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Is emergency medicine truly a high-performance domain — or do we just expect individuals to compensate for weak systems? Nathalie Pattyn, physician, psychologist, and human-performance researcher, challenges how medicine understands performance, resilience, and mental health. Drawing on operational deployments with special forces, long-duration Antarctic missions, and more than 15 years of research in extreme environments, she argues that emergency medicine is high-stakes but not system-designed for high performance. When performance depends on individual heroics rather than robust systems, burnout and moral injury become inevitable. ● Why readiness, robustness, and resilience are not interchangeable ● Why resilience alone cannot compensate for poor system design ● What medicine can learn from aviation and other mature high-reliability industries ● Why experience does not automatically create expertise ● How mental performance can be trained — and where medicine consistently fails ● Rather than focusing on “fixing” individuals, this lecture makes a clear case for redesigning systems, cultures, and training if we want sustainable performance without sacrificing mental health. Recorded at TBS in Zermatt. LINKS TBS Zermatt: https://www.tbs-zermatt.org All talks from TBS: / @tbszermatt #EmergencyMedicine #CriticalCare #HumanPerformance #PatientSafety #MedicalEducation #HighReliability #SystemsThinking