On a recent shift, I cared for a stroke patient with a story that, on the surface, was one that we hear all too often in Emergency Medicine.

“Mrs. A”, as we’ll call her, arrived hypertensive and aphasic with a hemiparesis and left-sided neglect. Family told EMS that she had no known past medical history, yet the paramedics suspected that she likely hadn’t seen a doctor in many years.  It wasn’t that she had no medical conditions. It was simply that her medical conditions were undiagnosed. As the story unfolded, it was a little more complicated than that.

Just over a year ago, Mrs. A and her family immigrated to the U.S. from Indonesia, and she did not speak or understand English. She had yet to be seen in any health care setting in the U.S., and, quite likely, she had never seen a doctor in her entire life.  Now, in her early 50s, a lifetime of medical neglect pushed her headfirst into the devastating consequences of an undiagnosed and untreated chronic condition—a hemorrhagic stroke caused by long-standing, untreated hypertension. 

My heart ached for this woman and her family, knowing that she would likely never fully recover, and that her devastating diagnosis could have been so easily prevented had the most basic medical care been available to her.

The Pandemic, Burnout, and the Search for Meaning

As many of us can relate to, the moments that I love most in my career are the ones when I feel like I truly made a difference to a patient and their family. However, those moments are farther apart than I wish they were, and the day-to-day challenges that our specialty faces often take the forefront, now more than ever.  We continue to battle the weight of hallway beds (or chairs) bearing the brunt of the boarding crisis, seemingly endless and growing gaps in specialty coverage, and ever worsening administrative demands taking more and more of our time.

In the wake of the COVID-19 pandemic, it can be challenging to admit what the statistics and our experiences clearly reveal: frontline workers in our specialty bore an outsized share of the burden. We witnessed suffering on an unimaginable scale, and stretched our limits until the very fabric of our profession began to fray. The center of what brought so many of us to the field in the first place, to help people, could not hold.

Consequently, burnout in emergency medicine is at an all-time high. According to a 2024 Medscape report, 63% of emergency physicians experience burnout, the highest among all specialties. Emotional exhaustion, detachment, and moral injury have left too many feeling disconnected from the work they once loved.

While an exodus from medicine, especially emergency medicine, became a far too frequent reality, the salve came from returning to that moral imperative at the center of our pursuit. For me, that answer came through global health.

The Healing Power of Global Health

Mrs. A and patients like her remind me of how valuable and life-changing the care provided on medical missions can be.

These missions expand access to care and improve health for thousands of patients worldwide, and it’s mostly done through volunteers. I became involved in these projects through Envision’s Global Health Initiative shortly after its inception in 2019. This program has empowered growing numbers of both clinical and nonclinical teammates, residents, and students to volunteer to travel to areas around the world where the largest health care disparities exist. Our volunteer teams have traversed five continents to provide care for refugees seeking asylum and underserved residents alike.

A group shot of the first Guatemala mission. (Click to enlarge.)

Our teams donate their time and expertise, empowered with funding by Envision’s Charitable Foundation, to travel to these regions in conjunction with our partner organizations: One World Surgery (OWS), the Emergency Project (EP), IMANA, and, newly, Floating Doctors. With the on-the-ground support and leadership of these organizations, we provide primary care for those who would never see a doctor and ensure consistent, longitudinal care and management of their previously undiagnosed chronic conditions.

Through my experiences with the Emergency Project, I’ve witnessed the versatile power of our expertise to combat global health inequities, one deeply underserved community at a time. Instead of having to mediate patient care with the overarching challenges of insurance and bureaucracy, when we are on the ground, nearly 100% of our focus is on treating patients and growing health infrastructure and capacity.

During a recent mission, two of our U.S. emergency medicine residents, Dr. Alyssa Damstrom and Dr. Bryan Luu, together with a local nurse, were performing ultrasounds in a rural Mayan village, live-streaming scans back to their residency program for immediate feedback. With cutting-edge but practical tools like point-of-care ultrasound (POCUS), simplified AI-assisted EKGs, and emergency protocols, we’re equipping local health care workers with the skills to continue lifesaving work long after we leave.

The results speak for themselves. During that same mission, we met a 15-year-old boy—tachycardic, febrile, and struggling to breathe. He had been sick for days, but like so many others in the village, he had no access to diagnostic imaging, no way to determine the cause of his worsening condition. Within minutes, our residents used teleguided ultrasound, connecting him to expertise nearly 2,000 miles away, and diagnosed him with an empyema—potentially from an oncologic source.

Without this technology, he would have gone undiagnosed—his condition left to worsen until it was too late. But because of the Emergency Project’s approach, not only were we able to initiate his treatment immediately, but we also sponsored his access to follow-up care—offering him a chance he otherwise wouldn’t have had.

In a world where two-thirds of humanity lacks access to basic diagnostic imaging, what we accomplished that day was more than just a single saved life—it was proof of what is possible. It was a glimpse into the future of global health, where the right tools in the right hands can turn “too late” into a story of survival.

Thanks to Envision’s commitment to global health, the Emergency Project’s missions reflect a level of social responsibility rarely seen in U.S. health care. By supporting initiatives like these, they’re not just investing in global health—they’re investing in the well-being of their own clinicians and humanity.  Envision’s partnership in these missions have sponsored initiatives spanning across five continents–utilizing the skills of their clinicians to the furthest reaches. 

Dr. Bryan Luu reflected on his experience as a first-time volunteer with the Emergency Project and how it helped him to renew his passion and calling to be an emergency physician as a senior resident:

“Working in a hospital day after day can become monotonous and impersonal. You see the same walls; you become burdened with catching up on charting, and you even get used to the recurrent pathology of your presenting patient population.  My experience in Guatemala was a shock to that routine.  The practice of medicine was different. For patients who were too incapacitated to come to the clinic, we even made home visits in the mountains.  We made diagnoses and treated unfamiliar pathologies with less resources, and it was invigorating. For example, diagnosing an empyema on a 15-year-old while performing a POCUS ECHO that may have saved his life all while working closely with local community members deeply involved with making the clinic sustainable.  At the end of the day, I realized that the team became my community there.  Ultimately, I felt the experience refreshed and refocused my attitude towards medicine when I returned to the States.” 

Much like Dr. Luu expresses, each medical mission that I participate in renews my love of medicine in its most pure form, while introducing me to an incredible team of likeminded individuals who truly believe that they can change the world.

A Moment That Changed My Perspective

The personal meaning attained by physicians comes not only through the dramatic life-saving encounters, but through the routine difference-making that access affords.  It is not only the 15-year-old with empyema, but, sometimes, it is also simplest stories that stay with me, such as a 35-year-old Haitian man presenting to a mobile clinic in the Dominican Republic.

As a Haitian who escaped to the Dominican Republic to give his family a chance, he isn’t recognized at all by the country where he resides and cannot obtain an ID or a birth certificate, let alone access the national health care system.  He supports his wife, their 4 children, and both his and her parents with his work in the sugar cane fields and he knows that his health is vital to supporting his family.   He signs in with the simple chief complaint of “Check Up” and waits several hours for his turn to be seen today, knowing that our mobile clinic was his only opportunity to be evaluated by a doctor. As my Creole translator and I chatted with him, my mind drifted back to Mrs. A, my stroke patient from Indonesia. I wished that she had ever had a similar opportunity to have that “check-up” that never came for her. Perhaps she could have found her hypertension much sooner. I can’t imagine how many people like her a medical mission has saved without us ever knowing it, and how many more are still waiting for that same chance, one that may never come.

Global Health is Emergency Medicine at its Core

Each and every mission has further ignited my passion for medicine, and through these diverse experiences, one commonality that serves our community of emergency care workers is the purity of the experience. There are no insurance battles, no malpractice fears or MIPS to influence decisions.  It’s simply medicine in its most raw and essential form, taking care of fellow humans in need.

Organizations like EP, OWS, and IMANA have enabled me to work alongside and learn with some of the most selfless, skilled clinicians that I’ve ever met. People who not only save lives in their day jobs but choose to spend their valuable time off serving those who would otherwise have no opportunity at all.

This work reminds me that we have more to give—not just to our patients, but to each other. Emergency medicine isn’t just a career—it’s a calling. And sometimes, we need to step outside the walls of our hospitals to remember why we answered it in the first place.

For those seeking to rediscover their purpose, global health is waiting.

For more information about Envision’s Global Health Initiative, please contact Shawna Gelormino, Clinical Leader of the Envision Global Health Initiative, or visit Envision’s Social Responsibility webpage.

*Please note that patient specific details have been changed to protect privacy.