What a wild time to be an EM physician, let alone an EM physician in training. I’m sure that all program directors are getting questions that are difficult to answer since there isn’t necessarily an answer or there are only two bad answers to the question. Likewise, medical schools or training institutions may remove some elements of choice that should be available to you.

Here’s the old fart’s perspective on what’s happening, directed toward learners.

This is really, really going to suck, and it’s not going away in two to three weeks. This is a long-haul situation. Having noted that basic truth, this is also a learning opportunity for health care workers that has been unparalleled for more than a century. It is rich in experiences, no matter what choice an individual makes, in disaster care, infectious disease/epidemiology, clinical and public health, the psychology of infectious disease disaster on society, your institutions, your clinical workplace (all the component people), your supervisors and leaders, and your peers. It will provide a test and an introspection (hopefully) of your individual and collective professionalism. What drives your decision making when your obligations as an EM doc conflict head on with your personal mission-directed values? Which trumps which? Are the tenants and tendrils of professionalism weakened or dead?

I am happy that EM physicians are on the front line in the weeks/months to come. EM docs are flexible, think fast on their feet, know how to stretch resources and improvise, are dedicated to serving patients first, and can provide important leadership at the ground level. What better group to learn as they are doing (we don’t even get the advantage of the first in the triad of “see one, do one, teach one”)? I know we have fantastic leaders who will lead from the front and will be role models for finding our way through uncharted territory. Watch them. Learn from them. I hope that other institutions are able to share such a gift with their learners.

The majority of U.S. Army soldiers and Marines in World War II noted that they did what they did for their comrades, not for the lofty ideals that drove them to volunteer to serve. When push comes to shove during the upcoming months, this may become the determining factor for each of you. And if so, how rich will that experience be?

This will likely be the event that will define your future professional identity.

Even if you end up working excessive hours, or conversely are “locked out” of the emergency department, keep a diary during this—even if it’s dictating a few impressions periodically into an app on your phone. This may provide important learning points for the future or a place of introspection. Some of you will question your decision to serve as an EM physician. What better test of that decision?

And importantly, the more you learn through this experience, the better positioned you will be when the next one, perhaps even more deadly, encircles the globe once again. It will happen again during your career.

Carey Chisholm, MD
Professor Emeritus, Department of Emergency Medicine
Indiana University School of Medicine.