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I am Dr. Christine Kulstad, Co-Clerkship Director: How I Stay Healthy in EM

Zafrina Poonja, MD |

Dr. Christine Kulstad is an emergency physician and Emergency Medicine Co-Clerkship Director at UT Southwestern in Dallas, Texas. She maintains a sense of balance  by keeping fit, eating right, and making time for her family and friends. Her advice on staying focused is something we could all try. Here’s how she stays healthy in EM!


  • Name: Christine Kulstad, MD
  • Location: Dallas, TX
  • Current job(s): Co-Clerkship Director at UT Southwestern
  • One word that describes how you stay healthy: Consistency
  • Primary behavior/activity to help de-stress:  Exercise

What are the top 3 ways you keep healthy?

  1. Exercise. Exercise is the most consistently effective way for me to de-stress, in addition to its other health benefits.
  2. Maintaining Connections. Making time to stay connected with friends, family, neighbors, and my dogs. Since I’ve recently moved from Chicago to Texas, and I have family in California and Seattle, this takes some effort. But it is always worth it!
  3. Eating healthy. I cook fairly frequently so that I can make healthy choices, but I’m challenged by meal planning and grocery shopping. I’ve been experimenting with ways to make this easier, currently using Green Chef.

What is your ideal workout?

If I can find someone to work out with, that is my ideal workout, otherwise it changes periodically since I get bored easily. I am currently doing a mix of strength training at a gym, HIIT, and occasionally running.

Do you track your fitness? How?

I have a fitness tracker, but don’t use it anymore. I record what exercise I do on my Google calendar to keep myself honest (I’m pretty sure I worked out Tuesday, nope, better get my shoes on).

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

I have not found a great way to prepare for the first night shift. Caffeine is the key to my night shifts – I really like coffee! When I can’t get coffee, I chew caffeine gum (Military Energy Gum). Recovering after a night shift is easier. I sleep about 4 hours, and then get up, caffeinate, and go to sleep again at the usual hour. Not to brag, but I’m a pretty good sleeper, so I don’t usually have a problem getting back on a normal sleep schedule.

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

For me, hunger is not as big a problem as just needing a break. When I have tried to eat a snack or other meal, I end up inhaling it in 17 seconds, which is usually followed by dyspepsia and post-prandial fatigue. So now I don’t eat on night shifts, and usually have a protein bar during the others (9 hour shifts in my shop). I do try to make sure that at the halfway point of the shift I take a walk to get a coffee (I really like coffee), say hello to a colleague, or look at a video of my nephews on Facebook. I’m in a better mood and can focus much better afterwards.

How do you ensure you are mentally in check?

At work, when it starts to feel like the wheels are coming off, I’ve found it’s usually time to stop. Don’t make a call or pick up a new patient. Sit down and figure out who needs antibiotics, admission, re-evaluation, or discharge. This carries over to academic work as well. When I’m feeling like there’s too much to do, it helps me to make a to-do list. Not having to try to remember what I need to do decreases my stress and helps me prioritize. And crossing things off the list is so rewarding!

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

Burn out is so common in medicine. It starts insidiously, which is why it’s so important to recognize it early. Increasing your involvement in a related area of EM – administration, education, advocacy, mission trips – will help you rediscover your enthusiasm. Sometimes you have to try a couple of these before you find the one that works for you. I also find a lot of enjoyment in the small connections with patients, sharing a joke or learning a non-medically relevant fact makes me happier at work.

Best advice you have received for maintaining health?

Stay focused on it. It can seem like exercise, eating right, and managing stress are luxuries but they are foundational to being the best version of yourself. You will have more physical, mental, and emotional energy for others if you take care of yourself. I believe that this should be where you splurge: healthy food, a cleaning person, a meaningful experience, or a great fitness class instead of a new consumer good.

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

Dan Miller
Erin Zimny
Lynn Roppolo

Author information

Zafrina Poonja, MD

Zafrina Poonja, MD

Editor, How I Stay Healthy in EM series
Emergency Medicine Resident
University of Alberta

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