Being an Emergency Room Doc

Many of you have expressed an interest in becoming a doctor someday. But what does it take? And what is the job actually like? Dr. Shen, an old family friend of mine, is a physician working in a NYC emergency room. From the sound of it, he's got his hands full in the ER. Thankfully, though, he has graciously taken time out of his busy life to answer Victor's questions. Read on to see what he has to say...

Q1: What happens every day? What do you do?
A1: I see essentially anyone that makes his way into the Emergency room for whatever reason. This includes people who are itchy, are in pain, have been shot/stabbed, hit by a car, are giving birth, smelled something funny, have pus coming out of their arm, have diarrhea, are vomiting blood, want medications, hear voices, twist their ankle, are severely drunk, or are just visiting. My job is to figure out what's going as fast as I can without missing anything dangerous or life threatening and then to fix the problem either through medications, procedures, or referring to the appropriate specialist, like your heart doctor, or your surgeon for instance who might do something much more invasive like open heart surgery or removing your appendix. I don't do surgeries, but what I do include draining pus pockets, putting tubes down tracheas to help patients breath, and doing spinal taps.

Q2: If something goes wrong, what do you do?
A2: There are things that you can't predict happening, and you do the best you can. There are many other doctors working at the same time, many of which are specialists who can give their input as to what's going on if you ever have a question. If something goes wrong and you're responsible, you own up to it, and examine the case so problems like that don't happen in the future. Patients are very unpredictable and some even lie against their own better judgement.

Q3: Are you happy with what you do?
A3: Yes. It's very fulfulling at the end of the day. When you're in the midst of the madness in the Ed it's easy to lose sight of why you do what you do since you're stressed, tired, and frankly, people in emergency situations aren't the nicest folk. However, when all the dust settles, you yourself know what you've done and the good you've done for these people. Half of the patients you make a huge difference for and you can tell they're appreciative. Another quarter leave mad wondering why they spent so much time in the ED. These patients usually aren't that sick and have problems that I can't fix in one day. I don't feel bad that I couldn't fix them, it's just the nature of the disease or the human. The last quarter end up in the hospital, hopefully assured in some way that we the doctors know what's going on, but also somewhat apprehensive over the future course of the disease which may be dependent on the next several days of treatment or impending surgery.

Q4: Do you regret any decisions that you made as a doctor?
A4: I'm lucky since I'm still in training and none of the final decisions are on my shoulders; however, there are always decisions that are being made that you don't quite 100% agree with. In truth, it's very difficult to know what exactly is going on with many of the patients. You have limited resources and often limited information to make your decision and there will always be doubt. The trick is to make that doubt small enough by knowledge or tests so you can be reasonably assured that this person can go home safely.

Q5: What did you do to become a doctor?
A5: I went to college for 4 years, took a hard exam, went to medical school for 4 years, took more exams, and poof here I am. It's like jumping through hoops. You know exactly how high and how far the hoops are. The question you must ask yourself is if you are willing to put in the time and effort. Also, you have to decide if it is in fact what you want out of life / career. There a many ways to help people, many ways to make money, many ways to do good in the world -- becoming a doctor is a long journey, but a worthwhile one if you're doing it for the right reasons.

Thanks for your input, doc! Got a comment for Dr. Shen? Post them below! Want to hear from other professions? Write down your questions, post them, and I will see what I can do!