient badly or maybe
unfortunately lead to his death we feel
very guilty for that and especially when
we talk to the prelate –iv in the front
of the door and they put high input on
us high wishes I expected that I hear a
good news from you and inside me I know
that the case is so-so
so this is another really challenge fine
you can take faster decision but mostly
it will be unwise and this will affect
the patient safety you may take your
time and think and go to ask and take
and read again the literature and review
everything and become late and this is
also what affected the patient the
patient might die so the question here
how you are going to make a fast and
safe decision how you are make the
balance between two in fact most of the
time we are using analytical and
critical thinking what is this approach
this approach is very simple before you
think about any problem we advise
everyone please calm down control your
emotion I’m asking anyone of you have
you faced any situation before critical
situation and can you think about it
when you are under stress I doubt if
even you can think or take a decision
most of the time will not be the optimum
decision so I advise everyone to have
this and this is what we do we have to
cool down be away from any emotional
factor this is to clear your mind and to
let your mind starting again after it
hanging so if we have such a situation
after we relaxed and cool down and we
have to find the problem
of the patients coming to us are
complicated let me to say compo patient
patient come three-in-one so we have to
look for the problem and we have to use
analytical thinking that we need to
break down this problem into single
problems that easy for us to manage each
part separately and then we have to
collect as information as we can
definitely reliable information or
related aid related to information for
that and then we have to take
v-formation critically mean that take it
seriously don’t take the information
from superficial part and just to fill
the medical record after we collect
everything and we need to keep in
updated because the patient situation
always a changeable we have to take the
advice we usually call our consultants
or senior people or we’ll try to read
written literature’s and even we try to
call back our previous experience if the
doctor is senior enough after you
collect all this information you have to
gather it again and you have to
articulate it and to do approval
analysis and possibilities and then you
come out with options of solutions and
you put a plan for that plan a plan B
and you start I know it is more or less
talk but let me to give you a real
example of our life this patient coming
to us and this vision actually diabetic
patient who presented to us with
infection
we know that diabetic patient when they
got any infection the situation might
not be that easy unfortunately the
patient developed kidney failure because
this is in sequence of his infection and
water the dissipation develop heart
attack
so I have now three problem all in one
Beijing on hand in fiction Beijing heart
failure and patient kidney failure so
this is a complex problem and when I was
going in to ICU
I made the relative outside oh how is
our relatives gonna so I don’t know I
said okay I just came in and please wait
I will go there so I am under stress how
to many such situation the first is I
must cool down and I must clear my mind
and take everything in relaxed way then
I started to find what are the major
problem of these patients infection
kidney failure heart failure we know
that anyone get infection you will not
recover within one hour you need at
least a few hour for this antibiotic to
work if it worked
so I already exclude this one at the
moment because this one will be solving
this problem by giving proper antibiotic
but it will take time and then we have
two problems now either to touch the
kidney problem or to handle the heart
problem if I send the patient T to
dialysis with this heart attack the
patient might die if I wait for the
heart to be stable and just wait for the
kidney as well the patient may die so I
am in situation you have to solve one
first then what we did we collect all
the data needed from the lab we did all
the in we collected all the information
and we started to follow the same
approach take each information
critically and we started to again
gathering this information called our
consultant take the advice and we put
some analysis and we come up with the
plan
Lenny that we must wait for a while
cannot change the patient directly to
hemodialysis
hemodialysis still can wait two hours
then what if the plan doesn’t work I
already put a plan B so this is
analytical way of thinking and solution
options and solution plan fortunately
this patient move on in a good way not
in bad way and he recovered after two
weeks so I’m very happy relieved the
feeling when your celebration will be
very happy so this is approach which we
use in the medical part but you will ask
me you are a doctor facing on this one
and you make a lot of money so what is
the role of us don’t forget whatever I
decide to do I cannot do without your
permission if you are waiting in the
front of the door you are the one who’s
supposed to give me the consent so I
hope that you will not face this
situation but are you ready to think
fast and wise if I come out of the door
and tell you I have a and B you have to
decide because I need your fast consent
which means you have to think fast and
wise as well I think not everyone
expected that we face this situation or
I hope that not to face in miracle but I
have one question which is do you think
we can face the situation in normal life
most of the time I feel that my clinical
experience only for my work because I
know my family usually does not like to
be treated by me we don’t have a trust
of that I think always a doctor like
this right so I did believe that this
clinical and the way of thinking might
help me only in my career but then few
years ago I faced one situation at the
personal level I have one son and one
daughter the daughter already graduated
by masters the son already was in
secondary school and he is also biology
man as his father but he doesn’t like to
be a doctor he wanted to be dentist or
pharmacists unfortunately he did
his best to beat the high mark but
acceptance in Egypt is more than 95% to
accept in pharmacy or indentity
I was confused my mind freeze and I did
apply him to come here to study
biomedical course in Malaysia the last
minute no respond he only got a content
course in Egypt the day he wanted to
register I receive a call from Malaysian
that my son accepted I said Wow
good but they said under condition that
he has to repeat some subjects he has to
pass certain language if yes welcome if
no good bye back to Egypt so now I am in
situation which I have to cool down he
is my only son and you know the feeling
of fans are not that far from the
feeling of doctor/patient so what I did
I called him and then I told him we have
to think we have to collect the
information we have to study the
prospective of each one I have to know
your capability which one you like it is
easy for us to go for accounting just to
go and register and get it so it is easy
today but maybe in the future not the
good option while we can take the
challenge now and go to Malaysia and
we’ll try our luck but it will be
difficult now but may be the easy in the
future so in fact after we do the same
approach and this is how our career
experience can help us in the personal
level we managed to come to Malaysia and
everything went well and this year he is
in the third year of the bio medical
course in fact today now he isn’t the
flight back to Egypt that’s why I
postponed my fight to be here
so in conclusion in my advice what we
need to do if you face any critical
situation in medical or non-medical
number one you have to control your
emotion and calm now and you have to
find the problem and break it into small
single one try to manage
each problem separately and then after
that you can collect all the information
needed and then gathering all the
information articulated both options of
the solutions and put solution plan but
whatever the outcome
you should not regret because if you win
you can lead and if you lost a still you
can guide thank you [Applause]