He is a middle-aged man with a ruddy face and full cheeks standing behind the hot food in the hospital cafeteria. Heavy set and holding tongs in his meaty and gloved hands, he wears a white dining coat and the most genuine smile, so heartfelt it warms and energizes even the most tired and burnt-out resident. I don’t typically get to grab breakfast while at work, but on flight shifts, there’s usually some time for my favorite: three eggs, three bacon, and three butter. Today is a typical flight shift, and after sign-out, I broke away to grab some nutrition to fuel me through my flights and learning experiences over the next 12 hours. As I walk up, he says, “How’s my favorite doctor!?” with his big grin and lively blue eyes. We share a brief and pleasant exchange. “I’m doing much better now that breakfast is coming. How are you? Three eggs, three bacon, and three butter, please.” I realize I’m now smiling as big and warmly as he is. I feel lighter than I did walking into the cafeteria. Life is great. Smiles really are contagious. He says he’s doing well and, “I’ll tell my wife I saw you!” Smiling and tilting his head, “Take care, my favorite doctor!” “Thanks, you too!” I happily take my delicious breakfast, my newfound energy, and my reignited passion for patient care to the flight office.

On my way back to the roof, I reflect on the first time we met in the emergency department. It was over a year ago now; I provided care for his wife when she had fallen and injured her leg. The laceration was gaping and required sutures. Unfortunately, it was on her leg that had lymphedema, which caused a great deal of anxiety. I held her hand through some tears and gently informed her she needed stitches. She pulled her hand from mine and adamantly refused. She was understandably worried about more trauma from suture placement and poor wound healing from the lymphedema. “I’m usually so careful with this leg! I’ve never hurt it before,” she cried. I respected her worries, acknowledged her concerns, and empowered her: “You’re in charge. You make the decisions. I give the recommendations. I don’t do anything that you won’t let me do.” I told her and her husband to take their time and consider my recommendations. After some time to consider things, she wanted me to suture her leg. She tolerated it very well, and thankfully the wound healed without issue.

Now, on the rare occasion that I’m in the cafeteria for breakfast, I get a reminder of why I am here, why I chose emergency medicine, why I don’t mind the long hours and lack of circadian rhythm. In emergency medicine, we have the privilege to be there for patients in their most dire of times and on their most anxiety-provoking days. We have the potential to positively impact the rest of their lives. During the brief time they are in our emergency department, we can make a lifelong difference, and when we’re really lucky, our patients return the favor and give us something to smile about, refuel our compassion, and maybe even sneak us an extra piece of bacon.

Dr. Gende is chief resident in the department of emergency medicine at the University of Iowa Hospitals and Clinics in Iowa City.