A Documentary On ER Burnout And Healing Outdoors

We talk with Tyler Jorgensen and Katie Masters about River Therapy, a new film that follows emergency clinicians stepping outside the hospital to face burnout, grief, and the grind of a broken system. We trade real-world ways to reset an overworked nervous system and build resilience through community and time in nature. 
• The origin of River Therapy and why the ER community needs it 
• Burnout in emergency medicine as isolation grief and chronic stress 
• Filming on the Pecos River in far west Texas as a deliberate reset 
• Prescribing nature as “microdoses” and “macrodoses” that fit real lives 
• The sensory contrast between ER noise and quiet that helps the body recover 
• Why “work hard, party hard” is not a sustainable recovery plan 
• Screening plans and a post-film Q&A to keep the conversation going 

I hope that everybody comes and we can have some nice discussions about um how to build our teams up and build resiliency and getting outside together.

Transcript

The Dirty White Coat Returns

SPEAKER_00 0:09

Hey people, I always feel the need to apologize because I started this idea of the dirty white coat to have these discussions about emergency medicine, about public health, about all this stuff, and then Josex gave me a job on the pit, and I ran over there and did it. But I'm gonna try and keep this going until I retire from that show because I think this is a really important project.

A New Film On Burnout

SPEAKER_00 0:32

And one of the really important projects that we need to talk about right now is a movie about stress and burnout, and we're gonna do it at ASEP, and so let's have the discussion to fire you up so that we can see you there at ASEP. And I love the fact that I've renamed this thing like seven different things. It's uh going downriver, across river, going up the river. It's all of the rivers. A couple of years ago, Tyler wrote an editorial on the Annals, and I was just looking at Tyler. It's over two years ago now, or it's almost exactly two years ago, that you wrote this editorial Looking Downriver. I was so impressed by it and by your writing. And that we got together, we had a little chat about PTSD and burnout and what we're doing in Emergency Medicine to solve the problem. It had a lot of people really interested in it. Uh it's been a discussion that's been ongoing for a few years. And now you

How River Therapy Came Together

SPEAKER_00 1:22

found yourself some ER doc that also has a husband who's a filmmaker, and now you've made a movie. So tell us what the hell is going on.

SPEAKER_02 1:28

Well, Mel, thanks so much. You know, um, talking about this stuff is near and dear to my heart. I love our emergency medicine community, and we're all um we're all facing a lot of challenges. You know, um Katie Masters um is uh one of the PAs who I worked with in our ER for a decade, and her husband is a brilliant filmmaker. And Katie and I and others in our group have always sort of recharged out in the wild places and uh out on rivers, out camping. And Katie got this wild idea. What if we uh what if we made a film about ER folks um kind of trying to make sense of it all out in a beautiful place? And uh that's what we've got. Katie's been Katie and her team have put together a beautiful film um called River Therapy, and we're so excited uh we're gonna be able to uh show it to show it to the ER world soon coming

Grief Resilience And Team Culture

SPEAKER_02 2:28

up at ASAP. Katie, I should let you take it from here.

SPEAKER_01 2:32

Yeah, this was something that I've just been wrestling with for a while. You know, I work with amazing, smart, awesome ER docs, and I just feel like everyone's crumbling, you know, they're leaving a medicine, they're burned out, they're grumpy, and I'm just I feel like I've been the hype girl for my team for a while, trying to kind of keep everybody going. And so I wanted to make this film, you know, about community and building resilience in our teams and using nature as a tool to help with that. So we were gung-ho to make this film, and then our dear friend and former medical director died out of nowhere. And so it just really like escalated the stakes for us that wow, we really need to tell this story. We need to kind of rally the troops and show that we don't have all the answers. You know, we can't fix this broken healthcare system, but we can change our approach, we can build each other up, we can get outside, we can laugh, we can play, we can build out those other parts of ourselves out of the hospital. And and nature is just such a great way to do that, and it's such a healthy way to do that.

SPEAKER_00 3:46

I'm looking at your background,

The Pecos River Location

SPEAKER_00 3:48

Katie, and you look like your house is in the middle of a forest. So, where did you guys uh where did you shoot this film?

SPEAKER_01 3:56

Um, so I drug everybody out to far west Texas on the Pecos River. Um, and it's this gorgeous little river that's like Caribbean blue in the middle of the desert. Um and uh yeah, it's a little bit of a drive from Austin, but it it really feels remote and it's just glorious, a glorious spot to spend a few days charging our batteries and and processing some grief, honestly.

What We Hope Viewers Feel

SPEAKER_00 4:22

Tyler, what do you hope that this um movie achieves? And as you say, I think the premiere is going to be at ASIP, I understand, that we're all gonna be together.

SPEAKER_02 4:32

That's right, Mal. Yeah, I mean it's just like dirty white coat. I I hope that this people hear these stories, they see the journey that we've been on and they hear that they're not alone in this. You know, we all are kind of in our isolated pockets of emergency medicine in our communities, at our institutions, and it feels sometimes like does anybody else understand what's going on? It's kind of like watching the pit and feeling seen. We hope that this movie people see it and they're like, oh my gosh, yeah. And you know what? These people are finding a way to put one foot in front of the other, they're holding each other up, and you know, we're gonna make it through this thing, and let's let's come up with some positive strategies, um, you know, some some healthy ways to deal with

Microdoses And Macrodoses Of Nature

SPEAKER_02 5:18

with all this hard stuff that we're facing.

SPEAKER_00 5:20

So you're basically prescribing nature for PTSD, depression, burnout. So what's the dose? What's the frequency? Give it to us.

SPEAKER_01 5:29

Oh man. What do you think, Tyler?

SPEAKER_02 5:32

I I'm guessing that Katie would say there is a dose. That's good.

SPEAKER_01 5:36

Yeah, unlimited.

SPEAKER_02 5:39

Well, and I will say this, Mel, you know, uh, and you'll appreciate this term. Uh, microdosing is also very healthy. So I think that uh you need microdosing along the way, and then you need some big doses uh, you know, every uh what, every few months? Katie probably needs a big dose every month.

SPEAKER_01 5:58

I would really love a big dose uh every month, but I've got two little kids and a crazy filmmaker husband. So really, if I can get if I can get a quarterly macrodose and then like weekly microdoses, I'm doing all right.

SPEAKER_00 6:10

Tell us about those micro doses. As simple as just going for a walk in the park, having lots of plants around the house. What is this microdosing?

SPEAKER_01 6:18

Oh gosh, for us, um, we live in Austin, um, backing up to the Greenbelt, which is a really wonderful kind of connection of trail systems that you can get down to a beautiful creek. Um, so just taking a lap in the woods um or finding a a nice cool pool to to swim in is is such a good way to reset.

SPEAKER_02 6:40

Yeah, that's my my microdose as well involves uh our creek system here in Austin. For me, uh I kind of head out the front door, meander through the woods a little bit, and then get down to the water and at least take my shoes off and get my feet in the water. If not, just sit in there for a little bit, look up at the sky for a minute. Um just kind of slow down, you know, slow down for a bit. And then kind of regroup and head back.

ER Stress And Nervous System Reset

SPEAKER_02 7:05

That's that's my microversion.

SPEAKER_01 7:06

It's such a contrast, right? From just the sounds of the ER. Gosh, I feel like I've gotten so sensitive to all of the beeps and the the just the noise of the ER. And I get out to a quiet place and I'm like, oh, this is amazing.

SPEAKER_00 7:23

Yeah, I I'm really looking forward to um seeing the movie with everybody at ACIP. It's really important. I was just talking to a PhD psychologist about stress, and um, she was saying just how activated your central nervous system is, your adrenals are when you work in emergency medicine. Like you are on overdrive, and you have to find a place to um to do exactly as you said, a place of rest, so that your central nervous system can just take a break for a while, even for a short while. Um Mine is I walk to the beach every day. I I live about two miles from the end of a pier uh in Santa Barbara, and so uh every day I walk down to the end of that pier and I just sit there and I look back at the mountains just for like 10 or 15 minutes and then walk back. And it totally is restorative. Um, and then like you say, some big macro doses later on.

SPEAKER_01 8:14

No, I feel like um I just I observe all these ER doctors and providers, and it's just very much like a work hard, play hard lifestyle. You know, they'll we'll make a bunch of money, work a bunch of shifts in a row, and then go travel and kind of turn and burn almost. And we have to be more intentional with how we recharge um and really choose things that that make us better. Um, it's just it's not a sustainable cycle we're doing right now.

SPEAKER_00 8:47

It's a classic thing is to work hard and then party really hard, drink really hard. And um, it's not the healthiest way to do it.

Screening Details And Q&A Plan

SPEAKER_00 8:56

So when and where are you showing this uh movie?

SPEAKER_01 9:00

So I'm hoping that we're gonna screen it October 7th um in the afternoon at ASAP. Um I hope that everybody comes and we can have some nice discussions about um how to build our teams up and build resiliency and getting outside together.

SPEAKER_00 9:17

How how uh long is the movie? And is there a QA afterwards or before?

SPEAKER_01 9:21

I think the film is gonna run about 50 minutes, and I'm hoping to rope you into a QA so we can chat about it.

SPEAKER_00 9:29

Well, that's the plan. Um October 7th in the afternoon. Um, you'll have to check the scheduling because these things always move around a little bit. And we'll meet afterwards and um we'll talk more about this. So I'm really looking forward to it. Thank you for putting this all together. It's

Gorgeous Footage And Final Thanks

SPEAKER_00 9:45

a really important topic that we talk a lot about, but I don't think we've talked enough about it yet.

SPEAKER_02 9:49

Well, I just want to say um um, Mel, this can be added whenever. I I want to hype up Katie a little bit. This this film that Katie and her team have made and are continuing to edit is absolutely gorgeous. You know, you you don't necessarily think of West Texas as being uh like an oasis out there, but this river, this ribbon of green, it's just gorgeous. They have the most beautiful cinematography, really compelling interviews. Katie has a way of getting uh these hardened ER folks to you know come out of their shells a little bit and get real and vulnerable. And I think the film's coming together really, really in a wonderful way. I think it's really gonna connect with our community. And that's the whole the target audience for this film is the ER community, and and you're gonna see that when you watch it. And I think it's it's really gonna hit home with people.

SPEAKER_00 10:42

Can't wait to see you all there October 7th.