Anonymous writes: “Say, Uncle Panda, you’ve convinced me that medical training blows and that the only difference between being somebody’s prison girlfriend and residency is that your cell-mate/husband usually lets you sleep after he sodomizes you. Are there any good things about your job? ”

Excellent question. Naturally, it is easier and more interesting to complain about things. If all I did was opine about how much I liked everything and how wonderful, kind, and wise the entire medical profession was I think I’d probably have about six readers, all of them geeks, and all of them regularly exclaiming, “Darn, that Panda guy sure can write!” And, there would be just too much competition from one of many fine Smurf homage sites.

Not to mention that you would find reality far different than the rosy picture I painted.

Still, I do like my job and here are a few reasons. Some of them apply to my job in particular as Emergency Medicine is somewhat different than many of the traditional specialties, others apply to medicine in general.

1. I don’t have to internalize my patient’s complaints. Many of them are sick, really sick. The kind of sick that you, reader, may find hard to imagine living as you do in the prime of your youth and health. I see, almost every day, some example of the body’s seemingly inexhaustible capacity to hang on in the face of failing organs, deranged chemistry, brain damage, and absolutely horrific injuries. But it’s cool. I’m not that empathetic. I don’t believe the patients want that kind of thing anyways. Given a choice, most patients would prefer an authoritative physician who thoroughly understood their aortic stenosis and their congestive heart failure over some smarmy, slobbering empathy-whore.

2. Every now and then a patient comes in who is dismissed by the nurses, laughed at by the mid-levels, and generally treated like a malingerer until you walk in, bring your medical training to bear, and make an obvious diagnosis. Sheepish looks all around. Respect from the nurses who take pride that you have been brought up so well, envy from the mid-levels who keenly feel their lack of knowledge, and a gratitude from the patient who finally gets the respect he deserves. Medicine at it’s most visceral and gratifying. Cheeses and hams all around. (Absolute Doctor Rule Number One: Everybody gets the benefit of the doubt.)

3. I don’t care what you’ve heard, physicians are still respected by almost everybody, especially when either they or a family member are sick or injured. In our “Call-Me-Bob”, I’m OK, You’re OK society a physician is one of the few people still called by his title. I occasionally have a young, tattooed, patient making a career out of fighting authority who never-the-less struggles with the correct way to address a doctor. He knows first names are wrong. “Mister” is out of the question. It is finally, with relief, that he discovers “Doctor” is acceptable. Kind of sets the mood. If you act like a physician, you will be treated with respect. This goes back to not slobbering on the patients. They want kindness and respect but they don’t want you smothering them either or being their best friggin’ friend.

By the way, I always call patients by their title which is, at a minimum, Mister, Miss, or Mrs. My mother (who reads my blog, by the way) taught me good manners.

4. My colleagues are as profane and irreverent as I am making for a really fun work environment even when things are ostensibly blowing hard. While we are circumspect around the patients and in areas where the usual compassion fascists prowl, I have only heard Marines and sailors swear as much or tell more off-color jokes. This may bother some of you but (and I say this with respect) you can pound sand. If you don’t like it, go into a specialty at a program where they wouldn’t say shit if they had a mouthful, gather up your skirts, and waggle your fingers while making tsk–tsk noises to your heart’s content.

5. We get to avoid most of the rush hour traffic. I once had to drive to work at a normal time and it took me three times as long. Good Lord. It may be dark when I leave but all the traffic lights are blinking yellow.

6. Free food. Don’t underestimate it. At my program, we eat for free in the cafeteria. I probably drink about eight or nine Diet Cherry Cokes (the official soft drink of Panda Bear, MD) per day so the savings are huge. Plus it’s nice to have a perk or two. It makes one feel special.

7. Emergency Medicine gives me the opportunity to practice Christianity. I may hate doing it, it may make me ill, but if Christ washed the feet of beggars I can certainly remove some disgusting wino’s urine-soaked socks and examine his filthy, gnarly, fungus infested feet without complaint or change of expression and without making the wino feel like he is bothering me by coming in for some warmth and a meal. I hate doing it, of course, as I am no Mother Teresa but I hope the Lord gives me some credit for the action, not the thought.

Except for action, most compassion is metaphysical crap anyways.

8. Going home. It’s the best feeling in the world to get done with a shift, especially on or around the designated quitting time. This is probably unique to Emergency Medicine, especially in residency. Most residents have the devil’s own time escaping at the end of the day. There is always something that can stall your egress and it is usually something trivial or people without families, outside interests, or lives who get all of their social interaction at the hospital and want you to hang around. Not to mention that there is always work to do. You can stay at the hospital 24-hours a day seven days a week if you want and nobody would complain.

But that’s why they have a on-call team, not to mention night-float. I hate call but I do it. And I don’t try to pass off consults and admits that come in at 4:55PM to the day team because they came in during the day.

9. It is an interesting job. We see a little of just about everything from genital warts to leukemia. Sure, some things are bread-and-butter but not everything is. Major trauma is pretty cool too and I am working towards being as calm and collected as my senior residents and attendings.

10. I get to wear pyjamas to work.