I have the privilege of being a first-year medical student. Awkwardly learning how to perform the physical exam, repeating the same questions to collect an HPI from standardized patients, unsure of how all of my mediocre skills will translate to the precision of the physicians I attempt to emulate. I have settled into the pace of lectures, and the rush of experiencing the human body has left me as I ...

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I do a strange thing as a physician almost daily. I go to alcoholics and have them promise me they'll go home and continue drinking. Then I release them back into the wild to do just that. I'm an emergency physician at an urban hospital, and I see alcoholics every single shift, brought in by the ambulance "found down" -- that is, found passed out in public places or belligerent on ...

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"Gunshot wound to chest, pulseless, 20 minute ETA." When that's the EMS report, it gets your attention.  Despite the wonderful theatrics of modern medical shows, and the best efforts of real-world, sweat-drenched paramedics, those of us who have done this long enough can translate that report.  For the layperson it means:  "Dead." I saw that last week. And the week before I saw another tragic, unexpected death in a man not much ...

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Although I didn’t think much of the statement when I first heard it from my residency director, now, nearly twelve years later, I realize its value.  I learned so much during those three years.  I learned to prepare for success prior to every procedure I started to avoid clumsily searching for needed equipment mid-procedure.  I learned what an eternity of time I gained during an intubation if I could be ...

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Well said, Zubin.

The following excerpts will give you an idea of what life can be like while practicing emergency medicine in very beautiful, very coveted areas of the United States. I will not name towns or hospitals, as the situations are highly reproducible from place to place and season to season. We’ll just call it St. Resort hospital. If you doubt me, call up your friends who work in such locales, with ...

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When I was pregnant with my first child, I worked full time as a physician in the emergency department.  I worked mostly 9-hour shifts, but some 12-hour shifts as well. Days, evenings, nights, holidays and weekends were divided up amongst the entire group of physicians. I worked my share of those shifts as well. I have worked in the ER while pregnant twice now, and while I am proud to be ...

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"You need to come to the ED ASAP." A new patient was admitted at 2 a.m. and requested for a crisis counselor. Unlike with cases of sexual assault, survivors of domestic violence had to specifically request for the presence of an advocate when I was volunteering in NYC back in 2009. This woman, I’ll call her Sadie, had already taken the first courageous step to seek help. I briskly walked past ...

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I  have lately been discussing the state of health care with a lot of doctors. I’m a doctor, and I’m also a consumer of health care services. Imagine my surprise when I visited a local ER on a three day weekend, hoping to get some advice from someone who might be able to use the panoply of diagnostic tools available in the ED to help me mitigate the pain of a ...

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What do I need to know as I age?  While scientists ponder the questions of water existing on Mars and if it can essentially sustain life, my duty it to assess if there is life left in Oliver -- a nursing home patient transferred to the ER. Oliver was not oxygenating well but appeared to be resting comfortably. Reportedly, Oliver had fallen that day and EMS discovered a sizeable bruise ...

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