Letter from the Editor

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I couldn’t stop staring at the eerie photo I had just taken from the 7th floor of the Texas School Book Depository, peering out over the intersection of Elm and Houston. I was standing in almost the exact location from where President John F. Kennedy had been assassinated on Nov. 22, 1963. I could almost see the black car speeding away to Parkland Hospital, Jackie Kennedy, in her blood-stained pink suit, crawling desperately over the back seat.

One visit to the Sixth Floor Museum in Dallas this past December, and I was hooked. Hooked on the gruesome Zapruder film, the conspiracy theories, the fears and hopes played out by the American people, and the steaming pot of current affairs that boiled over into one of the most notorious crimes of the 20th century. It was all-consuming.

Of course I couldn’t help but think about what the scene must have been like in Trauma Room 1 shortly after that fatal shot. The account of the hospital operator frantically overhead paging any available doctor to the emergency room (to which two general surgeons in the cafeteria decided to respond) is almost ludicrous compared to the automatic trauma team activations of present day, not to mention the automatic presence of board-certified emergency medicine physicians. It could not have been more different.

Then I read an interview with Dr. Ronald Jones, a chief surgical resident at the time, who recounted the details of the event he still remembers so vividly: the President’s lifeless stare, the restrictive back brace they struggled to remove, the wedding ring that Jackie Kennedy slipped off his left ring finger. The memories, even to this day, are exhausting to relive. Maybe it wasn’t so different after all.

While we continue to suffer through tragedy, loss, and enormous grief within the walls of our own trauma bays today, we are blessed with countless life-saving pharmaceuticals, medical devices, and technologies that were completely unheard of just 50 years ago. But we are also burdened by administrative and systemic nuances that have attributed to alarming rates of physician burnout and fatigue. Surely Dr. Jones did not encounter issues of intense overcrowding, boarding psychiatric patients, battles over fair reimbursement rates, intense fears of litigation, or feelings of exploitation and loss of professional autonomy.

As emergency medicine physicians in training, we spend every day trying to master the knowledge and skillset required to become excellent clinicians capable of caring for any patient (or God forbid President of the United States) who enters the doors of our emergency department. But as in politics, every day we are also trying to learn within a practice environment that is increasingly driven by money, policy, and power. And sometimes these two worlds collide.

This is exactly what happened to the the emergency medicine residents at Summa Akron City Hospital in Akron, Ohio, this past January, who found out with 4 days’ notice that their entire faculty and program director were being replaced after a failed contract negotiation.  Unfortunately, this transition of contracts led by hospital administrators did not account for the needs of its residents, initially leaving them without any dedicated educators, causing them to halt their interview season and placing them at risk of losing their GME funding.

Your EMRA Board of Directors was deeply distressed by this situation and wrote an open letter expressing our concerns. Excerpts from this letter, along with a Q&A with Summa’s new  program director, can be found on page 6 of this issue. This is not the first time EMRA has gone to bat for the residents and medical students it represents, and it certainly will not be the last. After all, advocating for your needs is one of the three pillars upon which this organization stands.

Especially during the presidential transition, and at a time when the future of the American health care system is as unclear as ever, we will continue to fight for what is right and just. I would thus encourage you to become involved with EMRA’s advocacy initiatives (see p. 4, 9)
and to attend ACEP’s Leadership & Advocacy Conference, March 12-15 in Washington, D.C.

After all…

It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again…who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

Stay strong out there, my friends.

Abby Cosgrove, MD

Abby Cosgrove, MD

Editor-in-Chief, EM Resident, Washington University in St. Louis, St. Louis, MO
Abby Cosgrove, MD

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