25 Years in Emergency Medicine

25 years ago today- on July 6th, 1995, I walked into an ER and worked my first shift ever as a full-fledged emergency physician. Bill Clinton was in his first term as president, we were mourning the loss of Kurt Cobain, and the world of email and going "online" was still new. I was 28 years old, fresh out of residency, infused with the latest and greatest knowledge and skills, and full of piss and vinegar. You could have fired me out of a cannon. I was ready to take on the world; I had "arrived."  I thought I knew something.

Turns out, I  was a child who didn't know shit.

A quarter century and 4200 shifts later, I now know better. I may have had book smarts and enthusiasm, but I lacked emotional maturity. I could manage a difficult airway, calculate pediatric infusion rates, and juggle multiple traumas at once, but had absolutely no understanding of either myself or the humanity around me. 

I felt supercharged...entitled. My sense of entitlement led to behaviors that fed my ego, fed my disease. I became a condescending, snarky, arrogant asshole. But I had a mahogany wet bar stocked with all the top shelf stuff. BFD.

We were still newlyweds, still young, and in love. I had the opportunity of a lifetime, the chance to shine, and took it. We built a home life, had children. I immersed myself in active fatherhood. I became president of my hospital's medical staff. I established a merry little band of missionaries who went to Haiti and served an impoverished orphanage. 

Then I fucked it all up.

While I was doing it “all,” my alcoholism took crept up on me like a panther, then pounced.  It was subtle at first- beers at picnics, cocktails at professional gatherings. It eventually morphed into a drink after work, then two. Then it was every night after the kids went to bed. Eventually I abandoned the mixers, the social excuses...and then the glass entirely. In the end, I was gulping cheap vodka from a plastic bottle all night long while isolated in the windowless basement where I moved. This took 20 years. Then one day I went over the proverbial cliff, crashing  and burning in epic fashion, taking all those I loved down with me.

If I said these last four years in recovery have been rainbows and unicorns, I would be lying. No longer using my general anesthetic, I have been forced to feel the pain of decades of bad behavior and poor choices. I am divorced. To keep my medical license, I am tethered to a professionals’ monitoring program. My teenage children don’t speak to me. I am enduring the negative consequences of  my drinking career to this day.

But that's OK, it had to be that way. Nothing happens in God’s world by mistake. The “gift of desperation,” as they say in AA.

I am surviving. I am growing. I am healing. I am making living amends to those I love, one day at a time. 

...and I'm back to practicing the wonderful, godforsaken medical specialty I have loved since the nineties.