Over the weekend, I helped take care of a critically ill patient. Multi-organ system failure, hypotensive, GI bleeding out of both ends. Needless to say, she required multiple, serious interventions before she was even remotely stable enough to be transported to the ICU.
During the course of her treatment, an ultrasound revealed that she had fluid accumulating in the space around the heart, so I was able to watch a resident perform a pericardiocentesis. Basically, this involves sticking a needle into the patient's chest and drawing the fluid out into a syringe. The resident aspirated nearly 300cc of murky yellow fluid before he was done.
As I watched, I wondered, how could there be any better job? As an emergency physician, you splint fractures, manage airways, suture complicated lacerations, treat heart attacks and ingestions, and, oh yeah, once in a blue moon stick a needle into somebody's chest.
Is this an overly-rosy picture of the profession? Of course. Is the price of admission dealing with the drunks, punks, and skunks that occur with far greater frequency than the truly fascinating cases? Absolutely. But the sheer variety of skills required and of pathology encountered as an emergency physician is pretty impressive.
I've spent the past few years being the low man on the totem pole, catching glimpses into the world of EM while dodging bedpans and abusive patients. With med school around the corner, I can't wait to start moving closer to what I feel to be a pretty great way to earn a living.
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