An emergency medicine doctor and blogger

Do your medical colleagues know about your journalistic work?

Yes, and many of my colleagues tease me about it. “Is this conversation going to end up on your blog?” is a common refrain. But of course the conversations stay private. I make an effort to protect the identities of patients and coworkers, and even mask which hospital I’m working in. Originally I was really nervous about the blog. Residency is in some respects my first real job, and some administrators don’t take kindly to having employees talk about their work online. So I was up front with the residency leadership about my activities, and I asked if they thought it was a liability. They urged me to be careful but have been quite supportive. Not only have I continued working with http://medgadget.com, an internet journal of emerging medical technologies, and my own blog, but I’ve started blogging our residency journal club discussions as well.

What’s it like working in the emergency department in New York city?

Any emergency room features plenty of exciting moments, but sick patients and tired residents don’t make for much glamour, I’m afraid. The New York city spin on emergency medicine is more people in less space, and bioterrorism makes its way into differential diagnoses a little more often. Compared with television, the lighting isn’t as flattering, there’s no makeup, and I don’t perform as many thoracotomies. But we do see our share of unique characters and memorable presentations.

What is training like in a wealthy cosmopolitan city?

Mount Sinai’s emergency medicine residents spend half their time at Elmhurst Hospital, a few miles away but right in the middle of one of the planet’s most diverse neighbourhoods. This is a disadvantaged immigrant population, and many patients have never seen a doctor before. We’ve seen malaria, tapeworm, and even some leprosy plus a lot of straightforward medical problems that have gone unchecked for years. Sometimes I have trouble believing patients’ stories because it’s hard to accept that health care could be so bad in such a wealthy city. Mount Sinai Hospital is between the posh Upper East Side and poorer Spanish Harlem, so we see a mix of backgrounds there too.

Given your passion for medical technology and informatics why did you go into emergency medicine?

Medical informatics is about getting the right information to the point of care to help decision making. This information includes patient data and evidence from the literature so that doctors can make the right choices for their patients. The need for timely relevant information is most critical in the emergency department, so from that perspective emergency medicine was a good choice of specialty for me. But of course, I love working in emergency departments for more fundamental reasons. The pace, the procedures, and the diversity of patient presentations all appeal. My interest in healthcare technology is just icing on the cake.

Who have you met while interviewing doctors and medical students for Medscape?

I really enjoy corresponding with the people we’ve profiled for Medscape. I’ve interviewed a hospital chief executive; a doctor turned television chef; a transplant coordinator; a chaplain-novelist; and many more talented doctors, nurses, students, and healthcare professionals. They’ve shared such interesting experiences on their blogs—and they’re skilled writers as well. I don’t think I’ve seen or done enough to be in quite the same league as the people I’ve interviewed.

What’s your advice for medical students?

Start a blog. As I wrote in a column for Medscape, medical school is a transformative but isolating time (www.medscape.com/viewarticle/545546). A public journal can update friends and family who might otherwise not hear as much from a preoccupied student. Blogging also prompts reflection and records intellectual and emotional growth. Medical student bloggers also make connections with other students who are considering the same specialties or places to train.

Competing interests: None declared.

Provenance and peer review: Not commissioned; not externally peer reviewed.

      

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