After seeing your fifth or sixth toothache of the day with severe dental caries, you begin to think that everyone smokes meth. After talking to your third or fourth 20-something who’s on disability for their “chronic pain,” you start to wonder who’s actually working in the community. When your second or third morbidly obese child comes from one of the outlying towns, you wonder about the strength of the local gene pool.
I’ve sometimes left the E.D. at night worrying about the people in my new community. While this community doesn’t have the Knife and Gun Club I left behind in the city where I trained, I feel like the perceived social environment may be more insidious. But, like I said, I have a skewed view.
Then one day I had an epiphany as I drove the main street of this small town. Even though it seems like we see half the town in one day in the E.D., it’s actually a very small percentage of the people who live here. The people who come through the E.D. aren’t the people I see working in the grocery store, delivering the mail, running the gas station, etc. Ok, well, sometimes those people do get hurt too, but they aren’t the chronic back pains, chronic dental pains, chronic anythings. They are the people with the emergencies. They are the people who I got into Emergency Medicine for… and somedays that thought is enough to keep me going through one more shift.