This is the keynote address from Essentials of Emergency Medicine 2019. Transcript below...

 

There are moments in this job that are glorious ... magnificent.   The great save, a moment of kindness, and unexpected show of gratitude, nailing a difficult procedure or diagnosis. There are times that this job will make you want to cry tears of joy. Think about the last time you felt that way

There are moments in this job, however, that are dark. Moments when we, inside, feel Darkness. While I was putting this talk together, a friend of mine texted me that a patient had just died, it was a young man who had bee alive and laughing the day before.  Darkness. We see death, feel stress, see cruelty, feel burnout. At the end of some shifts, you feel so beat down it’s an effort just to think. There are times when this job will make you want to just... cry. Think about the last time you felt that way.

There are very few callings in life that evoke such extremes of emotion.  And these extremes happen in each one of us, individually. 

You do the work and have your own unique experience. You are the one that goes to the shift. You are the one who feels the excitement, feels the anxiety. It's all inside of you. An N of one.  

But Being an an N of one can be lonely, isolating. Yet here's the thing. In this room, look around....

In fact, and I know that this feels weird but, take 20 seconds. Turn to the person on either side of you and say hello and introduce yourself, tell them your name, where you’re from and them give them a high five. 

That person you just met, as well as everyone else you see in this arena… this is your tribe, your team. It’s a big team. No matter how big it is, though, we are a collective with shared experience, knowledge, and ethics. Whatever sad, joyous, crazy thing you see or do, these people, your people, are right there with you. 

You know...50 years ago, this group, this specialty barely even existed.

I can remember my dad, whose formative years were in the time when there was no one who specialized in emergency medicine. When I told him I wanted to be an Emergency Physician, he said “Why are you going to waste your time doing that, is that even a real job?” 

That was how much of the world saw us.

Let’s be honest, we still get asked by some of our patients, "What field we’re going into when you’re finished rotating through the ER?"

In the big picture though,  we are now leaders in the house of medicine. You could say our specialty is a leader, but more so, it’s our community. How empowering to be part of something larger than ourselves where the ethos is to care for others in the best possible way. 

You may be a first year resident, new nurse, in paramedic academy, or maybe you’ve been doing this for decades, a grizzled old dog. It doesn’t matter. What we do in each day is the same. 

Think about walking into your shift. There is endless potential. And in that day, you will treat the young, the old, Rich, poor, drunk sober. Care for the the well, and the dying.

Taking on the difficult and dirty tasks, doing what most others don’t want to do. Doing it 24/7/365- weekends holidays, nights, days, and we get the job done with a smile and a common goal of excellence. We. Our community. 

And that community is made up of of each of you, each of you with your own story. Each of you an N of one. Doing hard work, good work. Each of you is like a single drop whose ripples change the world. 

You are emergency medicine.