Author: Tim Horeczko, MD, MSCR, FACEP, FAAP (@EMtogether – Assistant Professor, Department of Emergency Medicine, Harbor-UCLA Medical Center; Founding Director, Research Associates in the Department of Emergency Medicine (RAD-EM); Host and Coach, Pediatric Emergency Playbook – PEMplaybook.org) // Edited by: Manpreet Singh, MD ( @MPrizzleER ) and Alex Koyfman, MD (EM Attending Physician, UT Southwestern Medical Center / Parkland Memorial Hospital, @EMHighAK )

Life is Short, the Art is Long; Opportunity Fleeting; Experience Perilous; and Judgement Difficult.

– Hippocrates of Kos

Why are we here?

Resuscitation and reanimation are our duty, our purview, and our pride, but they are a part of the whole of our charge: to safeguard, to comfort, to guide.

To Safeguard

We constantly strive to understand better the who, what, when, and how of critical conditions and treatment, and to have the courage to act. As perpetual learners, we safeguard our patients by providing them with our best clinical selves through continuous improvement, individually and in support of each other. We safeguard also in a less exciting but equally important way: we do our best not to let them fall by the wayside.

Our advanced and varied skill set is essential, and the laurel of the House of Medicine. We have the fortitude to take on the role of the emergent obstetrician-gynecologist, cardiologist, pulmonologist, gastroenterologist, neurologist, dermatologist, radiologist, pediatrician, surgeon, internist, and infectious disease specialist. Whereas other specialists may see a prism that they can fine-tune to their own taste, we see a kaleidoscope of symptoms and signs, a dazzling array of humanity, and we do our best to focus on the subtle emerging patterns that will prompt us to act.

The onslaught is real, and we do not rest. Comorbidities flourish in a garden of personal and institutional neglect. We are here to safeguard people from that little-redness-that’s-probably-simple-cellulitis. If we are not here to evaluate for the insidious-and-not-always-initially-apparent-necrotizing-fasciitis, who will? Who really can best help the infant with stable-pneumonia-seen-today-at-his-doctor’s-office–until-he-worsens-and-slows-his-breathing? We are the ultimate bodyguards. We are vigilant, but we are prudent.

The stakes are high, and we protect our patients. We do this all with a wink and a smile, and roll with the daily punches. Few understand our mission, our intention, and our service. We are at our strongest when we are propelled by these internal forces.

If you are interested in reading the rest of this and other EM Mindset pieces, please see “An Emergency Medicine Mindset,” a collection evaluating the thought process of emergency physicians. This book is available as ebook and print on Amazon.