Why ER medicine?


“When was the exact moment when you decided go into Emergency medicine?”

Evan, a friend and former scribe in my ER posed this question to me recently.

I remember it like it was yesterday… (insert flashback waves)

There I was, strapped to a gurney screaming my head off.

I writhed in a mixture of my own vomit, urine, and blood after consuming too many of “Mama Jojo’s mystical fun shrooms.”

Wait.

Sorry.

Wrong flashback, let me try that again

<ahem> I remember it like it was yesterday.

During my third year rotations of medical school, I knew just what I wanted to go into.  That’s right, I was going to be a… pediatrician.

I mean, it just made sense!

Kids are fun, hilarious, and usually pretty nice. Little kids don’t fake symptoms to get narcotics.  I led a youth group and everyone loved me, it was all going to be great.

Then, well, then I did my pediatrics rotation.

As it turns out, kids become much less fun after barfing for three days. Fun fact, many kids spawn from insane, neurotic, and often psychotic parents. They want to know why little Jimmy has a high temperature of 98.9.  When you try to explain that this is normal, they yell at you since little Jimmy normally runs at 94 degrees so you need to fix this. Also, when kids have actual severe medical problems, they instantly had to be shipped off to the (you guessed it) ER. Don’t get me wrong, I love pediatricians and they are amazing, beautiful, wonderful people.

But Peds got removed from the options for me.

But then I found my calling. Yup, I knew after a few days I had it all figured out.

Surgery.

Surgery is awesome.  I truly loved my rotation.  Quirky, amazing, brilliant physicians emanated a cloud of knowledge and awesomeness during my weeks.

However, after working 80+ hours for eight weeks, I realized something. Surgeons are often married to their jobs.  I still love surgery, but I knew it was not my calling. I loved procedures, but I also loved a family life, a personal life, and I desired a bit more freedom.

Then, for 30 seconds I considered IM.

Then I realized how much mental agony a pager could cause.

Radiology? Very cool in theory, but personally I’d lose my mind in a dark room all day. My ADD wouldn’t let me pursue it any further.

Family Practice? I loved my FP rotation, but, much like pediatrics, whenever interesting sick patients arrived in the office, off they went to the ER.

Then I did my ER rotation.

I knew I was home.

I wish I had some fantastic story where some strapping ER attending leaped over a gurney, roundhouse kicked an unmedicated psychopath back into their cot, shot a Haldol dart into them for sedation, and then at the same time intubated a crashing CHF patient in the dark with a bent spoon and a child’s snorkel.

Alas, it was not so (it was a bent spork).

However, so far I’ve experienced a career that for me has far more positives than negatives.

I enjoy the insanity.

I love doing procedures.

I like intubating, putting in central lines, suturing up people after any and every crazy thing happens.

I always stories that come ONLY from the ER.

What’s that? Let me get this straight…

“You got bit by a skunk… after chasing it and attacking said skunk bare handed (true story).  You’re an idiot, but hey, it makes a hell of a story!”

I see anything and everything.

I see terror and humor and heartbreak and triumph and much more in a single shift.

“You put what where with who? Wow.”

I laugh.

I cry.

I see people routinely on the worst day of their life. And some, when they realize that though they were mangled in a terrible accident, they realize this day might actually also be the luckiest day of their life.

When I started I figured the surprises would fade.

Nope.

New surprises come in every day.

I love it.

Why ER?

I make a difference.

Every. Single. Shift.

I help people whose lives seems unlivable due to depression and give them hope.

I manage the worst septic shock and resuscitate patients moments before death.

I intubate those in respiratory failure.

I see everything from gunshot wounds to gummy bears in the nose.

I also get to talk about cartoons to every 4-9 year old who comes in with the sniffles. Like I said, I have other interests, and personally, I’m a cartoon addict, but that’s for another time.

It’s not an easy career.

You want easy? Look elsewhere.

You want to make a difference?

Come.

Join me.

It’s not for the faint of heart, or faint of stomach.

But know that when it is all said and done, you’ll be able to look back and know that what you did truly, TRULY mattered.

Now go see that lady with a stubbed toe.

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