"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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The cost of medical service provision in the United States is one of the most palpable strains on the health care system, but we must not forget that cost is the sibling of quality and access -- without considering the three as such, we will undoubtedly fail to navigate our country’s health care quandary. Low-quality care inevitably results in the need for more care in the form of readmissions, while ...

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An excerpt from Trauma Room Two. Sometimes when I am bored, when it is all sore throats and dental pains, when I feel more like I am a social worker and a hand-holder than an emergency medicine physician, I play a game. I do not look at the chart before ...

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