A few weeks ago, my employer sent me to a three-day out of town conference. I had mixed emotions. It would put a burden on me to work more than usual both before and after it, but I couldn’t help but look forward to the blissful, uninterrupted sleep I would get in a cozy, quiet hotel room. There was guilt when I realized that my wife would shoulder the full ...

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I was at work a few nights ago. We had had a patient death early in the morning before I got there, and the body was still in the room awaiting the JP’s arrival. The family was en route back with the children (he was only 57) and the body was not presentable. Blood, saliva, a gaping mouth and lividity with rigor were a bad combination for the kids to see. ...

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I had never heard the term “throughput” before a meeting at our hospital two years ago. It was used to discuss how the emergency department (ED) could yield greater profits by faster patient turnover. Coordinating various duties (including intake, admitting, and cleaning staff; lab and radiology; nurses and doctors) patients could be shuttled into and out of the ED earning the hospital $2 million more per year. This strategy was implemented ...

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A few months before election day, a grassroots group was created on Facebook called Pantsuit Nation. As the name probably implies, it was a group for Clinton supporters, where we shared our positivity about Hillary Clinton as a candidate and offered endless empowering stories about why we were voting for her. The group was secret, but as its numbers swelled to over 3,000,000, it was hard to keep ...

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He didn't correct me when I addressed him as “Mr.,” only grimaced in his hospital gown like any other 80-year-old with abdominal pain. I knew he was intelligent when he began giving a history of present illness so precise I could transcribe it verbatim into my note, but it wasn't until he described his pain as “epigastric” that I gleaned he had a medical background. “Are you medical?” “Yes, I'm a retired ...

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I’m in the midst of a run of shifts in the emergency department. I’m doing locums away from home. Last night, I left work at about 3:30 a.m. (My shift was 6 p.m. to 2 a.m.) It was busy — not "crazy busy," just "normal busy." I finished my last note, wrapped up the information about the one patient I was leaving behind with the valiant night doctor and headed ...

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As she lay on the gurney telling me she was tired and having vaginal bleeding yet again, I was doing my own biopsy of her medical record. It stated very clearly that palliative care and hospice had been recommended to her for her end-stage gynecologic cancer. So, why, I’m thinking, highly annoyed, is she now in the ER, late at night, creating problems for me? Why could she just not accept ...

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Recently I've seen a number of reports of women who are denied the ability to help in a plane emergency because they are not believed to be doctors. While most of the denied women are of color, since this became public a large number of women of all races have come forward because of similar racial and gender discrimination. I am an emergency physician, and I was once called to duty ...

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Four years ago, I was having a conversation with a friend of mine. We had graduated residency the same year and our careers had taken us to different parts of the country. It was ACEP 2012. We’d been mingling with old friends and current colleagues, and the conversation turned to kids. I told him my wife and I were getting ready to start having children. He said he and his wife ...

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"Good morning, Sandy. How was work?” How do I answer that in a normal way? Any given shift in any given ED is comprised of the gamut of emotions playing out behind the calm facade of physicians and nurses. Afterward, we often don't articulate or even process the roller coaster of feelings. The story of a recent Monday overnight illustrates the wild ride of emotions most people don't realize that emergency ...

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