After working in the emergency department as interns, we essentially ran the department. We had staff on call and another resident above us, but I enjoyed the “episodic-ness” of emergency medicine. — Harry F. Mills Jr., MD, ABEM
There were things we couldn’t do in the ED. We couldn’t intubate in the daytime because that was anaesthesia. We could do it at night because they weren’t around. — Richard Stennes, MD, MBA, FACEP
This kid needed an airway, so I had to do a cricothyrotomy on him, and I sent him off to Children’s. The kid did great, but I was a nervous wreck for the rest of the shift. — John Sherman, MD, FACEP
KK: I have a question for all three of you who’ve practiced much longer than Zach and I have. Was there ever a situation where you knew you were the only option for the patient?
RS: It was my first shift in 1971, and the moonlighting radiology resident couldn’t go to work that night and said, “Could you go down there and work tonight?” I showed up, and they said, “Who are you?” I remember a patient walking in with an ice pick hole to the left of his sternum. He sat on the gurney; he was getting worse. I listened to his chest—Rice Krispies. I got an X-ray, and there was widening of his mediastinum, and I thought, “What the hell is this?” He promptly died on me. Had this guy come in a year later after I learned about opening chests, I probably could have at least performed a pericardiocentesis. It didn’t take very long before I started doing things I really had no training in, and it was either, “You’re going to die, or I’m going to try to do this.”
JS: I had a young kid who was hit by a car, and most of the damage was to his face. He essentially had no airway. This kid needed an airway, so I had to do a cricothyrotomy on him, and I sent him off to Children’s. The kid did great, but I was a nervous wreck for the rest of the shift.
HM: Well, you had to change your underwear fairly regularly when we were working in those days. That’s improved.
JS: I think it really was more fun, but the patient care is much better now. There’s just no question about it. We now have to put up with patient satisfaction surveys, be sure our charting is perfect, and follow all of the regulations. None of that was an issue back then.