If your life were a book and you were the author, how would you want your story to go?
That's the question that changed my life forever.
Growing up in the hot Last Vegas desert, all I wanted was to be free.
I would daydream about traveling the world, living in a place where it snowed, and I would picture all of the stories that I would go on to tell.
At the age of 19, the day after I graduated high school, I moved to a place where it snowed and I became a massage therapist.
With this job all I needed were my hands and my massage table by my side and I could go anywhere.
For the first time in my life, I felt free, independent and completely in control of my life.
That is, until my life took a detour.
I went home from work early one day with what I thought was the flu, and less than 24 hours later I was in the hospital on life support with less than a two percent chance of living.
It wasn't until days later as I lay in a coma that the doctors diagnosed me with bacterial meningitis, a vaccine-preventable blood infection.
Over the course of two and a half months I lost my spleen, my kidneys, the hearing in my left ear and both of my legs below the knee.
When my parents wheeled me out of the hospital I felt like I had been pieced back together like a patchwork doll.
I thought the worst was over until weeks later when I saw my new legs for the first time.
The calves were bulky blocks of metal with pipes bolted together for the ankles and a yellow rubber foot with a raised rubber line from the toe to the ankle to look like a vein.
I didn't know what to expect, but I wasn't expecting that.
With my mom by my side and tears streaming down our faces, I strapped on these chunky legs and I stood up.
They were so painful and so confining that all I could think was, how am I ever going to travel the world in these things?
How was I ever going to live the life full of adventure and stories, as I always wanted?
And how was I going to snowboard again?
That day, I went home, I crawled into bed and this is what my life looked like for the next few months: me passed out, escaping from reality, with my legs resting by my side.
I was absolutely physically and emotionally broken.
But I knew that in order to move forward, I had to let go of the old Amy and learn to embrace the new Amy.
And that is when it dawned on me that I didn't have to be five-foot-five anymore.
I could be as tall as I wanted!
(Laughter) (Applause) Or as short as I wanted, depending on who I was dating.
(Laughter) And if I snowboarded again, my feet aren't going to get cold.
(Laughter) And best of all, I thought, I can make my feet the size of all the shoes that are on the sales rack.
(Laughter) And I did!
So there were benefits here.
It was this moment that I asked myself that life-defining question: If my life were a book and I were the author, how would I want the story to go?
And I began to daydream.
I daydreamed like I did as a little girl and I imagined myself walking gracefully, helping other people through my journey and snowboarding again.
And I didn't just see myself carving down a mountain of powder, I could actually feel it.
I could feel the wind against my face and the beat of my racing heart as if it were happening in that very moment.
And that is when a new chapter in my life began.
Four months later I was back up on a snowboard, although things didn't go quite as expected: My knees and my ankles wouldn't bend and at one point I traumatized all the skiers on the chair lift when I fell and my legs, still attached to my snowboard — (Laughter) — went flying down the mountain, and I was on top of the mountain still.
I was so shocked, I was just as shocked as everybody else, and I was so discouraged, but I knew that if I could find the right pair of feet that I would be able to do this again.
And this is when I learned that our borders and our obstacles can only do two things: one, stop us in our tracks or two, force us to get creative.
I did a year of research, still couldn't figure out what kind of legs to use, couldn't find any resources that could help me.
So I decided to make a pair myself.
My leg maker and I put random parts together and we made a pair of feet that I could snowboard in.
As you can see, rusted bolts, rubber, wood and neon pink duct tape.
And yes, I can change my toenail polish.
It was these legs and the best 21st birthday gift I could ever receive — a new kidney from my dad — that allowed me to follow my dreams again.
I started snowboarding, then I went back to work, then I went back to school.
Then in 2005 I cofounded a nonprofit organization for youth and young adults with physical disabilities so they could get involved with action sports.
From there, I had the opportunity to go to South Africa, where I helped to put shoes on thousands of children's feet so they could attend school.
And just this past February, I won two back-to-back World Cup gold medals — (Applause) — which made me the highest ranked adaptive female snowboarder in the world.
Eleven years ago, when I lost my legs, I had no idea what to expect.
But if you ask me today, if I would ever want to change my situation, I would have to say no.
Because my legs haven't disabled me, if anything they've enabled me.
They've forced me to rely on my imagination and to believe in the possibilities, and that's why I believe that our imaginations can be used as tools for breaking through borders, because in our minds, we can do anything and we can be anything.
It's believing in those dreams and facing our fears head-on that allows us to live our lives beyond our limits.
And although today is about innovation without borders, I have to say that in my life, innovation has only been possible because of my borders.
I've learned that borders are where the actual ends, but also where the imagination and the story begins.
So the thought that I would like to challenge you with today is that maybe instead of looking at our challenges and our limitations as something negative or bad, we can begin to look at them as blessings, magnificent gifts that can be used to ignite our imaginations and help us go further than we ever knew we could go.
It's not about breaking down borders.
It's about pushing off of them and seeing what amazing places they might bring us.
Thank you.
Raise your hand, and be honest, if you've used the phrase "crazy busy" to describe your day, your week, your month.
I'm an emergency-room doctor, and "crazy busy" is a phrase you will never hear me use.
And after today, I hope you'll stop using it, too.
Here's why you cannot afford to use "crazy" to describe your busy.
Because when we are in what I refer to as Crazy Busy Mode, we are simply less capable of handling the busy.
Here's what happens.
Your stress hormones rise and stay there, your executive function in the prefrontal cortex declines.
That means your memory, your judgment, your impulse control deteriorate, and the brain areas for anger and anxiety are activated.
Do you feel that?
Here's the thing.
You can be as busy as an emergency department without feeling like you're crazy busy.
How?
By using the same tactics that we use.
Our brains all process stress in similar fundamental ways.
But how we react to it has been shown by research to be modifiable, whether it's emergencies or just daily, day-in, day-out stress.
Now contrast Crazy Busy Mode with how I think of us in the ER -- Ready Mode.
Ready Mode means whatever comes in through those doors, whether it's a multiple-car pileup, or a patient having chest pain while stuck in an elevator, or another patient with an item stuck where it shouldn't be.
When you're know you're dying to ask.
(Laughter) Even on those days when you would swear you were being punked, we're not afraid of it.
Because we know that whatever comes in through those ER double doors, that we can handle it.
That we're ready.
That's Ready Mode.
We've trained for it, and you can, too.
Here's how.
Step one to go from Crazy Mode to Ready Mode is to relentlessly triage.
In Crazy Mode, you're always busy, always stressed, because you're reacting to every challenge with the same response.
Contrast that with Ready Mode, where we triage, which means we prioritize by degree of urgency.
This isn't just a nice way to get your to-do list done.
Work by Dr. Robert Sapolsky shows that individuals who cannot differentiate threat from non-threat and react to everything with the same response have double the level of stress hormones.
Which is why this is the first skill to learn.
You can't take care of them all at once, but you don't have to.
Because we triage.
Red -- immediately life-threatening.
Yellow -- serious, but not immediately life-threatening.
Green -- minor.
And we focus our efforts first on the reds.
Now hear this.
Part of the problem in Crazy Mode is that you are reacting to everything as if it is red.
So start by triaging correctly.
Know your reds.
They're what is most important and where you can most move the needle.
Now it's easy to be confused by noise, but what it noisiest is not always what is most red.
In fact, my severe asthmatic patient is most at risk when he's quiet.
But my patient over here, demanding that I bring her flavored coffee creamer, she's noisy, but she's not red.
I'll give you an example from my own life.
Last spring, my house flooded, my one-year-old was in the ER, I was supposed to do a fundraiser for my four-year-old's school and the final chapter of my book was beyond late.
Maybe not ironically, that was the chapter on stress.
(Laughter) My red tasks were getting my one-year-old better and finishing my book.
That was it.
Remember, relentlessly triage.
The house flood repair?
Well, once we had stopped and stabilized the damage, it was no longer a red.
It felt red, but it was in fact just noise.
No, no really, it was quite noisy, this picture on the far right is me wearing earplugs to focus on my book, while the floor is being mechanically dried around me.
Know your reds, and do not let your non-reds distract you from them.
By the way, it is liberating with a green task to, every once in a while, be able to remind yourself, "That's a green task.
No one's going to die."
(Laughter) It's OK if it's not perfect.
Now there's one last triage level that we use in the worst scenarios.
And that is black.
Those patients for whom there is nothing we can do.
Where we must move on.
And although it is gut-wrenching, I mention it, because you each have your own equivalent black tasks in your life.
These are items that you must take off your list.
And I think many of you know what I'm talking about.
For me, this was the fundraiser.
I had to step down.
Because as we in the ER know, if you try to do everything, you have no hope of saving your reds.
Step two to go from Crazy Mode into Ready Mode is to expect and design for crazy.
Half of handling crazy is how you prepare for it.
So if step one we triage, step two, we design to make those tasks easier to do.
Science shows us that the more options we have, then the longer each decision takes.
And the more decisions we have to make, the more exhausted our brain gets and the less it is capable of making good decisions.
Which is why this step two is about finding ways to reduce your daily decisions.
Here are four easy examples you can use in your daily lifestyle.
Plan.
Plan your entire week's meals on the weekend, so that when it's Wednesday at 6pm and everyone's hangry and requesting pizza, you have no decisions to make to get a healthy meal on the table.
Automate.
Never leave anything to remember that you could automate, whether it's scheduling it as recurring or saved list, or recurrent purchases.
Colocate.
When it comes to exercise, store all the equipment that you need for a certain activity together, charged and ready, so you don't spend energy looking for it.
And decrease temptations, for anyone driven by sugar cravings.
Anyone?
Say aye, go ahead.
That itself is its own form of Crazy Mode and self-medication for Crazy Mode, but stop working your willpower.
Design differently.
If a food is out of immediate reach, such that you have to use a stool to reach it, even when it's chocolate, study participants ate 70 percent less without thinking about it.
I know.
Let that sit for a second.
(Laughter) Design to make the choices you wish to make easier.
Which bring us to the third step to go from Crazy Mode to Ready Mode, and that is to get out of your head.
Come with me.
Different story.
I'm working in a small, satellite ER, when a woman comes in in labor.
I realize that the cord is wrapped not once but twice around the baby's neck.
And I'm the only doctor.
I was scared.
But I couldn't let it derail me.
Because, you see, we all get nervous.
We all get scared, but it's what you do next that matters.
That first feeling isn't the problem.
It can be an important sign.
The problem comes when we let it derail us.
When that internal monologue starts and we catastrophize and we start to get that tunnel vision.
That's how you think when you're in Crazy Mode, and you cannot solve anything that way.
Now I promise to come back to the story, but first, how do I get out of my own head?
There are many tactics that you may hear, but for me, I find it best in the moment to actively put my focus on someone else.
To deliberately make myself see the person in front of me, see myself in the arena with them -- what do they need, what do they fear and how can I help?
This may sound like a whole lot of warm and fuzzy to you, but it's not.
In fact, research shows that when you prime your brain with what is, essentially, compassion, we disrupt that tunnel vision and internal monologue.
You widen your perception, so your brain can actually take in broader information, so you see more possibilities and can make better decisions.
Try it.
Know that your internal monologue can derail you.
And realize that when you get out of your own head, you get out of your own way.
Now what happened to that baby?
I focused not on my fear, but on the mother and the baby and what they needed me to do.
And got the cord off of the baby's neck, and a healthy screaming, kicking baby arrived, just as the dad ran in from the parking lot, "Hi, you have a son, I'm Dr. Darria.
Congratulations, you want to cut the cord?"
(Laughter) And for a moment, the strong cries of a newborn drowned out the beeps and the sirens that are the normal sounds of the ER.
But there was also something else.
Because when I walked back out of that mother's room, I saw several of my other patients hovering nearby.
I suddenly realized that despite their own problems that had brought them to the emergency room, they had all come together to root for this baby.
And they now together shared in the joy.
Because that is what happens when you go from Crazy Mode to Ready Mode.
Others notice.
They want it too, they just don't know how, they just need one example.
Which could be you.
Own the busy.
But stop calling it crazy.
You've always had that ability.
But now ...
you're ready.
Thank you.
(Applause)