I had been driving a 15-year-old Volvo that leaked through the sunroof whenever it rained. The power in the driver’s side door was out. Which means you can’t roll down the window or use the power locks or adjust the mirror. It used to have a third row, but the seats were permanently down because the release mechanism was broken and would cost $1000s to fix.
The alarm system was on the fritz and it would randomly make the lights all flash while with car was just sitting there with no one around it. You’d have to use the actual key to unlock the doors when this happened all the while praying the battery wasn’t dead.
The radio would occasionally turn on or off of its own volition. The seats were cracked and a mess. When you put the blinker on to turn left the interior light came on and flashed (my kids liked that “feature” the best).
Growing up in my family, you bought a car and drove it until my dad couldn’t fix it anymore. Then you found someone who could and limped it along a little further. He has stories about welding a penny to a hole in the radiator during a family vacation to keep the car running and get us all home.
Finally, I traded in that worn-down Volvo and bought myself a brand-spanking-new car.
Well, I was in that car one fine morning after getting it, and I wanted my feet warmer but the car cooler. So I figure I’d set my feet to warm and the passenger to cool. I couldn’t get the thing to work. The dual button light was off, but it wouldn’t separate the two sides.
Then it dawned on me. Activating the dual button separates the two sides. The engineer who built thought that normally both sides are connected, but hit the dual button and that separates the two sides. I originally thought, hit the dual button and since it says “dual,” it means both work together.
I probably pushed that dual button 10 times not remembering which way was on or off before thinking it through and making the connection. After that, I never messed it up again. A little context goes a long way.
Funnily enough, I had another example happen while looking over some things for ACLS. I always struggled with pulseless electrical activity (PEA). That’s no pulse, but the ECG looks relatively normal. I could never remember what to do. Then as I’m reading the book on day, the connection comes to me.
- Hypotension is a leading cause of PEA. So what that means is that the heart’s still beating but there isn’t enough blood to move around to create a pulse.
- Cardiac Thrombus is a leading cause of PEA; same story. If there is a blockage, there is no blood moving around, despite the heart continuing to beat. It’s a pump doing its thing without any fluid in it to pump.
Boom! I’ve got it forever. No need to study or make up flash cards. Done. I’ll remember that for this exam and for the when I take ACLS again in 2 years.
What’s even better than that? Well now that I know why, I’ll also remember to treat them with fluids. It gets so much easier when you piece the whole puzzle together.
When you keep forgetting the same things over and over and over it’s because there is no connection there. You’re just holding onto facts. When you keep getting it wrong and forgetting, take a few minutes and figure it out. Then it sticks forever. It’s worth the time tradeoff to really see how one piece of information fits into the whole tapestry.
Once you get this understanding and you want to start testing your memory, you’ll want to start using The Final Step. TFS is a quick-paced question book made up of over 1,200 questions designed to make sure that info sticks in your brain like gum on the bottom of your shoe on a hot day.
Get your copy here: The Final Step
Brian Wallace
