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ER Goddess: My Stupid Heart Belongs to Medicine : Emergency Medicine News


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I’ve been writing this column since 2015. I’ve poured out my frustrations and revelations related to our crazy specialty in an article every month for over six years. This month, as I sit down to write my 75th article for REM, I’m having a little trouble finding a compelling topic that isn’t a variation on a theme that has appeared in my other 74 articles. My same laments keep coming back.

I’m usually inclined to use my pieces to express how difficult medicine is getting. My fourth article, exactly six years ago, was titled “A Career in Medicine is a Cruel Mistress,” and that theme has come up ever since. “Billboard Slaves”, “Looking for the Exit”, and “Beloved Heroes or Replaceable Widgets?” are just a few examples.

My other favorite topic is physician mental health, or lack thereof. My very first article, in November 2015, was “Suffering in Silence No More,” and since then I have been anything but silent about the struggles we face. “#DocsTalkSuicide: Ending the Silence”, “Overcoming Depression is a Journey, Not Just the Flip of a Switch” and “Be Your Own Hero: Say No and Set Limits” are some of the articles I have written on the mental health of physicians. .

I’ve been saying the same things for years, since before the pandemic, and unfortunately it always seems necessary to repeat them. It’s hard as a writer to continually come up with new, creative ways to advocate for the same physician needs. Yet it is infinitely more difficult for a doctor to watch the state of medicine continue to deteriorate, leaving more of our needs unmet. It’s almost to the point where words seem superfluous because the dire situation speaks for itself: no beds, colleagues dying, mass exoduses of nurses. My weak articles are like screaming into a hurricane.

Nothing worthwhile comes easy

Yet here I am, still writing and still writing my post for February 2022. Why? Well, for starters, silence feels like giving up. More importantly, my stupid heart belongs to medicine. If I had the strength to leave, I would have done it already, but I can’t. I blame the big naked winged baby we celebrate this month; this cursed cherub can be some kind of moron with his blind arrow. Cupid’s cursed medicine arrow pierced my unhappy heart over 30 years ago, and here we are.

Just as one always manages to love a surly uncle, inappropriate aunt, or rival sibling, I always feel love for medicine even when I don’t really love it. Like all loved ones, medicine can be tough, but nothing worthwhile ever comes easy. Fulfillment will not be found by avoiding difficult conversations, awkward extended family gatherings, depressing funerals, and all the other difficult parts of relationships. Likewise, true fulfillment will not be found day trading from the couch instead of digging into more emotionally and even physically taxing, yet meaningful work. It’s hard, but the real satisfaction comes from not walking away when things get uncomfortable.

The house of medicine is certainly dysfunctional, but it is my house. I may lament the hardships of being in this profession, but I will be no more tolerant of non-doctors who do shit to us than my son Graham would be of someone outside our family who threatens his brother Cole. My sons can hurl insults at each other at home, but Graham will hurl himself onto a football field waving his fists if he sees another child fighting with his brother. My relationship with medicine is similar. After a decade in training and two in the trenches, she has as much place in my heart as my sons, my sister, my parents, my fiancé. Like all my relatives, it may be boring, but it’s my pain in the ass.

Cupid may have been drunk, but for better or for worse, dear medicine, I’m stuck with you. When I sit down to write and my same laments come back, I will dutifully put them on the page because I care. I will say what must be said about the consequences of corporate medicine on doctors and patients, and I will repeat it as many times as necessary, even if I look like a nag.

Six years from now, I could very well have written 150 articles that are all variations on the same themes because that’s what matters to my huge, stupidly loyal, medicine-loving heart. Each post is a testament to how much I care, a love letter, and when you cherish something, you don’t stay silent.

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Dr Simonsis a full-time nighttime emergency physician in Richmond, Va., and mother of two. Follow her on Twitter@ERGoddessMD, and read its past columns at