It seems like only a few heartbeats ago that Dr. David Wagner, one of the true founding fathers of emergency medicine, convinced me to join him for a dinner meeting where a totally unknown CME promoter, Bruce Herlitz, wanted to chat about starting a newsletter featuring “emergency room medicine.”
Actually, it was 1976, but it still seems like yesterday. Turns out that Bruce Herlitz had been organizing conferences for numerous medical specialties, an often quite boring task, as he put it, but his interest was tweaked when he heard about a bunch of misfits, cowboys, and adrenaline junkies who had decided that the ER was not just for interns or a temporary penance for a nascent surgeon or a few pariahs of the medical staff.
It also seemed that these ER upstarts had gotten under the skin of organized medicine, and had a few local and ever-increasing national heated run-ins with almost all other specialties, especially anesthesiologists, surgeons, and internists. The turf battle had begun, and EMN (originally named Emergency Department News and then Emergency Medicine and Ambulatory Care News) wanted to carry the flag for the Che Guevaraesque medical revolutionaries. Even the pediatricians were appalled that these ER guys had ideas about otitis media. But all of the detractors acknowledged that the questionable mental health and sparse medical acumen of “those ER guys” was at least passable at 3 a.m. and on weekends and Christmas day. Curiously, once the sun came up on Monday, our expertise and prowess evaporated. It was now time (9–5, Monday-Friday) for the real doctors to take over.
“Imagine, those ER guys think they can find the trachea, let alone intubate; give antibiotics to septic patients without the advice of the medical resident; and even treat pulmonary edema with Lasix outside the ICU. Those guys will never last, and that cockamamie, harebrained, half-baked, loopy, and downright silly fantasy hasn't a ghost of a chance of becoming a true medical specialty.
“The ER is such a God-awful place to work, with all those old people, homeless, and psych patients. But just to be sure, we better nip this farkacht idea in the bud before they multiply like rabbits. Hell, someday they might even think they can start a central line, read their own EKGs and x-rays, or understand ultrasound.”
With no board status in the offing, no promise of a living wage, and just out of a disheveled, potluck, largely self-taught, and totally fear-filled but captivating residency, I knew every emergency medicine resident in the country (all 10 of them). So I paid my own way to a meeting in a Howard Johnson motel in Michigan with some really old guys (at least 40 years old) who had a really crazy idea of starting a formal organization of similar weirdoes, eventually to become ACEP, ABEM, SAEM, AAEM, etc.
So Dave Wagner, Jerris Hedges, Steve Davidson, and I took a similar chance on Emergency Medicine News, with the concept of bringing interesting stories and needed medical information to a small but sprouting group of ER novices via what was a brilliant and new concept. One no longer had to wait for a textbook to be published before medical information was exchanged or new ideas promulgated. Now EMN is perused monthly by more than 34,000 clinicians!
EMN was born without the Internet, cell phones, voice mail, texting, Twitter, email, or even Microsoft Word, but with a trusty but actually revolutionary IBM Selectric typewriter (with the requisite bottle of White-Out) and the always reliable U.S. Postal Service.
Over the years, EMN literally scooped the medical journal world with stories such as a bizarre skin rash on gay men (Kaposi's sarcoma), a disease (AIDS) that made one susceptible to unheard of infections (pneumocystis), a new voracious bacteria (MRSA), and a solution for crowding (inpatient hallway boarding). Most recently, EMN highlighted ESBL bacteria and the new superbug status of the gonococcus. Of course, there was the omnipresent almost real-time reporting on natural disasters (Katrina and Haiti), new antibiotics, medical snafus galore, totally absurd insurance regulations, another application of ultrasound, the newest airway maneuver, and the latest volley of inscrutable CMS proclamations and questionably motivated black box warnings emanating from the CDC. (Forget Droperidol; now even Zofran and azithromycin have QTc implications).
Emergency medicine now attracts the brightest and best medical students, quintessential clinical researchers, and enviable procedure innovators. All that's fit to know is captured by EMN, from breaking stories to the latest ultrasound pearls from Christine Butts, toxicology you would otherwise never hear about from Leon Gussow, the incredible insight and wit of Edwin Leap, literature reviews from Luis Lovato that we are wise not to ignore, myth-debunking videos from Larry Mellick, app reviews we can't live without by Alex Mohseni, fascinating cases by Ravi Morchi, the medical-legal expertise of Carlo Reyes, podcasts that make you think from Ryan Stanton, the new generation's perspective from Graham Walker, challenging cases that test your acumen from Jennifer Wiler, and provocative reporting by Ruth SoRelle, Anne Scheck, and Gina Shaw, all under the creative genius of Lisa Hoffman, editor extraordinaire.
Beginning with simple reports of minor diseases and trivial injuries but with a flair and relevance that ER guys craved and could not find elsewhere, EMN now touts cutting-edge science and innovations, honchoed by an editorial board of the most brilliant clinicians anywhere, names known even to the casual aficionado of organized emergency medicine. The inevitable dimming of older stars has been replaced with the newest supernovas of emergency medicine. When another star rises, EMN will surely put them in its sky forthwith. What EMN and every single emergency physician do every day really does matter.
Thanks, and happy birthday, Emergency Medicine News. It's been a great 35 years.