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
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ACEP Now: Vol 35 – No 12 – December 2016
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.
5 Responses to “Emergency Medicine Founders Discuss Origins of the Specialty, How It’s Changed, and What the Future Holds”
December 18, 2016
Cindy Pearsall Sussman MD FCEPI was sorry to not see a credit given to Dr David Wagner, the real “grandfather of Emergency Medicine” in your article. Dr Wagner was a general surgeon at the Medical College of Pennsylvania in Philadelphia and noted the immense need for an Emergency Medicine residency program. His was the first, and paved the way for many more to come. As a graduate of that program, I am proud to say that we were well prepared for just about anything that came our way. Dr Wagner deserves credit for having the foresight and energy to get the field on its feet.
December 18, 2016
Cindy Pearsall Sussman MD FCEPCorrection- Dr Wagner was a pediatric surgeon
December 18, 2016
MarianKevin,
Thank you for an insightful article regrading the history of emergency medicine and where we are headed.
I find it ironic that there are two articles in this edition of ACEP eNow discussing diversity in emergency medicine, however, your interview panel lacked diversity. I am certain that this was not intentional, but it certainly highlights the unawareness at times of this particular issue.
December 19, 2016
Kevin Waninger MD FACEPEven more important, Dr. David Wagner was a great role model and a really nice man. I am a better doctor, and even more important, a better colleague, friend and father, because of my interaction with Dr. Wagner.
November 22, 2018
Kathleen Nakfoor, Ed.D, MBA, MSIS, RNI had the privilege of working with Dr. John Wiegenstein, MD and Dr. Eugene Nakfoor, MD from 1970 to 1975. I was told “history is being made in this emergency room” and know this to be a fact. I recall working with Dr. Wiegenstein the nights before he head off, yet, to another meeting to battle for EM as a speciality. He entertained us with stories of his less than impressive luggage when checked into the presidential suite. I was well aquatinted with stories of progress being made in EM.
What has been overshadowed by the enormity of ACEP formation and EM becoming a specialty, are the historical changes that were made in emergency department management. I recall Eugene Nakfoor, MD, also a founding ACEP member, telling me stories of the fact no one knew how to bill for services, such a practice was unprecedented. He garnered “departmental status” in which he controlled all hiring and firing of the entire staff.. He and the nurses developed the original scribe system, not the one in existence today. There has never been such a well managed emergency department using the scribe; actually a pivotal individual with whom the department was organized.