I tell my daughters that the biggest difference between adulthood and a childhood is that decisions get more difficult as we grow up, and here’s proof: I have worked my last shift as an emergency room doc. I can’t believe I am saying that, but there it is, one of the most difficult decisions I have ever made.
The main reason to hang up my ER spurs is something else I can’t believe I’m saying — I am getting too old to work the way I have been. My ER shifts are always at night, sandwiched between full days as a family doc and hospital administrator. The 40 hours straight once or twice a week used to be a breeze when I was just a kid physician who bounced back from them like a tennis ball thrown hard against the wall.
At age 54, on the other hand, 40 hours straight leaves me feeling more like an egg thrown against the wall. Even if I go to bed early the night before my shift, then go to bed early the night after, two days later I still feel like something that ought to be culled from the herd and left for wolves.
And speaking of hard truths, here’s another: at 54 I am now “mature” enough to know that my “use by” date could be right around the corner. My father, after all, found out his shelf life ended at age 39, when a heart attack dropped him in his tracks. In the hourglass of my time, I feel the sand much more than I used to, including the speed with which it slips through my grasping hands and the accumulating weight of it now up around my waist.
When I was young and my time seemed infinite, taking lots of it to work didn’t feel like a tradeoff. Now, every minute with my youngest daughter still home, for example, seems precious. For some reason the possibility of losing my future with my wife to a pulp truck on the road home from the ER seems more real now than it used to, perhaps because I take less for granted these days, or because I am still a kid in love who wants another 30 years with his main squeeze.
And then there’s this: I have never made an error in the ER for which I could not forgive myself. That does not mean I have not made errors, nor that some of the ones I have made will not sadden me forever for the harm that resulted. But it means I never made a deadly error that permanently harmed or killed a child, or was the result of sheer stupidity or carelessness. To walk away from 20 years in the ER and be able to say that is a gift one should not look in the mouth or take lightly.
More than that, I have been given the gift of 20 wonderful years of service in the emergency care of the people of the great state of Maine, in partnership with some of the finest people I have ever met. These years have added a tremendous clinical and emotional diversity to my professional life that goes way beyond what I ever expected when I started working in ERs while a resident in training in order to pay off crushing educational debts.
Leaving now means leaving the ER without tarnishing that gift by performing at less than the top of my game, or by playing in that great game long after I stopped enjoying the work. I have colleagues who are not so lucky.
Nothing about this decision will be more difficult than leaving behind the extraordinary hospital staffs with whom I have worked over these years. People such as Mark and John and Matt and Rachel, Chris, Maxine and so many others who stand on the ER line at night for the rest of us, holding back the forces of illness and death. Bless them all for what they have done for me and do for all of us, and thanks for the privilege of standing there with you for the last 20 years.
Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and interim CEO at Blue Hill Memorial Hospital.