A Budding Emergencist
Monday, July 31, 2006
  "if you build it, they will come

Note: this began as a comment reply, but I dug the idea of "build it and they will come," so here's my thoughts:

Hey platypus,

Thanks for visiting! I love your blog. From the trenches, eh?

No, no, it is true--build it and they will come. I think it's some kind of corrolary to Parkinson's rule where work grows to fill the time alloted to it.

Bear with me for a minute here, it's like this: Long ago, I stopped beig a perfectionist. I was working for a painter, cleaning up and painting repo'ed HUD homes for the state to sell. Now, it's understandable that having your house repo'ed is not an incentive to keep it sparkling clean. But this house was a ****hole; there was a dead bird in one of the cabinets, and the grease was 2 inches thick on the kitchen floor. I started scrubbing the kitchen floor. 2 hours later, I had reduced about 1/4 of the grime coving the floor to a fine mist that was insidiously making me insane. My boss comes over, and says, "What the hell? This should take 1/2 hour, not 10! Stop being such a perfectionist, you'll never get anything done."

I realized then that "good enough" was a worthwhile goal to strive for, and now I'm realizing that it's very important in medicine. In a small and busy ER, the idea is, get them stabilized, and get them wherever the hell they're going, NOW! But in a slightly larger ER, it's "well, we're not that socked in, so I can get that CT that would make the diagnosis a slam dunk." Yes? Makes sense, yes? Is good?
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Emergency medicine, from the beginning of a new doctor's career.

Location: Big City, Metropolis, United States

Walk softly and carry a big vocabulary. Don't be inhuman. Find and greet God in every person you meet. The patient is the one with the disease. Do not get distracted. Charity begins at home. Do good and be happy. Don't just do something, stand still. Wear sunscreen. Don't get anyone pregnant, and don't go to jail, young man. Budget your luxuries first. You don't know what you don't know. People like learning, they just don't like being taught. When in doubt, go out. When life gives you lemons, make lemonade. Honey attracts more flies than vinegar.

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