I work as an emergency physician in the emergency department at a Level 1 trauma center. Because time is of the essence, when we get a trauma into the ED, they are automatically deemed a Doe – John or Jane. Due to the number of traumas we see at our trauma center in a given year, another word gets added to the Doe to make them easier to identify. It …
The emotional toll of trauma care
Sometimes doing what we do is so hard. We get intimately involved in our patients’ lives, and instead of maintaining a clinical distance, you get sucked into the drama that has unfolded in their lives—the very events that bring them to the ED on this day. Then there’s a great difficulty in not judging, in not letting what you learn about them affect you or distract you from doing the …
When saving a child isn’t possible: a heartbreaking day in the ED
I am a true crime buff, and I work in the emergency department. Sometimes the two seem to blur together.
In my career, I have followed my patients to the coroner’s office, going to see the autopsies on traumas, sudden deaths, or sometimes murders. We can do CT scans or MRIs. I can look at images and labs galore, but there’s nothing like looking at a fresh dissection to really appreciate …
The forgotten patients: When missing people are just lost
From the beginning of medical school, you are taught the rules of patient assessment; you are taught the “ABCs” – airway, breathing, and circulation. You don’t move on to B until you have established A. You don’t move on to C until B is established. If at any time you lose A or B, you go back to the beginning. Emergency medicine doctors are all about A. My first patient …
ER doctor’s adrenaline-fueled night: from life-saving procedures to unpredictable chaos
Interior hospital: (Patient screaming and crying out as they are wheeled in through the ambulance bay and brought into a room …)
Doctor: What brings you in today?
Patient: You gotta help me, Doc … My chest hurts. I think I’m having a heart attack!
Doctor: OK, sir. We’re going to do a series of tests, including an EKG and chest X-ray, and give you aspirin.
Patient: Whatever you’ve got to do, I don’t …
Against medical advice: Patient leaves hospital despite heart attack diagnosis
Fifteen years later and I can still see it.
I wasn’t able to go to the scene that night, but several of my colleagues did. As morning broke, a new shift of my colleagues went to the scene. And on the next morning, I did. We were there to provide medical support to the hundreds of investigators, evidence collectors, workers, and firemen who were helping with the scene. We were working …
Remembering Colgan Air Flight 3407: a medical responder’s story
It was the final hour of my shift, and I was cleaning up for my colleague who would be taking over. Glancing at the clock, I decided I could see one of the “easy” fast-track patients just to help offload the board a bit. I figured he wasn’t going to take long, as his complaint on the board was “sore throat.” What I came to find out was that he …
Encountering a gentle soul amidst stomach cancer
As an emergency physician, I’m a strong proponent of living wills, POLST forms, and discussing uncomfortable topics with your loved ones. Even making decisions about your child being an organ donor, if, Heaven forbid, something happened. You never know when the “last time” might be.
A recent case I had served as a reminder of this. The patient and their spouse came to the hospital for what was supposed to be …
Powerful lessons from a tragic hospital incident: the importance of living wills and last goodbyes
I think that from time to time, everyone has had the feeling that they weren’t doing their best. Maybe something we did wasn’t the right thing at the time. Perhaps we should have thought about it longer or acted sooner. We often second-guess the decisions we make, whether they involve matters of love, career, finances, child-rearing, or even where to meet the in-laws for dinner.
While I can do that in …
How an emergency physician’s knowledge and confidence save lives in high-stakes situations
Doctors come from different backgrounds, and we all start medical school with various life experiences. Few people know that I actually started off life as a journalism major. I wanted to write about other people and their life stories. I wanted to travel and photograph what the world had to offer. Then, having lost my journalism job and getting hired at a nursing home as a receptionist, I ended up …
From journalism to medicine: Unveiling the untold stories of patients’ medical conditions
Emergency departments have their share of regulars. The patients come back time and time again. Some you don’t mind. Some of you inwardly cringe and say, “Oh, God, them again.” Seriously, George, this is the second time this shift.
They come and go until you notice that you haven’t seen someone in a while. You don’t say their name because there’s an unspoken superstition that, like saying “Beetlejuice” three times, they’ll reappear. …
The struggle to save the unpredictable: a look inside emergency departments
Last night, one of my work colleagues asked me how I do it. I looked over at them, a little confused. They looked back at me earnestly. How do I continue to come to work every shift and not burn out? How do I keep finding meaning in what I am doing? How?
They’re a yearling emergency medicine attending. They’re just getting started in their career, whereas I am several long …
Why I keep coming back to the ER: reflections from a seasoned attending
Suicide isn’t beautiful. It’s not glamorous. It’s not Virginia Woolf, with pockets full of stones walking calmly into the water surrounded by trees and dappled sunlight with string music playing in the background as you slowly sink under the water.
Suicide is blood and vomit pouring out of your nose. It’s losing control of your bladder and bowels and soiling yourself. It’s blood all over the bathroom floor. Or, it’s bits …
Suicide isn’t painless for those left behind
I love listening to podcasts on my way to work, and I was most excited when the second season of Dr. Death started. If you didn’t listen to the first season, it was about Dr. C. Duntsch, a neurosurgeon in the Dallas area who should never have been operating on people. He even left his best friend paralyzed from the neck down due to a botched surgery.
The second season follows …
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