First Person: Mary Palmer, traveling emergency room doctor


(D.A. Peterson)

I could pick up my phone right now, and there’d be e-mails from recruiters looking for part-time ER docs. People like to concentrate in places like Washington, D.C.; they go to school here, they start families here, they have a life here. But in other parts of the country, the demand outstrips the supply.

Every place I work has its own culture — and its own electronic medical records system. I love the people, but could you imagine learning new software at work every few weeks?
I used to think I had a hard time with transition, but I am someone who likes to immerse. It feels good to concentrate, to compartmentalize. When I’m at a location, it’s eat, sleep and go to work. If I can’t find satisfaction in work, why make that sacrifice? I have to find dignity and worth in what I do. I do that by focusing on the patient. Medicine has become so corporate. We are cogs in a wheel. Doctors are expendable, too. So I have to always look through the eye of the needle: at the patient. That’s what I tell new residents: See the patient. Nothing else.

My theory is that in emergency medicine, we have more teachable moments with patients. More is at risk, and sometimes that means patients are listening more intently. If I smell smoke on a patient or suspect that someone may be drinking too much, I will look them in the eye and say, “You have to stop. Now. This is your chance. I have someone in the other room on oxygen who cannot breathe. They wish someone would have told them to stop.” I don’t get to do follow-ups, so I don’t know for sure, but I believe these patients hear me. I have to believe it.

When I think of the different places I’ve worked, I see faces of people I’ve worked with. You fall in love with them. You’re with them in these very intense situations. If you can pull together as a team, you’re so thankful for every little victory — that you got that heart attack shipped out fast or that catheter in. I watch my co-workers deal with death and dying with such grace, such humanity that I can’t help but love them.

I’m working at [Prince George’s Hospital Center] part time now. I love it. It feels like home. I think it’s because PG is where I’ve come into my own, grown as a physician. It’s where I’ve been most in the trenches, where I get sick, sick patients. Because I’ve had so many dying patients, I’ve developed a style. I touch people. I give them a hug. I will say to a family, “I can go in and press on your loved one’s chest some more, but I think it’s best if you be with them, because the odds aren’t good.”

I long for community, of being in one place all the time, but this has taught me to make a connection, to be fully present for the patient and the people I’m working with, no matter where I am.

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