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All good things

All good things “The emergency department,” I remind students during each clerkship rotation, “is not a final destination.” Amid all the challenges, changes, and continual growth that define a career in emergency medicine, one maxim endures: everyone—living or dead—must eventually leave the department. And now, it's my turn to depart. A new ED awaits.I chose emergency medicine as a specialty knowing that I would forgo longitudinal relationships with my patients. A worthy trade, in my estimation, for the privilege of treating strangers during what is often the worst day of their life. As a student, however, I never anticipated forging such a meaningful bond with the department itself. Nine formative years—spanning residency, fellowship, and a junior faculty appointment—were anchored by my time spent within the walls of our ED. With this chapter drawing to a close, I recognize how such a dynamic and beautifully chaotic environment built the foundation of my career.The ED that I entered in July 2014 for the first night of my internship looks entirely different today. Renovations and refurbishments over the years changed the department's physical layout and appearance. Room numbers were reassigned. Residents graduated and nursing staff turned over. But core elements persist. Ms. Mae's gentle lilt floats down from the speakers during an overhead page. Nurse Bailey hurries down the corridor in her signature white stockings. Functioning otoscopes? Still few and far between.Countless lessons learned in this department receded long ago into my subconscious, but some memories prove indelible. Delivering a baby boy in trauma bay 2 on my birthday. Guiding a future chief resident through her first intubation in room 3. Consoling a grieving husband outside room 10 after an unsuccessful resuscitation. Standing in any given treatment room, I can summon a teaching pearl imparted by an attending at that bedside, recall the nuance of a procedure once performed under those lights, or visualize the face of someone I treated in that space.The emergency department offers an endless churn of new patients and circadian disruption, a kaleidoscopic mix of physicians, staff, and chief complaints. No two shifts are ever the same. The mission, however, never changes: the ED is always open and staffed with a team ready to care for anyone, anything, anytime.Nearly a decade after my first shift, that mission remains the core of my professional identity. It was instilled by the ever‐changing crew of dedicated nurses, technicians, pharmacists, environmental staff, advanced practice providers, respiratory therapists, physicians, students, physical therapists, secretaries, and many others who graced this department and taught me how to treat all patients with compassion, skill, and respect.As practitioners of the most time‐focused branch of medicine, emergency physicians intuitively understand that all teams sign out, all bleeding stops, and all good things must come to an end. Entering the ranks of department alumni, I take comfort in knowing that the quest for working otoscopes will continue in my absence, as will the ED's commitment to welcoming everyone who walks through its doors. I remain grateful for my time here and hope that I contributed something worthwhile in return. A new department filled with new faces will soon form the next phase of my professional journey. But the memories of this ED and the lessons it taught me will forever form my practice.CONFLICT OF INTEREST STATEMENTThe authors declare no conflicts of interest. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png AEM Education and Training Wiley

All good things

Klein, Matthew R.
AEM Education and Training , Volume 7 (2) – Apr 1, 2023
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Publisher
Wiley
Copyright
Copyright © 2023 Society for Academic Emergency Medicine
eISSN
2472-5390
DOI
10.1002/aet2.10859
Publisher site
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Abstract

“The emergency department,” I remind students during each clerkship rotation, “is not a final destination.” Amid all the challenges, changes, and continual growth that define a career in emergency medicine, one maxim endures: everyone—living or dead—must eventually leave the department. And now, it's my turn to depart. A new ED awaits.I chose emergency medicine as a specialty knowing that I would forgo longitudinal relationships with my patients. A worthy trade, in my estimation, for the privilege of treating strangers during what is often the worst day of their life. As a student, however, I never anticipated forging such a meaningful bond with the department itself. Nine formative years—spanning residency, fellowship, and a junior faculty appointment—were anchored by my time spent within the walls of our ED. With this chapter drawing to a close, I recognize how such a dynamic and beautifully chaotic environment built the foundation of my career.The ED that I entered in July 2014 for the first night of my internship looks entirely different today. Renovations and refurbishments over the years changed the department's physical layout and appearance. Room numbers were reassigned. Residents graduated and nursing staff turned over. But core elements persist. Ms. Mae's gentle lilt floats down from the speakers during an overhead page. Nurse Bailey hurries down the corridor in her signature white stockings. Functioning otoscopes? Still few and far between.Countless lessons learned in this department receded long ago into my subconscious, but some memories prove indelible. Delivering a baby boy in trauma bay 2 on my birthday. Guiding a future chief resident through her first intubation in room 3. Consoling a grieving husband outside room 10 after an unsuccessful resuscitation. Standing in any given treatment room, I can summon a teaching pearl imparted by an attending at that bedside, recall the nuance of a procedure once performed under those lights, or visualize the face of someone I treated in that space.The emergency department offers an endless churn of new patients and circadian disruption, a kaleidoscopic mix of physicians, staff, and chief complaints. No two shifts are ever the same. The mission, however, never changes: the ED is always open and staffed with a team ready to care for anyone, anything, anytime.Nearly a decade after my first shift, that mission remains the core of my professional identity. It was instilled by the ever‐changing crew of dedicated nurses, technicians, pharmacists, environmental staff, advanced practice providers, respiratory therapists, physicians, students, physical therapists, secretaries, and many others who graced this department and taught me how to treat all patients with compassion, skill, and respect.As practitioners of the most time‐focused branch of medicine, emergency physicians intuitively understand that all teams sign out, all bleeding stops, and all good things must come to an end. Entering the ranks of department alumni, I take comfort in knowing that the quest for working otoscopes will continue in my absence, as will the ED's commitment to welcoming everyone who walks through its doors. I remain grateful for my time here and hope that I contributed something worthwhile in return. A new department filled with new faces will soon form the next phase of my professional journey. But the memories of this ED and the lessons it taught me will forever form my practice.CONFLICT OF INTEREST STATEMENTThe authors declare no conflicts of interest.

Journal

AEM Education and Training – Wiley

Published: Apr 1, 2023

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