Brian J. Levine, MD, FACEP

Brian J. Levine, MD, FACEP
Brian J. Levine, MD, FACEP

Medical School: University of Vermont

Residency: Christiana Care Health System (formerly Medical Center of Delaware)

Current Position: EM residency program director and aeromedical transport program associate medical director, Christiana Care Health System; associate professor of emergency medicine, Jefferson Medical College

Every time you use the EMRA Antibiotic Guide (or its accompanying app), you're tapping into the work of editor-in-chief Brian Levine and his team. It makes the teacher in him very happy.

“I've worked on the Antibiotic Guide for a while now, and it's something I love doing because it's always evolving and there's always new information to share,” he said. “Plus I get my residents involved, and they get to learn things from a different perspective.”

Levine, who also contributes to the EMRA Medical Student Survival Guide and is a frequent author and speaker, has amassed dozens of honors throughout his career (his CV includes a laundry list of recognition like “Top Emergency Physician” and “Outstanding Didactic Instructor of the Year” and “Joseph F. Waeckerle Founder's Award”). EM Resident visited with him to find out what lessons are most helpful when building and sustaining your career.

Why is it important to do “extra stuff” outside of the emergency department?
I think it allows you to maintain passion in emergency medicine. If I just did clinical practice four days a week, 8-12 hours a day, I would not build or maintain my passion. I think you have to find what fits your personality and what gives you energy and enthusiasm – and then go do that. I try to instill volunteering among my residents as well. I think as physicians we're obligated to give back to the community. Our residency contributes volunteers for cancer camp every summer, with 6- to 8-year-old kids who have a totally different set of worries in their world.

What has been your favorite volunteer experience?
I think the EMRA Antibiotic Guide and the app really required me to develop a lot of different mental skills and built me up as a leader, from coordinating with our own residents to working with the editors and then the peer reviewers and finally the staff at EMRA. That whole multistep process, done with each new book edition, really teaches me how to communicate, collaborate, sometimes motivate — to be a leader.

Who gave you your best career advice? What was it?
I had juvenile rheumatoid arthritis that caused me to wear braces at 8 years old, and I was angry at the world. But I had some really great physicians who I admired. The way I was treated was so caring and so ingratiating that I wanted to be like all of them. In high school and college I learned that you need to know how to help people with a variety of ailments and treat them appropriately – not just for their conditions, but for who they are as people. That's what my doctors had done for me. That's the backdrop of my desire to go into medicine.

What's the most exciting thing on the horizon?
I love teaching medical students and residents. I think when you teach you really learn more and you become a much better physician. I think teaching makes you appreciate where you were and where you're going. It keeps you young, it makes you smarter — and you have to learn how to read people and relate to them. You have to teach in a nonthreatening manner so the student learns. Students are sponges for material, and if you can pass along information in a way that makes them love to learn like you love to teach, it just grows from there.

If you were just starting your residency now, what would you do differently?
If I was applying to residency in 2015 I probably wouldn't get in! It has become so competitive. But I wouldn't do anything different in residency itself. I enjoyed my time at Christiana. It's such a unique program with so many mentors from so many backgrounds. Of the residencies I looked at, there were a couple of medical school-style residencies that were high in academia and a couple that had a community slant. When I interviewed here and talked to the residents, they were so confident that they could go anywhere in the world and handle anything, because they had gotten such a broad scope of experience through the program. I thought to myself, “That's a true emergency medicine experience. I want that.” When I became a faculty member here, I wanted to take those great things I learned and make them better. Slowly over the course of 15 years, it has become part of my dream of making one of the best programs in the country even stronger. We want to continue to produce graduates who are recognized as leaders, great emergency physicians, community advocates — it's the whole picture, a well-rounded experience. That is still the fire inside of me.

How will things change during the next decade?
Medical education for the past 100 years has been fairly stagnant, and now — finally — schools are recognizing that you have to change your tune and adapt to the explosion of knowledge. Now it is much more interactive and patient-centered. Teaching students how to absorb the ever-changing world of medical education, which evolves so rapidly, is a new challenge. Students are much more savvy and electronic. They're the full definition of millennial, and millennials get ragged on a lot. Because they learn in a different fashion they often get dismissed, but we as teachers have to change our approach. Teaching methods are so archaic that it affects the way students interact and learn. They get bored and then they appear uninterested, which isn't actually the case. Students today are definitely a different breed; they come in with a different set of goals and expectations, and they were just brought up differently. We have to take that into account.

Best time management tip
That is a challenge we all struggle with. The problem is, if you enjoy something people continue to hand you more responsibility. So the first thing is”¦ learn to say no. Only accept the activities that will add to your passion. It's all about having an appropriate amount of activities that you can give 100 percent toward. It's using Google calendar appropriately and sticking to your schedule. It's being a Type A person who is responsible and organized. It's surrounding yourself with people who can help you. I've learned to dish off certain responsibilities. But it's not just about responsibilities; you need to be a whole person. I do some volunteer work, and I'm a drummer in a band. (Editor's note: Code Blue, the all-EM physician band, launched in the early 2000s and plays rock covers from the ”˜80s and ”˜90s, currently averaging one gig every month.) If you're finding yourself getting overloaded, either try to drop something or pass it off to someone who can give it the attention it needs. There's no magic formula, unfortunately. It's difficult to learn and nobody else can really teach you. You have to know how you yourself handle different things. It's a certain amount of trial and error. If you're doing things that you enjoy, it adds to the total picture of who you are and allows you to wear many different hats. So it really comes down to who you are internally.

Best tip for surviving a shift during full moon
Be prepared for anything. Besides all the foreign bodies in inappropriate places, my most exciting case was several years ago when a guy got bit in the face by a poisonous snake and blew up like the Michelin man. He was about 30, and he was hand-feeding a poisonous snake that bit him on the arm first, and then he tried again to feed it and the snake bit him in the face. Thank God his girlfriend had an additional brain cell: She convinced him to come to the ED, but he didn't think it was that big a deal at first. It almost killed him. When we saw him, we knew this wasn't going to be good. We used up so much antivenin, that we had to get it flown in from the Philadelphia Zoo. But he walked out of the hospital a few days later vowing he would get another exotic pet.

Most awkward encounter with a patient
When I went into a room with an 80-year-old guy and a woman in her 20s and I said, “You must be the granddaughter.” He gave me the angriest stare and said, “I am her husband!” So now I only say, “How are you related to the patient?” So now I do a lecture on the art of the schmooze. Deep down we all want our patients to do well and we're there to serve them, but sometimes the things you see make you want to react: laugh, get angry, whatever. But you have to maintain that semblance of separation. And you have to gain their trust instantly – I think the research shows people will judge you within the first 15 seconds. So there are a lot of little social cues you have to learn on your own or at least have someone guide you. It's the art of emergency medicine.

Random Insights
Why the drums? It's physical, fun and luckily I was born with some skills! In general, if I hear a song, I can play it on drums quickly.
Best song to play on drums: Everybody learns Tom Sawyer by Rush.
Neil Peart or Charlie Watts? Neil Peart kills Charlie and the world knows it!
Ever met Billy Joel, you both being “Lawnguylanduhs” and all? Ha – nevuh!

Less Music-Y But Still Random Insights
Last non-textbook you read: Pleasure reading? Hahahaha! I am seriously reading “Ghost Rider” by Neil Peart.
Favorite city you've visited: Cape Town was awesome – a mixture of old, new, young, vibrant, beautiful.
What goes on pizza: Meat of any kind works. Nothing like NY pizza or bagels – can't get that stuff in Delaware!
How you get your exercise: Banging on the drums, hitting the treadmill.
Most-used app on your phone: The EMRA ABX Guide – duh! Someecards is hysterical, though.