This chapter explores the foundations of emotions from empirical research in neuroscience, biology, psychology, multiculturalism, and primatology. The phenomenon of emotional experience is depthless and ever complex. The reader learns to appreciate how social and emotional intelligences are necessary if one is to learn the nature of emotions. Cultural meanings, languages, and world paradigms may seek to define emotions. However, this chapter argues that by developing a multicultural humanistic psychology approach to understanding emotions, readers can appreciate their flowing nature that is not known by definition, but through relationship.

Despite more than a decade since my own exposure to Bayes’ Theorem3,4 during medical school, its concepts still ring true in my day-to-day practice of emergency medicine (EM). For review, the theorem utilizes pretest probability to help clinicians interpret results of testing. Afterall, each medical test has a set of unique test performance that includes sensitivity, specificity, and likelihood ratio (LR). With test characteristics and disease/community context in mind, pretest probability can even be used to decide if testing is indicated in the first place! Most medical specialties involved in patient evaluation, workup, and diagnosis apply these conceptual frameworks to some degree in their daily practice. What’s unique for EM clinicians is that the same concepts apply not only to diagnostic testing, but also to facets of history-taking and physical examination. As an experienced EM physician, if an interview question or physical exam maneuver is unlikely to change my workup and treatment of a patient, I often defer it.

This chapter discusses multicultural humanistic psychology, which is a theoretical foundation that seeks to engage the culturally relative self-actualization processes of the individual and community through the diverse spectrum of multicultural facets, so that wellbeing and social and emotional intelligences flourish. This paradigm synthesizes the strengths of both humanistic psychology and multicultural paradigms to support clinicians and educators in engaging with phenomena in the rapidly changing world. Multicultural humanistic psychology is not about validating Western cultural paradigms so that a new theory can be prepackaged and distributed globally. Rather, it is a way to awaken the potential of consilience, to recognize and transcend limitations, and acknowledge that together the fields are more relevant to global challenges. This paradigm guides the further discussions on social and emotional intelligences.

Emergency medicine (EM) is a prototypic example of a domain whereby decision-making is required without complete information. Although it is not unique, it certainly is a hallmark feature of the specialty. In fact, high-stakes decisions are frequently required under time-sensitive conditions with incomplete information. When a patient arrives in the ED with hemodynamic instability, initial decisions are made without a definitive diagnosis. The clinical team hedges toward management plans that effectively “buy” them time to improve hemodynamics while minimizing harm to the patient. Adding further challenges to the situation, there may be simultaneous and competing priorities elsewhere in the department. These high-stakes, time-sensitive conditions inherent in emergency medicine mandate a solid decision-making system. It is incumbent upon the clinician to develop pragmatic tactics and strategies that can be used in real time at the patient’s bedside. Clinicians are required to balance speed at the expense of certainty.

This chapter utilizes an existential perspective to educate readers on the importance of responsible decision-making and creating meaning in life. The author explores how social and emotional intelligences help foster wellbeing and create meaning in life. However, decisions can be affected by negative emotions and desire for risk-taking. This chapter discusses the negative psychological effects of the COVID-19 pandemic and how it caused existential crisis for many around the world, influencing emotional responses and thus decision-making habits. Recovery and wellbeing can be found again in the ability to create meaning from the years of death and psychological destruction.

Essentials of Social and Emotional Intelligences explored the phenomena of the social and emotional intelligences (SEI). Through a multicultural humanistic psychological perspective, readers discovered that SEI are shared by more life forms than previously believed, and that the meanings of the human experience provide unique insight into these phenomena. This exploration was necessary because the current focus of study and instruction on social and emotional learning rests on superficial concepts of social and emotional phenomena. By exploring emotions beyond isolated, static concepts and reductionist definitions, new understanding emerge within diverse contexts – this supports one to transcend the dull confines of erudition and enter into the flowing, living moment of the here and now. Although SEI may have been explored in separate chapters in this book, that does not indicate they are isolated phenomena; rather, they are interrelated, interdependent, and blend like colors in a flowing watercolor painting.

The key grouping structures relevant to metrical stress theory are the categories of the prosodic hierarchy. Prosodic categories can be divided into two types: interface categories and rhythmic categories. The interface categories are the utterance, the intonational phrase, the phonological phrase, and the prosodic word. The rhythmic categories are the foot, the syllable, and the mora. The key principles governing prosodic grouping are Constituency, Strict Succession, and Headedness. Constituency insists that prosodic groupings occur in the dominance relationship specified by the prosodic hierarchy. Strict Succession insists that phonological representations not skip prosodic categories moving lower to higher in hierarchy. Headedness insists that every instance of a prosodic category designate one of its immediate constituents as its head (its most prominent constituent). The combination of Headedness and Strict Succession insists that phonological representations not skip prosodic categories moving in the either direction, either lower to higher or higher to lower. Two special configurations play key roles in the theory: recursion and overlap. Interface categories may exhibit recursion, but recursion of rhythmic categories is prohibited by the Simple Layering condition. Instances of the same prosodic category may overlap so that they share a constituent.

Emergency medicine requires a unique approach to decision-making with a constant struggle between efficiency and thoroughness. I have heard it said in emergency medicine that “we must get the disposition right, not necessarily the diagnosis.” Disposition is an important part of our decision-making; however, we must also strive to understand the diagnosis – or potential diagnoses – and the next steps in care beyond the emergency department disposition. To achieve this, emergency physicians must strive for clinical excellence for every patient who enters the door. This takes considerable effort in the broad specialty of emergency medicine. My decision-making is influenced by my training and practice in emergency medicine and inpatient critical care. In the emergency department, I’m considering how my care influences the next management steps and what I would do after admission or discharge. This approach to decision-making takes time and continued effort to develop and maintain, but the reward is the best possible care for our patients and the respect of our colleagues.