I am in that autumnal season in which I choose my two areas of study for
the academic term. My pursuits have been wide ranging over the years
but the recent PBS series on Shakespeare’s tetrology history saga made
up my mind. I have now plunged headlong into Richard II, the two parts
of Henry IV and Henry V, with even more zeal than I did as a youth
studying under the legendary G.B. Harrison.
I decry the death of civil decorum and protocol. We are in the midst of a
war on decency, responsibility and proper human discourse. Those who
know me will concur that I am not a prude. In fact, far from it. I
advocate no thought police, fashion police or official adjudication of
language or manners. After all, we’re not the French (sacrebleu!).
There is no universal definition of a weed. Look it up. It’s really that
plant that we don’t want growing in our garden; a subjective point of
view in which personal taste trumps botanical knowledge. But just as the
quintessential garden elements are a matter of opinion, so are the
important events of our history. Time is the only dimension we are all
forced to march along with at exactly the same rate, and it allows us to
look back at events and have perspective.
This column is a nested narrative, but lest you think I am fulfilling
the path of Mary Shelly’s Frankenstein or Ovid’s Metamorphosis, be
assured that medicine is still the medium. The time frame is the last
ten days of my life, during which I testified in a jury trial in defense
of an emergency physician and lectured to 300 physicians in New York
Licking old wounds is what you do at my age. This issue of EP Monthly
explores the question of workforce, like it was a “terra incognita”. We
have discovered a new problem! Eureka! This is like Christopher Columbus
claiming he discovered America.
Last month I was given the distinct honor of giving the opening address
to the Swedish Society of Emergency Medicine as our specialty became
officially recognized as a board certified entity in Sweden. The Swedes
have watched with growing envy over the years as emergency medicine in
America has gone from a rag-tag army of the restless and bold to one of
the most sought after medical training programs in existence.
This month I present a potpourri of concepts and Quixotic explorations
of ideas mostly brought on by travel, cocktail parties and my obsessive
study of obscure topics. Hold onto your hats. My first topic is the
current struggle which the country seems to be having over marriage.
As I sit here listening to the endless debates on why the sequester will
destroy/help us and whose fault it is and why things are so bad, I am
forced to contemplate fundamental changes in the American culture which
got us to this point. It is not simply a red state/ blue state thing. It
is not just the rich being demonized by the poor. There is a
fundamental shift – a splintering – taking place in both culture and
tradition in the once united America.
If government is the answer, just imagine how stupid the question is.
George Orwell was correct when he commented: “In a time of universal
deceit, telling the truth is a revolutionary act.” Disinformation – or
non-information – is everywhere. Most 24-hour news is 24 hours of crap.
When last I put pen to paper, we discussed the vexing problems of the
complex code breaking we are obligated to teach our young colleagues.
These codes of statistical mathematics, definitional precision, and
societal interaction are still the core of what we give to residents,
and are lessons that stay with them long after data about antibiotics
and SSRIs have been forgotten. But there are also the specific truths
(lest I say aphorisms) of the practice of emergency medicine they must
also master if they are to long survive this most grueling of careers.