We walk down the halls, time and time again, each encounter a new discovery, mystery, or typical presentation. As ED providers, we see new faces, entwined with “frequent flyers” that have become in a weird way part of the family. Our job is often loosely entangled with our identity and existence. It becomes hard to have dinner conversations without discussing therapies, changes in health care, Obamacare, or “unusual cases.” We feel their heartache and rejoice in their victory. We are frustrated by lack of responsibility and ownership in personal health but invigorated when a patient is triumphant.
Emergency medicine is a unique specialty in that we see it all. Each ED room a new encounter, a new adventure. A typical night may include anything from the common cold to calling child-protected services for suspected abuse. We treat broken bones and STDs like a work of art. Our specialty is an unusual one in that we are asked to walk from a room full of hurt and pain where a loved one has met an untimely death and enter a room where an acute case of gastroenteritis is in full force. We must keep our game face on, as each new patient deserves our best and should be oblivious to what is happening down the hall. How do we do this? Why do we do this? How is this sustained?
A mentor and good friend once told me “Jeff, everyone has a need. It may not necessarily coincide with the chief complaint. Our job is to find out what this need is.” I’ve learned through the years, that people are complex, and life can be hard. Models and schematics are a rough outline, and life can be messy. It was the realization that has made me a better emergency provider, human, and hopefully friend. I see patients for what they are: people. Chest pain has evolved to now include anxiety and apprehension. A psychotic outburst now includes a lost person looking for a reason.
Why do I do what I do? Why will I do it until my last breath? It’s because, in the midst of the chaos, I’ve learned to care. I feel their pain and rejoice in their victories. I take home part of their loss and am encouraged by their triumphs. I see my grandmother in the eyes of the ailing old and feel the parent’s pain when a child is ill. I’m an emergency doc and somewhere in the midst of the storm I’ve become human. It’s OK to care; it’s OK to give your patient a hug when need most. Sometimes we are their only advocate.
I look down the long hallway, lined with examination rooms and trauma bays. What use to be chief complaints and “interesting cases” has evolved. I now see people for who they are: people. I guess the deeper question is who has evolved? This is why I’m an emergency doctor. This is why I do what I do.
Jeffrey McWilliams is an emergency physician who blogs at Advocates Of Excellence.
Image credit: Shutterstock.com
