LAUSR

INTRODUCTION Twenty-three years into this journey as a pediatric orthopaedic surgeon, my path is littered with mistakes made. The collision of a "family-first" philosophy with the demands of my busy academic surgical practice-not pretty. As a canary in a toxic coal mine, I have failed to fix the mine, so I have focused on being the very strongest and resilient canary possible. METHODS This is a retrospective study of mistakes made and lessons learned. The mistakes include submitting to the tyranny of perfectionism; failure to resist the tendency to measure ourselves against others; saying "yes" to every request; thinking my job is Monday to Friday, and career is nights/weekends; being given a big new job, but using same old time/energy management strategy; sloppy time management; failure to manage energy; considering sleep "a waste of time;" failure to manage attention; dragging the challenges from my day through the door each night; thinking that the skills that make me good at work are same that will make me good at home; aiming for work-life "balance;" and sometimes losing sight of our mission. RESULTS It is too soon to tell whether the lessons I have learned from all my mistakes are essential to preventing burnout. Although I am certain my results to date are significant, I cannot prove statistically significance. I am working to develop Appropriate Use Criteria for time and energy, and Best Practice Guidelines for prioritizing where to focus attention in life. DISCUSSION We need to manage our energy, time, and priorities with great care, and learn from the experts who are trying to teach corporate executives and professional athletes how to function in a high-pressure environment. CONCLUSIONS Pediatric orthopaedics is one of the most wonderful professional callings. We can and should be happy and resilient canaries. The owners of the coal mine should hear us singing sweet songs about the children we care for even as they make the air increasingly toxic.