Cataldo Corrado Jr., MD, FACEP, was the youngest of eight children. Named after his father, a family physician in Uniontown, Pennsylvania, and affectionately dubbed “Little Doc” by his family and friends, the younger Dr. Corrado was drawn to medicine from the start.
Explore This IssueACEP Now: Vol 39 – No 03 – March 2020
He started his medical education in the early 1960s before being drafted into the U.S. Army for two years right before the Vietnam War. He got his first glimpse at what life might be like in emergency medicine when he was assigned to the medical clinic on the base, part of a team of medical personnel who served in all capacities for the community, treating the service men and women along with their families, young and old. The clinic was the only medical facility on the base; there was no emergency department. “If anybody had an emergency, we had to take care of it right there in our clinic,” Dr. Corrado remembers.
When he returned from his military service, he finished his internship and accepted the first emergency position at Pittsburgh Hospital in Pennsylvania. A year later, he decided to do a residency in orthopedics at West Virginia University Medical Center in Morgantown. But life intervened: Dr. Corrado’s mother passed away about six months into his orthopedics residency, and he took an emergency medicine job back in his hometown to be closer to his father.
He intended it to be a temporary stop. Instead, it became a legendary 53-year run that saw Dr. Corrado create a rural emergency department that handles 50,000 patients per year while also developing a local EMS system to serve Fayette County, Pennsylvania.
He finally “hung up his cleats” in September 2019 at age 82, feeling wholly content with what he jokes is the “shortest résumé in the world.” A few months after his retirement, he took time to reflect on his impactful career and what he learned along the way.
JG: When you were trying to decide between orthopedics and emergency medicine, what do you think ultimately compelled you toward emergency medicine?
CC: I think it was the variety. Orthopedics can be pretty much the same thing. Emergency medicine has some sameness to it also, but it certainly has a lot of variety. And then in the early 1970s, that’s when emergency medicine was really starting to become very challenging and we were doing a lot more. It was much different than the other specialties because it involved all of them.
JG: What has it been like to watch the evolution of the profession into what it is today?
CC: I remember when we first started in emergency medicine, we were nothing but a triage. Did the patient need to be admitted or not, and that was the only decision you made. But now, we do major work-ups in the emergency department, we do major interventions in the emergency department, and, of course, I came in up an era where there were no CAT scans, no ultrasound, no MRIs. It was pretty primitive. It has been really remarkable the progress we’ve made in all of medicine but mostly in emergency medicine. I think we’ve made more progress than any other specialty.
JG: Do you remember what it felt like to suddenly have that new resource or technology?
CC: Sure—I remember CAT scans. We had no way of taking care of people with intracerebral bleeds. We didn’t know whether they had an intracerebral bleed or stroke or a tumor. In regard to patients with abdominal pain, we had no definitive way to diagnose a ruptured abdominal aortic aneurysm. I remember most of the time, if it was the right scenario and you could feel a pulsatile mass, it was probably an aneurysm. But we had no way of proving that. And then they went to the operating room, and we hoped we were right. Now, you can do a CAT scan or an ultrasound in a few seconds and make a diagnosis.
Ultrasound has been even more influential in the emergency department. I’m only sad that I wasn’t very facile at using the ultrasound. I envy some of the younger emergency physicians coming out of residency who are very good with ultrasound because that made a big difference. You can make a lot more diagnoses right at the bedside. That’s even a bigger change, although certainly CAT scans and MRIs, especially in the field of trauma, that was a big change to the good.
One of the most important things is ability to manage airways. We didn’t know how to manage an airway back in the late 1960s and early 1970s, but that gradually got better. We went away to those courses and learned how to do intubation with the correct and proper way of induction. And then the other thing that has been very important is the procedural sedation that we do in the emergency department. We’re really very competent now, and what a change. Before, we had to call anesthesia down, and if they were tied up, they weren’t available, or if it was the middle of the night, especially in a rural hospital, there was nobody there.
And, of course, the use of computerized records, too. I’m a big fan of computerized records. I know a lot of people don’t like them. They do slow you down, but the EMR is very helpful. It’s given us so much information that we didn’t have before. I remember we used to have to go through pages and pages of old charts to figure out something, where it’s so much easier now.
JG: Was it hard, when you had been in the profession for so long, for it to be continually evolving? Or did you enjoy the process of learning things like ultrasound or new techniques that were always popping up?
CC: Oh, yeah—I enjoyed learning. [The advances] were all exciting to me. They weren’t hard to understand either. CTs—there are so many tutorials online now, which has helped make it easy for us to learn how to read CTs and be able to at least get an initial diagnosis until we got an official radiology reading. There have been so many good changes, and they were not hard to adapt to. Actually, I often wondered, “How did I practice without them? Without MRI? Without ultrasound?”
JG: Many physicians struggle with burnout. You had such a long tenure. How did you stay fresh and enthused and maintain it for so long?
CC: I don’t have any secrets. Just keep reading and learning new things. Everything is just so exciting! In fact, [reading and learning is] the one thing I miss. I had wonderful support from my family, especially my wife. When I couldn’t go to a social function, she was the one helping everyone understand why I couldn’t be there. She was probably the most helpful thing. And she enjoyed emergency medicine. She’s not a physician, but she was excited about all of my stories. I think keeping up with your family life as much as you can and, at the same time, reading and learning new techniques are the most important things to fend off burnout.
JG: That’s interesting what you said about having a support system—in your case, your wife—that helped you avoid burnout.
My wife made everyone understand why I couldn’t be at a particular function, and she understood herself. My children also understood and were extremely supportive. That was the most important thing. I still found time to ski, ice skate, roller skate with my kids. And I was team physician for my kids’ high school football team. There were lots of times where we missed important things we would have liked to have gone to, but that’s part of the business of emergency medicine. Yes, it’s true that we have so many times we have to work weekends and have to work night shifts, have to work on holidays. But at the same time, we’re not on call, and when we come home, we’re home.
JG: When you look back on your long career, what makes you proud?
CC: What I’ve done with EMS makes me the proudest. We had no EMS community when I started. We were getting tons of patients in the hospital without having any information about what happened to them so we couldn’t prepare for anything. And they received no prehospital care. Now it’s so much different.
JG: It sounds like you were a natural problem solver since you were heavily involved in developing your emergency department and creating your local EMS. What do you think compelled you to go beyond the status quo to make things better?
CC: My feeling at the time was somebody has to do it, and I was ready to step in. I wanted to make things better.
JG: What has it been like to retire? Has that been a hard adjustment?
CC: The hardest part is I still read about medicine, and every once in a while, I say to myself, “Why are you reading this? You can’t apply it to a patient.” The hardest part is that [my reading] doesn’t make any difference because I’m not taking care of patients. I miss taking care of patients and interacting with them.
JG: What advice do you give to young physicians who are just starting their careers?
CC: My only advice is, remember you have it better than anyone else. I think emergency medicine is the perfect specialty. That’s always my advice. I know they want more big things, especially coming out of residency, but they have to realize, and I tell them, “You’re the most important thing to the person you’re taking care of. That person is so thankful you are there and that they have someone to turn to at any time. Even if it may sound like a silly thing to you, to them, it’s not.” I think that’s the great part about emergency medicine. We’re there for those people who have nowhere to go, and some of them can’t get to their doctor for weeks and weeks, and at least we can help them out and solve their problem. Even though their problem may seem minor to us, it’s not to them. It’s major for them.
JG: You’re so positive and optimistic. That has to be something that sustained you during your long career—your “glass half full” attitude.
CC: I’ve been very fortunate. I always said I was the luckiest guy in the world because I just fell into emergency medicine. I grew up with emergency medicine, and I couldn’t be any more fortunate than that.
This interview has been edited for length.
Ms. Grantham is ACEP’s communications manager.