Not for Me

Finally, I found a job in medicine that is not for me: Emergency Medicine. This comes as a little bit of a surprise because I thought I would enjoy the fast-paced, high adrenaline nature of it. After all, trauma surgery was one of my most memorable rotations. I guess I still enjoy that part, but it is such a small part of the job it doesn't make up for the remaining, less-of-an-adrenaline-rush, more-like-a-frustrating-headache parts. And, the exciting stuff is a lot less fun when everyone is depending on you to make the split-second decisions of what to do next.

I can see how medical students would love this rotation. You get to see, and more importantly, do a little of everything. Instead of watching residents and doctors do everything, in the ER, students get to dive in: practice suturing, listen to the ambulance scanner call in patients, watch intubations, put in IVs, tap joints, see if your stomach can handle broken bones and amputations, and so much more. And the staff doctors cherry pick the good stuff for the med students to see. Isn't that the real reason we go into medicine - the good stuff? That's what is on t.v. Those are the stories family and friends ask to hear about during the holidays.

Unfortunately, I'm learning that isn't what the ER is. Sure, I've been able to do a handful of stitches, but I can't begin to count the number of abdominal pains, headaches, and back pains I've had to sort through. My clinic is full of these complaints, but in the ER you have a two fold problem. Not only do you need to diagnose and treat the chief complaint, but you also have to assess the patient's motivation. Why did they really come to the ER? After all, they think their problem is an "emergency." It is harder than you think to judge a person's motivations in the five minutes you have to learn their story - to essentially decide if their pain is deserving of relief. Unlike the clinic, there isn't the options of a two-week follow-up, or at least there shouldn't be.

Like I said, Not for Me.