Why I Keep Coming Back To The ER: Reflections From A Seasoned Attending


By Veronica Bonales, MD 

Last night, one of my work colleagues asked me how I do it. I looked over at them, a little confused. They looked back at me earnestly. How do I continue to come to work every shift and not burn out? How do I keep finding meaning in what I am doing? How?

They’re a yearling emergency medicine attending. They’re just getting started in their career, whereas I am several long years into mine. They explained that they were already feeling the effects of working in a broken system; where some days, it felt more like “catch and release” instead of helping others and saving lives. I thought for a moment, and the only thing I could think of at 3 a.m. was that I was solely reaping the benefits. I thought about all the things I could do because of my career. I work hard so I can then play harder. The work becomes a means to an end.

At that hour, they nodded slightly at my reply. I could tell it hadn’t been the answer they had hoped for. I think they expected some sage advice from a seasoned EM attending. But, that was my reply in the wee hours of the morning when I was equally weary and tired by the continuous wave that seemed to come in 24 hours a day instead of like “in the old days” when there used to be a brief respite during those early morning hours.

However, in light of a brand new day and several hours of good sleep, I started to think of a different response. We do what we do because we can’t imagine doing anything else. Thinking back, I knew that no matter what I became when I grew up, it would involve being of service to others. I’ve always had a natural inclination to help, teach, lead, and be a part of something bigger. Yes, I’ve thought about that previous want to be a travel photojournalist, but even then, I wanted to share stories that made people think, inspired people to be better, that challenged people to do more.

I’m at the point in my career where I look for small victories. Yes, the everyday frustrations of working in the medical field slap me in the face most every shift, but I look for that small bit of hope, of humor, of that sense that I am actually helping someone and making a difference in their life whether it be the Narcan’d patient in room 7 or the medical student who is still trying to learn to use their medical skills. I work in the present and toward the future. Now, if that allows me to continue to travel and enjoy my own moments of joy, well, I helped someone else while doing it.

Veronica Bonales is an emergency physician.


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    • Editor-in Chief:
    • Theodore Massey
    • Editor:
    • Robert Sokonow
    • Editorial Staff:
    • Musaba Dekau
      Lin Takahashi
      Thomas Levine
      Cynthia Casteneda Avina
      Ronald Harvinger
      Lisa Andonis

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