Every ED has patients who become part of the landscape. They come in once or twice a week, for all kinds of reasons. Sometimes they have chronic medical conditions they are unable to manage. Sometimes they are on the outskirts of society due to mental health or substance abuse disorders. The ER promises a few hours of sleep in a safe place and a meal. I formed an uneasy alliance …
The ED is swamped with new patient arrivals. As a result, the 20-year-old who told the triage nurse he is having difficulty breathing waits an hour before his turn in the triage room. The emergency department technician hands me the ECG—sinus tachycardia—and takes the vitals.
Me: “What brings you to the emergency department today?”
Him: “I feel like I cannot breathe. It started all of a sudden at work.”
As I scroll through …
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Emergency physicians Resa E. Lewiss and Courtney M. Smalley discuss their article, “Why point-of-care ultrasound belongs in emergency department triage.” Amid the crisis of overcrowded waiting rooms and long wait times, they …
The Pitt was compelling TV.
As an emergency nurse educator for a Stanford campus in Northern California, there is one thing that is required viewing for my new graduate nurses: The Pitt.
The ambitious series did an admirable job portraying the complex world of the emergency department. The procedures were clinically accurate. The spectrum of patients and social issues was nuanced and believable. They even showcased the incidence of post-COVID PTSD, an …
It rolled past me—the same dull, tan utility cart we usually use to haul IV pumps, portable monitors, or the occasional dead printer. No decorations. No sign. Just an enormous pile of candy and snacks.
To be fair, it wasn’t bad candy. There were Kit Kats. Some decent chocolate. But still, the message was clear: “We see you. We care. Here’s a Kit Kat.” And because our admin staff does care—a …
The emergency physician across from me had it all on paper: good schedule, six-figure salary, respected by colleagues, two kids in college, mortgage nearly paid off. “I should be grateful,” she said, staring at her coffee. “But I keep wondering — is this it for the next twenty years?” If you’re nodding, you’re not alone. That quiet restlessness isn’t ingratitude. It’s evolution.
The script we’ve all been given
From day one of …
I’ve lived a full life. A hard one. A beautiful one. A complicated one. And now, at 61, I’m finally beginning to live an honest one.
I was built in survival mode. Growing up as a Korean American boy in Central Texas—often the only Asian face in the room—my earliest years taught me that difference could either be celebrated… or punished. At first, it was celebrated. I flourished. But a move …
At 9:32 a.m., shortly after Hind and her family left their home in Tel al-Hawa, an Israeli military spokesperson issued an evacuation notice on social media, instructing residents of western Gaza City to head south. At approximately 2:30 p.m., Layan Hamada, Hind’s cousin, made the initial call to the Palestine Red Crescent Society (PRCS) dispatch after their car was struck by gunfire. At that moment, Layan and Hind were …
I read Dr. Harry Severance’s recent piece, “Violence in health care: Why doctors and nurses are leaving,” with a sinking feeling of recognition. He’s right. Health care is becoming the most dangerous profession in America. Violence is no longer rare or shocking—it’s something every physician and nurse now half-expects at some point in their career.
I still remember an early shift in the ER when I was stitching up a …
The field of emergency medicine (EM) is at a crossroads. Faced with rising burnout, a constantly changing health care landscape, and an evolving trend in unfilled residency positions, the specialty is now grappling with another proposed structural change: A proposed mandatory fourth year. While the idea has been periodically debated over the past two decades, it gained new momentum with proposed changes to the ACGME Program Requirements for Graduate Medical …
It’s a common scenario in the emergency department (ED). Peak cold and flu season brings in patients complaining of fever and chills, with increased heart rates and elevated white blood cell counts. Too many patients, not enough beds. As emergency medicine providers, we have to make quick, challenging decisions at triage, prioritizing the sickest patients based on their vitals and symptoms and getting them on the right care pathway.
When I first entered Aga Khan University Hospital as an emergency medicine (EM) resident, it felt like stepping into a whirlwind. The controlled chaos of the emergency department, the endless maze of technology, the pressure to make decisions in seconds—it all felt like too much. To make things harder, this opportunity came only after facing rejection last year—a moment that could have easily shaken my confidence. Some early on even …
The Pitt, a medical drama set in a fictional Pittsburgh trauma center, captures the human connections forged in emergency medicine. The show follows a team of residents and medical students through a relentless 15-hour shift under their seasoned attending, Dr. Michael “Robby” Robinavitch (Noah Wyle). Unlike melodramatic predecessors, The Pitt finds drama in the emotional toll of ER work, emphasizing resilience amid exhaustion. Its commitment to Read more…
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I’m a family medicine-trained doctor working in a rural ER. I drive 90 minutes to get there, and I do it because if I don’t, no one will. The county I serve has seen its nearest hospital close. The OB unit is long gone. Specialist referrals are hit or miss. And the patients? They’re sick. Sicker than they should be. Because when access to health care disappears, what follows is …
An excerpt from Under the Gun: An ER Doctor’s Cure for America’s Gun Epidemic.
My phone buzzed in the pocket of my blue jeans one Saturday night at around 10:30 p.m. as the standing-room-only crowd at Minute Maid Park, clothed in vibrant orange tones, erupted in cheers. It was game two of the 2019 American League Division Series playoffs between the Houston Astros …
Every time I turn on the television, there’s another commercial for a new drug treating a condition I’ve never even heard of.
It’s constant. And honestly, it’s exhausting.
I can’t help but wonder: What happened to real care?
I remember a time, 35, maybe 40 years ago, when doctors knew your name. They looked you in the eye. They read your chart. They listened to what you had to say before deciding. They …
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 …
I was checking into a hotel the other day and noticed a QR code to tip the front desk staff. In an era where we book online, check in online, and check out online, I am not exactly sure where that tip request comes from. Tipping culture has crossed a line. We can now thank anyone in the service industry with an easy Venmo payment.
And now I …
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 …
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Physician coach Seema Pattni discusses her article, “Why racism in health care is still an emergency.” Seema reflects on a painful encounter with an eight-year-old Black patient who wished to be white, …
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