The ED is pretty awesome at times: I get to suture, splint, order tests, and see patients actually being worked up for diagnoses instead of just arriving in the hospital diagnosis already in hand.
But mostly, it just reminds me of the year I spent as a waitress at a 24-hour diner in The Middle of Nowhere, America.
Luckily, most of the experiences and skills have transferred to the ED. For example:
1. Dealing with drunk people making poor decisions. Though I’ll admit, the drunks at the diners were mostly making the kind of poor decisions that could be worked off with a few hours at the gym.
The ED drunks’ poor decisions are a bit more..excessive.
2. Everyone is always pissed. The servers are pissed, the customers who’ve been waiting forever are pissed – and even the customers who actually got the right meal at the right time are pissed because of some trivial crap like how the vegetables on their plate are touching their mashed potatoes, or how they can’t have their cell phone with them in the MRI.
(Granted, if the nurses or cooks are pissed, it’s because I did something either incredibly unhelpful or stupid, so they have a right. But it still sucks.)
3. You’re running around trying to remember 15 things at once. Which is actually really satisfying and an awesome way to make the time pass quickly – but it does tend to mean that – statistically speaking – something’s bound to slip your mind every other shift or so.
… I much preferred the worst-case scenario being “Forgetting to refill the diet pepsi at Table 15” to “Forgetting to check the results of the head CT in room 4.”
4. People are crazy. And by “crazy”, I don’t mean merely psychotic. The psychotic people are GREAT. The real crazies the people who just have this warped view of the world where they’re convinced their bloody knuckles deserve to be seen before the guy with crushing chest pain, or that they should be able to substitute the side of coleslaw for “a side of ‘steak'” without paying any extra.
I’ll take the mentally ill over the crazies, every time.
5. The cynicism always wins. I don’t know if the atmosphere actually changes you, or if it just weeds you out if you don’t meet specifications – but there are plenty of optimistic and happy new nurses, medical students, and diner waitresses out there.
But there is nobody on earth more crotchety or intimidating than a career-long ED physician, nurse, or waitress.
Nobody.
Action Potential 
I know everybody says that ED patients are fun because you get to be THE ONE who diagnoses them. However that’s only partially true. Your primary job is to determine stable/unstable and dispo appropriately. A person receiving the ED patient on the wards still has a lot of diagnosing left to do because the ED person usually doesn’t have the time to do a complete work up and often misses something important because of this.
I do enjoy working with ED docs and nurses though. In my experience they’re a great group. Cynical, but awesome.
aww, I like the ‘crazies’. So much more interesting than ‘normal’ people and they make the day colorful 🙂
Awesome 🙂 I think I’m a little bit in love with you.
I waitressed too (and hated it with every bone in my body).
It taught me something else: how to handle throbbing feet. I would not be able to survive calls if not for the fact that waitressing required me to be on my feet for as much time.
Also, did you have the term “spinning” when you were working? We used it for when a waiter had too much on his plate (literally or figuratively) and the weight of it was too much. They get that startled deer-in-the-headlights look and then… everything spins out of control.
I’ve learned that that can happen during a particularly bad call, too.
Just wanted to pop in and say, hi, you are hilarious. I’ve been following your blog since I started med school and now that I’ve almost made it through one year, your posts seem even funnier. Keep them coming!
I actually was asked a question similar to this for my medical school interview. I had worked at a downtown sports bar for almost a year before medical school, and was asked how that would help me at all in my medical career. I assumed that he was trying to belittle my job choice as a server. Serving brought about some of the most stressful situations I’ve ever encountered to date. Having a 10-table section and three parties of six who all seat themselves at the exact same time and trying to keep 70 (literally) tabs straight without losing your head requires a special skill. I wish I had read this article before my interview so that I would have been equipped with even more answers 😉