One of the reasons why I decided to do an away sub-internship in St. Louis is because it is vastly different from rural New Hampshire. I knew that if I wanted to work in an urban area, I would want some exposure during medical school.
My first week in St. Louis, I was assigned to the night shift in the ED. I had no idea what to expect. Nights in New Hampshire were filled with consults and floor management, but mostly were transfers due to complex surgical management. In New Hampshire, we mostly saw complicated perforated bowels, gallbladder removals, and motorcycle accidents. I had seen maybe 1 GSW (gunshot wound) over the course of 3 months in New Hampshire.
My first night in St. Louis, we admitted 5 GSWs. The pace of the ED was non-stop. When I arrived 30 minutes early, I met my chief resident in the middle of a procedure in the trauma bay. The first thing my attending said to me that night was, “You’re not in New Hampshire anymore.”
The pace of trauma at a major urban trauma center is exhilarating. There is non-stop action, the ORs are on call 24/7. And the teams come together so easily. It’s a chorus of chaos in the trauma bay, but everything is controlled. There is one person devoted to orchestrating the entire symphony of surgeons, ED providers, respiratory techs, nurses, and radiologists.
I learned a lot during my week of nights in the ED, from resuscitation to techniques including chest tubes, femoral sticks, and REBOA. It’s an exhausting time, and I applaud everyone who’s committed their career to work in the ED at night.