Emergency Exigencies: A Postgraduate’s Prescription For Enriching Emergency Medicine Understanding

Written by Dr. Afeefa M Hakeem, MBBS, MD Emergency Medicine

Dr. Hakeem is a post graduate in the field of emergency medicine with an ideology to emphasize and excel in her field. Read on as she describes the field of Emergency Medicine, and gives a snapshot of her life in the ER.

Our nation has a massively growing population, where the birth:death ratio is 2.4:1, where almost for every two births, one death occurs, and the leading causes of death are cardiac arrests, myocardial infarctions, strokes, acute respiratory distress syndromes, road traffic accidents, polytrauma, poisoning, and burns. In in the all these situations, the golden period of the first 60 minutes of treatment plays a pivotal role.^[1]

That is where the role of the emergency department comes in, which has come a long way in India; from the recognition as an official department in the year 2009, to now, where the setting of the causality is to play a role of a post-office, to divert cases to the respective departments, and the doctors have the mind-set of managing cases with acute-to-serious illness, we have officially gone from “causality medical officers” to “emergency physicians”.^[2] 

I am pursuing my post-graduation in the field of emergency medicine, with my fuel being adrenaline, which, to us ER doctors, is an emotion. It is here in the ER, where my life is completely balanced between shifts and studies. While my fellow postgraduates have shifts according to their respective units and have off-duty days, we emergency warriors work always within our shift limits, to ensure you never see our department with the doors locked as soon as the OPD timings are done. There is always someone to replace another, whether day or night.

As mentioned earlier, shifts are the worst part of my department, but this ideology is also the best. With a stretch of 12 hours, being in shifts drains you completely and makes you weary, but once you handover the responsibility to the doctor on the next shift, the next 12 hours are completely yours, without any calls from your fellow healthcare professionals or any other interruptions, except for the classes which you have to attend, no matter when your shift is.

Sometimes it becomes difficult – equilibrating between the academics and where to adapt that knowledge, while also portraying skills in saving lives in the emergency room, in order to be marked as commendable physician. The curriculum is so boundless that you have to eventually know about all the other subjects, as they comprise within your limits of resuscitating and saving lives. Eventually we come know so much about every other subject, that we become the jack of all trades, and exist with the sense of gratitude of being the doctor you dreamt of, while also reviving lives.

Moreover, working in the high intensity of atmosphere has truly sharpened my ability to make quick decisions, which adds on to my crucial skill list in pursuing my degree. This specialty also thrives on teamwork by providing opportunities to collaborate with other various healthcare professionals, and looking farther ahead we all know that “Rome was not built in a day”. I still feel as a postgraduate that this branch will definitely have abundant career growth including leadership roles in emergency departments and academic institutions.

While emergency medicine is undeniably exhilarating and rewarding, it comes with its own set of challenges and drawbacks that warrant careful considerations. The major ones among these is firstly. emotional toll due to dealing with trauma, critically ill patients and unexpected outcomes, secondly being at higher risk of encountering violence from the patients and companions, and thirdly, navigating complex legal and ethical dilemmas such as informed consent, end of life care decisions, and patient confidentiality.

Despite the challenges and uncertainties inherent in emergency medicine, it remains a deeply rewarding and impactful field, where every decision and action can make a life-saving difference.

As I embark on my journey of being the emergency physician, I would like to carry forward lessons learnt, experiences gained and commitment to excellence that defines my profession.

REFERENCES

1. India data (no date) World Health Organization. Available at: https://data.who.int/countries/356 (Accessed: 01 May 2024).
2. Misra, A., Yadav, D.C. and Kole, T. (2023) ‘Emergency care in India beyond 75 years of Independence – problems and solutions’, Journal of Global Health, 13. doi:10.7189/jogh.13.03015.