Life lessons as an ER doc?

[HoosierdaddyO]

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Giving the commencement speech to my Alma mater next week and writing the speech… just curious what some of your funny, serious and sincere life lessons that you’ve learned while working as an ER doctor.

I feel like we have unique perspective to life and death and human interaction and curious to hear what some of you picked up over the years 🙂?

 

[HoosierdaddyO]

I’ll start… typically if you ever hear someone say, or if you feel the urge to say yourself “watch this” … 99.8 percent of the time anything that follows is usually a bad life decision lol.

 

[AlmostAnMD]

You have a great opportunity to do what I've always wanted to do

stand up

say this



walk away

 

[gutonc]

Life advice from a trauma surgeon friend of mine, but EM adjacent:
A kid named Brody has a 95% lifetime chance of being a Level 1 trauma activation

 

[bravotwozero]

Nobody who comes to the ED and says they were assaulted ‘while minding my own business’ was actually minding his own business

 

[AlmostAnMD]

Nobody who comes to the ED and says they were assaulted ‘while minding my own business’ was actually minding his own business

related tangent

I noticed that every car accident I've ever encountered the patient said, "it was the other guy's fault." I always had doubts, but on paper it's like whoever is at fault never goes to the ED

I had a guy tell me once that he definitely didn't run the light, he has witnesses that he didn't run the light (I assume he's telling me this because he thinks I care/writing this down, I do neither, I just want to know what CT buttons to press) and spent half the conversation about how surprised he was he got hit.

I walked out of the room and a highway cop was going in. He pulled me aside to ask a question, but offered that he had 4 witness statements that stated this guy clearly ran the light. I told him what he told me and he laughed, then walked into the room to hand the guy a ticket.

So then I knew, I guess, 50% are liars. I suspected as much but it was good to have confirmation

 

[HoosierdaddyO]

From what I’ve heard from ER docs, one big thing is how fast life can change in a blink. It really teaches you to appreciate the small moments and not sweat the little stuff. Also, humor helps a ton - sometimes you gotta laugh to keep going through the tough stuff.

I’ve noticed that too about how quickly life changes… also having a sense of humor about life is half the battle when bad things happen!!

 

[Tiger26]

A few thoughts in no particular order:

- When someone says they think they're going to die (with genuine conviction rather than psychiatric drama), that tends to happen

- The only useful vital sign should be whether you look younger than, older than, or equal to your stated age. It's okay to have the occasional bad habit, but it ages you quickly when done regularly. Also, smoking, drinking to excess, and drugs are bad.

- Telling us you have a high pain tolerance immediately cues us in on the fact that you don't (unless you're a farmer)

- Don't overlook unanticipated weight loss or usual symptoms, but generally don't come to the ED on Friday night to get them figured out

- The only person you can truly change is you

- Make sure you have great insurance if you ever plan on using healthcare

- Most things either get better on their own regardless of what we do or are occasionally unsavable no matter what we do.

- Lastly (for now), we'd all be out of a job if people used the ER only for emergencies

 

[amoxicillin_resistant]

A few thoughts in no particular order:

- When someone says they think they're going to die (with genuine conviction rather than psychiatric drama), that tends to happen

- The only useful vital sign should be whether you look younger than, older than, or equal to your stated age. It's okay to have the occasional bad habit, but it ages you quickly when done regularly. Also, smoking, drinking to excess, and drugs are bad.

- Telling us you have a high pain tolerance immediately cues us in on the fact that you don't (unless you're a farmer)

- Don't overlook unanticipated weight loss or usual symptoms, but generally don't come to the ED on Friday night to get them figured out

- The only person you can truly change is you

- Make sure you have great insurance if you ever plan on using healthcare

- Most things either get better on their own regardless of what we do or are occasionally unsavable no matter what we do.

- Lastly (for now), we'd all be out of a job if people used the ER only for emergencies

how much would u say are actual emergencies?

 

[Apollyon]

how much would u say are actual emergencies?

5%? Less? Depends on how good an ER doc you are. If you're trained and experienced in EM, little scares you. It's just another day.

 

[TooMuchResearch]

how much would u say are actual emergencies?

Well, the majority of things EM classifies as non-emergencies still don't have a great place to be seen outside of the ED in our system.

I'm looking at my board right now.
25% pending admission.
Mental health boarding.
Multiple acute on chronically ill that would not be managed from urgent care but will likely go home.
Remainder are urgent care level but there is no local open urgent care. Yes, they could probably wait for tomorrow, except for two of them that probably need antibiotics started tonight.

 

[Powdermonkey]

Always use a flanged base.

 

[HemeOncHopeful19]

Life advice from a trauma surgeon friend of mine, but EM adjacent:
A kid named Brody has a 95% lifetime chance of being a Level 1 trauma activation

I had an attending in fellowship that was CONVINCED that the Factor VIII/IX hemophilia genes were somehow closely coinherited with genes involved in getting into barfights/muggings/general risk taking behavior

 

[TooMuchResearch]

Always use a flanged base.

This, actually.

 

[BoardingDoc]

Always use a flanged base.

Recent 68 yr old guy where both he and his GF didn't get the memo. She apparently tied a string around it beforehand. This is, unfortunately, the 3rd time I have literally had to tell someone "you either need to use something with a flange at the base, or you need to buy a book on tying knots. I recommend the former."

 

[JacobMcCandles]

Recent 68 yr old guy where both he and his GF didn't get the memo. She apparently tied a string around it beforehand. This is, unfortunately, the 3rd time I have literally had to tell someone "you either need to use something with a flange at the base, or you need to buy a book on tying knots. I recommend the former."

View attachment 405389

Push in on his stomach until it starts coming out to where you can grab it...

 

[Powdermonkey]

One of our OG Trauma/general surgeons used to be a vet. She does a ring block around the rectum, grabs some footstools, and we get to birthin' in the ED. She does everything possible to keep them out of the OR haha.

We did have a guy that rode his bicycle in with a regular sized maglite up the backside x3 days. That.... didn't end well for him.


But seriously, most of medicine and life turns into a job eventually. Find what you hate the least and do that for work. That way, even when you're stressed and tired, it's still not that bad. And you can still have that thing that gave you your spark and keeps you sane to turn to when you really need it.

 

[Porfirio]

Use silicone rings. A Mountaineering titanium O ring is not what you want to use around your Johnson - even if it would save Mr. Johnson from a fall off a mountain. And especially do not use 3 of them on your Johnson.

 

[CoolWhipp]

One thing I’ve come to realize working in the emergency department is… apparently, it's never anyone’s fault--ever.

You take care of patients involved in a motor vehicle accident— both swear they had the green light, the right of way, were going exactly the speed limit, and were totally aware of their surroundings. No one was distracted, no one made a mistake. And yet, two wrecked cars collided. What a crazy world we live that this could happen.

 

[HemeOncHopeful19]

One thing I’ve come to realize working in the emergency department is… apparently, it's never anyone’s fault--ever.

You take care of patients involved in a motor vehicle accident— both swear they had the green light, the right of way, were going exactly the speed limit, and were totally aware of their surroundings. No one was distracted, no one made a mistake. And yet, two wrecked cars collided. What a crazy world we live that this could happen.

Their lawyer: clearly it was ED docs fault

 

[ERMudPhud]

There is a thread on here called "Things I learned from my patients" Its 20+ years old and 80+ pages long. Plenty of good stuff in there.