Another description of Emergency medicine

via Bloodletting

The best description of Emergency medicine ever…

Emergency Medicine.

Lifeguards working the shallow end of the gene pool.


Update: The SciGuy at the Houston Chronicles’ blog picked up Doc Russia’s quote above, and had this to say at the end:

Wow, that’s pretty harsh. Do all emergency docs feel as frustrated? GruntDoc seems to approve.

Frankly, I found it more amusing than harsh, but I’ll entertain the thought for a moment.

One the one hand, poorly-thought-out behavior of virtually any sort is a risk factor to meet professionally in the ED, so I suppose shallow gene pools could well be overrepresented in my patient population. I do think the none-too-bright are overrepresented in my ED, but that’s likely just observational bias. (Don’t write letters: accidents and illnesses happen to everyone, so it’s hardly universal that being in the ED = consanguineous parents.)

Harsh? I don’t read it as harsh, just as ironically humorous commentary on what we do and for whom we do it. Frustrated? Everyone in the ED is frustrated to some extent. Read this blog and the comments for a few examples.

I don’t have one of these t-shirts and don’t want one, but as a throw-away line, it’s pretty funny.

Hat tip to reader Gunjan for the link


  1. Allen,

    Perhaps I’m a little to grounded in the media world, where we have been accused on more than one occasion of being too politically correct. But the term “shallow end of the gene pool” implies to me that everyone who shows up at the ER is stupid.

    I may not necessarily disagree with the sentiment, by the way.

    In any case, you do a great job here and I enjoy reading.


  2. Goat Whacker says:

    Everyone who shows up in the ER is not stupid, but there are a great number who are there because they or someone else did something stupid. I’d also have to say one of the reasons I left emergency medicine was because of the nature of the patients I was continually faced with. Not very PC I guess.

  3. TheNewGuy says:

    The two best teachers are pain and loss of money, so mistakes that land one in the ER should theoretically double the learning potential. That said, it’s not the people who make mistakes that are frustrating, it’s when people repeat their mistakes.

    2nd or 3rd DUI crash?
    Stabbed for the second time, by the same GF, for cheating on her?
    Shot while dealing drugs (again)?
    Still doing meth despite being badly burned when their prior lab blew up?
    The state taking abused child after abused child from the same mom?
    Second or third motorcycle accident with no helmet/leathers?
    16yo pregnant with her fourth child (and can’t care for the ones she already has)?
    Umpteenth ER visit for GC/Chlamydia despite being counseled over and over on how to avoid it?
    Repeated ER visits for cocaine-induced chest pain?

    Sometimes “shallow end” isn’t that far off the mark, but that’s not where the frustration comes in. I think the frustration is taking your time, doing your best for somebody, exposing yourself to liability, having a heart-to-heart with a patient, only to have them go out and do it again.

    It’s no mystery to me why some docs get to the point where they just go through the motions, and don’t really care that much. It’s a defense mechanism, just like any other. It can be difficult to draw that fine line between caring enough to be compassionate, yet not caring so much that the disappointment and frustration become a burden.

  4. The news says there is a 4-5% unempoyment rate. Half of my patients are unemployed. Many can’t give an address or phone number nor do they know their social security number.

    In the last week I have taken care of a guy that was stuck in a chimney, a lady who smoked meth and drank two 24’s then climbed a ladder to trim a tree and degloved her entire arm when she fell, as well as countless DUI patients, 500 lb hertensive diabetics who don’t take their medication. Recently a husband “goosed” her wife up the ass with a air compressor as a gag and exploded her colon and left her with a colostomy.

    Yes, I am a lifeguard in the shallow end of the gene pool.

  5. Actually, the remark is not far from the truth. No not all ED visitors are stupid, but a fair number of them are.

    Job Security
    Cigarettes and booze, cars and
    Speed – you call, we haul

    The ones that are stupid, though are usually too stupid to die! (I’m probably going to hell for that one…)

  6. LOL

    Save me a front row seat when you get there Eric!

  7. Not an ED doc, but it seems to me it’s not quite funny. Sort of like its creator is working the shallow end of the comedy gene pool.
    But if you think that’s not funny, then maybe the original isn’t either.

  8. In Stitches says:

    Guy checks to see if his snow blower is still running by sticking his foot into the intake. Loses several toes.

    Guy checks to see why the hose at the gas pump isn’t delivering, by sighting down the nozzle. Gets face full of gasoline. Classic x-ray showing air/gasoline level in maxillary sinus.

    Guy decides to rub ears with Ben-Gay to “keep them warm” on his delivery route on a -10 degree Minnesota morning. Gets frostbite of the ears.

    C’mon. You can’t make this stuff up!

  9. Gardener gets 4 fingers amputated when he puts his hand in the lawnmower to loosen up an obstruction. Recovers, goes back to work, comes back into ER a few weeks later, mowing grass again, grass gets stuck in mower, he puts his finger stumps into the obstruction….amputated further down.

  10. mark Rabold says:

    As John Wayne said, “Life is hard. Harder if you are stupid”!