Dear emergency medicine,
Thank you. You saved my life. I'm not being dramatic here. Well, maybe just a little. But it's true: I don't know what I would have done these past 35 years if it hadn't been for you. Perhaps I would have played in the NBA (if only I weren't 5'6”) or been the lead guitar in a rock band (if only I had an ounce of musical talent). No, there's no doubt in my mind; you were the one for me, which is why my decision to leave you in January has been so bittersweet.
Like a prize fighter who has reached his zenith, I wanted to go out on top. I didn't want to be that doc who the ED nurses, though they still love him, secretly feel a tad less confident in because his skills are a tad less proficient. More importantly, I never want to be in a situation where someone's life is in my hands and those hands are shaking, or where a crucial decision needs to be made and my 65-year-old brain is failing me.
Back to our love affair, EM. Do you remember how it began? It almost never happened. It was during my sophomore year at Penn when I chanced upon a production by a theater group, The Mask and Wig Club. I was mesmerized, entertained, and hooked. My plan was to change my major from pre-med to theater the first thing in the morning, after I called Dad, of course. It would be a risk, but love conquers uncertainty, doesn't it?
Unlike many physicians I know, my older brother Tony, for one, I was never sure a career in health care was right for me. I chose pre-med at Penn because, well, at 18 and ready to party, I just didn't consider the other options. I knew where I was headed—Broadway! Or was Hollywood my destiny? Sure, there was a chance I'd fail, but love conquers failure, doesn't it? Dad didn't seem to think so.
My father, a renowned Philadelphia pathologist, shared his perspective on my newfound dream to pursue the performing arts. I can't recall his exact words, but certain phrases like “starving and penniless,” “one in a million chance,” and “waiting tables the rest of your miserable life” stick in my memory bank. How ironic, EM, that in his dream-squelching way, my dad played a key role in our ultimate love affair, which was still a few years away.
I resumed my half-hearted pre-med studies while I concentrated on the important aspects of my college experience—rugby, beer, and women. Needless to say, my first attempt at the medical school admission process was not successful. I guess that D in organic chemistry was an omen. But after obtaining a master's degree at Drexel University and improving my MCAT scores, I found myself matriculating at Hahnemann Medical College in 1978, still no more sure about my future as a doctor than I had been the night of that fateful conversation with Dad.
But with big brother Tony as a role model and a core of fantastic classmates and comrades, I began to like feeling like a physician. The next crossroads in this journey of uncertainty and doubt came in year three when young doctors-in-training need to declare a specialty before the residency match.
I kind of liked the OR, but no way did I want to be a surgeon. I definitely loved kids, but no way did I want to be a pediatrician. I really enjoyed delivering babies, but no way did I want to be an OB-GYN. And so on. I knew I detested internal medicine, but I figured a year of it wouldn't hurt and perhaps my true love would find me. Thankfully, you did, my dear EM.
It was now 1982, and EM was a relatively new medical specialty with relatively few residency programs. You caught my eye, EM, and I never looked at another. Our first couple of years were a bit rocky like many relationships can be; I was petrified by the responsibility of saving lives in the hectic emergency department of Johns Hopkins Hospital. But our love affair flourished with the guidance of my attendings and fellow residents.
Thanks to you, I even found my other true love when I came across the prettiest ED nurse in all of Baltimore and married her. We moved to the South Jersey shore where I became a founding partner of Cape Emergency Physicians, one of the longest-running single-hospital democratic ED groups in the state, possibly the entire country. What a ride it's been!
You gave me laughter, like the time I sprayed ethyl chloride on a man's pilonidal abscess as I was preparing to incise and drain it, not realizing the chemical agent was dripping onto his scrotum. He jumped off that stretcher so fast and ran through the ED screaming, “My nuts are on fire!” You gave me tears, like the night we coded that 8-year-old girl who had been in the ED the day before with a mild case of the flu. I will never forget that scene and so many others through the years, both joyous when a life was saved and devastating when one was lost, that generated such intense emotions for me and my ED family.
You allowed me the flexibility to take on other endeavors such as ringside medicine, urgent care, and multiple medical staff leadership positions at my hospital. And as your parting gift, you gave me extreme pride as I watched my son, Michael, complete his EM residency this past July.
Even though you put some restraints on me—working weekends and holidays, going 10 hours without eating or going to the bathroom, dealing with the occasional unsavory character whose violent outbursts made one wonder if he truly appreciated the efforts to ensure his medical well-being—I have always loved you, EM. And in some ways, with each and every shift over these past three decades, I got to fulfill my desire to be in theater with the ED as my stage, the staff as my fellow performers, and my patients as the audience for whom I genuinely loved to care. I have taken my final bow, with a night shift on New Year's Eve, no less, and embarked on my new life as a retired senior citizen, which I hope includes lots of golf, travel, and family time.
I'll miss you so much, EM. Farewell, my love.
Dr. Colettawas an emergency physician and a full partner of Cape Regional Urgent Care in New Jersey. He also worked in other capacities, including as the medical director of the Atlantic County Justice Facility, the chief ringside physician for the New Jersey Athletic Control Board, and the owner/operator of Casino Health Services in Atlantic City. He now resides in Ocean City, NJ.