Dr. Taku Taira is an emergency physician working out of LAC and USC. Despite having multiple commitments, Dr. Taira definitely tries to stay well, by finding ways to combine wellness into his daily routine. Staying active and continuing to push his boundaries are ways he maintains wellness and enhances his personal growth. Here’s how he stays healthy in EM!

• Name: Taku Taira MD
• Location: LAC+USC
• Current job(s): Associate Program Director, Husband to Breena and Father to Lev and Sei
• One word that describes how you stay healthy: Balance and Routine
• Primary behavior/activity for destressing: Exercise and playing with my kids and spending time with my family.

I wanted to thank both Drs. Poonja and Egan for inviting me to contribute to this column. I have to admit that I chuckled a little bit when I was asked to do this because I do not feel like I am a great role model with regards to health or balance, I hope that I can contribute by talking about what I struggle with and what I am working on.

What are the top ways you keep healthy?

1. Priorities. As I have progressed in my career and become a parent, the more the Paul Allen quote “You can have anything in this world, you just can’t have everything” rings true. The answer used to be just work harder, sleep less, work harder, sacrifice. However, as my responsibilities increased and the stakes got higher, working on one thing meant not working on something else. With that it became very easy to lose perspective and to focus on something because it was urgent not because it was important. Because of this I have worked on being more explicit and conscientious about my priorities and making sure that my life reflects those priorities.
2. Boundaries. My key strategy for maintaining priorities is to create boundaries. For me, the main culprit is email. Although it is a great tool, it also has the ability to dictate what you are thinking about and what you are working on. Its accessibility allows work to invade your personal and family time. The urgencies in email have a way of letting others dictate what your priorities should be. My strategy for email is to turn off the email notifications on my phone and my computer. I wait until later in the morning to check my email and I only check it 2-3 times a day. By doing this I have been able to better compartmentalize my work and personal life and to focus more on the big tasks at work.
3. Exercise. The importance of exercise is something that I constantly need to rediscover. It is one of those activities that is so easy to say “I don’t have enough time for it.” For me, exercise crosses so many domains and has such wide reaching effects. Exercise is an opportunity to gain mental clarity, to be in nature, to escape, to connect with others, to feel like you are part of a community, to meditate, and an activity where you can see tangible growth. It is something I can share with my kids and my wife. It adds to my sense of wellbeing and healthiness. It improves my quality of sleep and my ability to concentrate. Feeling healthy from exercising in turn makes me want to eat better. Now that I can see the multiple down-stream effects it seems crazy to me not to make this a priority. It means that I will go to the 5:30AM class at my gym so that I can exercise on days that I am working at 7AM. Although it means that I have to use a lot of my time for exercise, it is worth it to me, because it makes me a better doctor, program director, husband, parent, and person.
4. Growth. One of the keys to feeling mentally healthy is being challenged and growing. In this field and in my job, there are no paucity of challenges. Despite the multiple challenges, it is often easy to stagnate. Something that has been transformative in the last several years with helping me grow is audiobooks. I am an Audible junkie. I grew up constantly reading, however found that that I had less and less time and energy for reading. Being able to listen to audiobooks in the car has helped expose me to such a diversity of thoughts, perspectives, worlds, and skills. By listening to books in the car, I have been able to get through technical books that would be too dry to get a read through. It has helped me to expand my circle of knowledge, and to be exposed to thoughts and perspectives that are not common in our medical or education community. Although I have a great deal to grow as a physician, it has helped me to realize that I have so much more to grow as a person, mentor, leader, and colleague.

What’s your ideal workout?

In general, my ideal workout would be something that is either high in intensity or demands a great deal of concentration. Ideally, the only thing I want to be thinking about is the task at hand. Currently I have been doing a lot of Crossfit. I love the fact that everyday is a challenge. Either it is a challenge to complete the exercises or it is a challenge to push yourself as fast as possible. I also love long trail runs. I am lucky to live near several great trails that are both beautiful and not crowded.

Do you track your fitness? How?

Not really. When I was first getting into running I would use my Garmin to track my distances and calories burned. However with trail running, it is never really about how fast you can run. But I did find that having a visual representation of how many days in the week I had worked out actually helped me develop a routine. I also found knowing how many calories I had burned was helpful to make calories tangible. I could now look at a cookie and think about the fact that it would take 20 minutes of running at a high intensity to burn this off. Because of this I feel like I was able to make more rational decisions about my food.

How do you prepare for a night shift? How do you recover from one?

Routine would be the key. For me I do my best to stay up the night before as late as possible. When I wake up, I will pick up the kids and make dinner but regardless of how I feel, I will nap after dinner. On these days I will generally not check my email during the day so that I can take my nap with as few worries as possible.

If I have another night shift, I will keep this schedule. However after the last night shift I will sleep in the morning, but get up at 12:00 go to the gym and try to spend as much time as possible in the sun to help me reset my circadian clock. I will either sleep a little bit more in the afternoon or go to bed early. When I was a resident, at the end of a string of nights I would play golf immediately after my shift. This also helped me to stay out in the sun as much as possible to reset my circadian clock.

How do you avoid getting “hangry” (angry due to hunger) on shift?

I always have snacks in my bag. Luckily we have a good cafeteria, coffee shop, and places to get food right by the hospital. I know by now that I don’t function well when I am hungry or feeling frustrated, so I have become a big proponent of the Reset. For me the Reset involves either taking a 1-2 minute walk to the vending machine, stepping out onto the ambulance ramp, or getting a snack. I remind myself and the residents that the break is not for your benefit, but it is actually for the patient’s benefit.

How do you ensure you are mentally in check?

Ensuring you are mentally in check starts with awareness. Awareness in turn comes from self-reflection after you are feeling out of check. The more that you can gain awareness of when things are getting out of control, the more that you can start to employ strategies to get back into control.

Overall the key is prevention. The key to prevention is priorities. As I discussed before, things that are the most important, are easily taken for granted and are the most devastating to lose. Any time you can spend to connect with others or to understand yourself is time that will come back to you multiple times over. Along the same lines, it is important to give thanks as often as possible. This allows us to show those around us that we do not take them for granted.

What are the biggest challenges you face in maintaining a longstanding career in EM? How do you address these challenges?

I think that the biggest challenge is over commitment. There are so many things that are exciting and so many meaningful challenges, that it is hard not to want to be involved in everything. Over commitment prevents you from doing your best work, completing things on time, adds stress, and prevents you from effectively prioritizing things.

Best advice you have received for maintaining health?

It’s not really advice but I remember a talk by Peter Beblieux, where he talked about how he maintains his physical and mental health by “working out like a fiend.” For some reason that phrase always stuck with me. I also think about a talk given by Scott Votey at UCLA where he talked about the relationship between exercise and sleep. I always remember him talking about how high intensity exercise for 30 minutes helps your sleep that day, and 1-hour helps your sleep for that day and the next. That point stuck with me and helped me solidify my understanding of the downstream effects of exercise.

Who would you love for us to track down to answer these questions?

Jim Adams
Linda Regan
Saadia Akhtar

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