My path here was quicker than I expected when I began the journey of becoming a physician, but I am here. I no longer practice emergency medicine. My career as an emergency physician was cut short by the development of young-onset Parkinson’s disease.
My symptoms were manageable at first, and I felt like I was thriving as a new attending. As time marched on, however, some symptoms of the disease worsened and new ones appeared. The disease became a little more difficult to manage. They say that prioritizing sleep and exercise and keeping stress low are helpful for managing symptoms. It’s hard to think of a better way to laugh in the face of this advice than being an EM doc.
Day shifts, night shifts, mid shifts, constant schedule changes, and constant stimulation for nine to 12 hours, constant worry about your patients and decisions. I was able to extend my career for a few years by eventually moving to an EM job at the VA. I had excellent colleagues and great staffing. No trauma, no pediatrics, and fewer squads. I still constantly worried about getting a crashing patient during my “off time” when my meds were not working and I regularly took more medication than I should have. I noticed little slips in my cognition. I decided it was time to walk away on my own terms. I never wanted to stay to the point where I was making mistakes, or someone needed to tell me that it was time to stop.
It was a difficult decision, but after talking to my wife and colleagues (to whom I am forever grateful), I decided it was time. A number of feelings followed. I had worked so long and so hard for this career. My wife sacrificed so much to support me through it. My identity was that of an EM doc. What now? Who am I without this?
However, I also felt a resounding sense of relief. No more endless worrying about the decisions I made, how my patients were doing, whether I was going to be sued. No more arguing with consultants on the phone, juggling patients, and trying to transfer patients in our broken healthcare system. No more telling families that their loved ones died.
There is another side to that coin, though. I will miss the feeling of truly saving a life; the satisfaction of expertly performing a procedure or watching a student or resident successfully perform a procedure I just taught them. I will miss the small things, like bringing a homeless patient a blanket and a sandwich. Most of all, I will miss working with the best group of people in medicine.
Today I work as an employee and occupational health physician. The work is not as exciting as EM, but I am grateful. No one is dying. I work normal hours, Monday through Friday and no nights, holidays, or weekends. I help coach my daughters’ softball team. I’m home for dinner and bedtime with my kids. My Parkinson’s symptoms are much more manageable, and my nonmotor symptoms have improved the most. I have more energy. I used to have crushing fatigue, which has mostly resolved with a regular schedule. My meds last longer. My mood is better. Life is good.
Emergency medicine is hard and often unappreciated work, but I will miss it. I want to end by thanking and saluting all of you who continue to work on the front lines in emergency medicine. Your community depends on you.
