It was my first night at a new emergency department, so I was just getting used to the system and the people. Everything seemed to be going along smoothly. The staff was great and very welcoming. The patients were pleasant and generally not so sick as to create a stressful first shift.

“Hey sweetheart,” my wife said cheerily as I stared into my coffee. “Today’s your day.”

“Huh?” I said blankly. It had been a long night and all I wanted was to eat my breakfast in peace and go to bed.

“It’s your birthday, silly.

Have you ever arrived at the hospital for your shift with the sinking feeling that the odds were stacked against you? Sometimes it’s a quick look at the ambulances lined up waiting to drop off patients. If I walk by the waiting room I can sometimes get the feeling of whether people are waiting patiently or whether there is a sense of anger and frustration.

I came up the companionway of our boat, ready to take over the night watch from my daughter who was standing alone at the helm. “I see that the wind has freshened,” I said cheerily. This a term sailors use when it’s blowing like crazy.

Working the night after a holiday is always a bummer, especially Thanksgiving. I usually eat so much turkey, dressing, mashed potatoes, and pumpkin pie that I start to resemble the unfortunate bird himself. But my wife always drags out the Christmas decorations to get a head start on the next season. Every other year I’m spared from this duty as it is my turn to traipse off to the hospital for another shift. Thankfully, it’s usually quiet. I guess most people are laying around stuffed like I was. But a few make it in to the ED with the usual complaints.

“If the Republicans win big they plan to choke off health care reform,” said my wife while reading the morning paper. “That’s what you want, isn’t it?” She’d heard me rant about the long-term negative effects that the recently passed bill would have, and I think she was hoping this election cycle might put an end to it.

When the phone rang at 4:30 in the morning, instead of sleepily reaching for the bedside phone, my wife literally jumped out of the bed. With an elderly parent, she is always worried that such late night calls mean bad news. I, on the other hand, have a more sanguine view of life, and try to avoid any such thoughts that might interrupt a good night’s sleep.

  As a Navy reservist assigned to a Marine Corps unit, my annual training requirement – AKA “summer camp” – usually meant going with my Shock Trauma Platoon to some foreign country to stand by while a Marine rifle company carried out a live fire exercise with the military from the host country.

It was a hot Saturday night and the ED was packed, as usual. All the histories seemed the same: “I was sittin’ on the stoop drinkin’ a few cool ones . . . then he said . . . then I said . . .” Countless cuts, bruises, and possible blow out fractures filled every room.

I believe that the answer to defensive medicine and the damage it has done to our health care system lies in our own hands. We are the ones who establish the ‘standard of care,’ beneath which is negligence. 

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