When I was graduating from high school in 1996, the television show, ER, was reaching the height of its fervor. I enrolled at Ohio State that year knowing that I wanted to be a physician, but unsure of what my specialty would be. I knew that I loved the adrenaline rush that comes with sports, I enjoyed working in a team atmosphere, and I thrived on leadership roles. When I watched George Clooney as Dr. Doug Ross on ER, I pictured myself barking out orders and saving lives in the ER. I must admit that as I finish my first year of life out of residency, I have not been disappointed by my choice. I'm not trying to say that my life is like an NBC drama. Some days it's filled with patients with chronic back pain, nursing home patients with urinary tract infections, and colicky babies. But it does still have its "ER" moments.

I can't think of any other specialty where one can lead a trauma code, resuscitate a sick patient with a life-threatening burn, or shout out medication orders as you save someone with near-death anaphylaxis after a bee sting. Each day I arrive at work wondering what awaits me. I discovered as a medical student that you can't study for a shift in the emergency department like a surgical student can prepare for the next day's appendectomy. Variety rules the day. As an emergency physician, you may have a college professor experiencing chest pain next to a college athlete with a shoulder dislocation in a room adjacent to a pregnant patient experiencing preterm labor. We, as emergency physicians, pride ourselves on a broad depth of knowledge that we can tap at a moments notice. In the emergency department is not enough to know the answer. You have to know the answer and have the courage to treat in the blink of an eye.

As a former hockey player and forever weekend warrior, I enjoy working at a place with a team atmosphere. The emergency department staff must function at all times as a team if they are to treat a dying patient. A perfect example is when a patient comes in with a cardiac arrest. An observer will see the attending emergency physician barking out orders; the emergency medicine resident may be at the head of the bed attempting to establish an airway while the pharmacist is drawing up medications. All the while, the nurses are starting IV's and the medical students are doing chest compressions. It takes a team of people working together in a high stress situation to resuscitate a sick patient. I pride myself on being able to teach and lead in those situations.

Emergency medicine gives me a great opportunity to be a leader. As the attending or head physician in an academic emergency department, I am in charge ensuring that the residents, students, nurses, patient care aids, and pharmacists are instituting the best care we possibly can. Much like Dr. Green, the attending physician on "ER", was a teacher and mentor to Carter the medical student, we spend much of our time teaching, leading, precepting, and ensuring that the residents are providing excellent care to the patients.

For patients in an academic or university emergency department, it can be confusing as to who their physician is. Many patients may see a medical student first, then a resident, followed by the attending physician. I try to explain this to them using the show, "ER", as an example. I may be seen explaining, "Mrs. Jones, the first person you saw was a medical student, like Carter on the show 'ER'. The second person you saw was a resident physician, like Dr. Benton". Finally I will say, "Hello, my name is Dr. Nick Kman. I am the attending physician and I will be your Dr. Green."

My wife must occasionally remind me that I am no George Clooney.