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    I happened upon this post after waking up at 1:30 AM after a troubling dream that seemed to be a mix of several cases from my past. I am a just retired emergency physician who well remembers walking out of the Ottawa Civic 38 years ago on the last day of my emergency medicine residency. There were no support groups then, or even a well structured program and my instructors were only a couple of years older than I was. No one felt the need to debrief, or inquire into the well-being of a colleague. The “lone ranger” mentality that keeps us going was strong and the only advice given was to just “suck it up”. That worked for most of us, for most of our careers. Emegency medicine has a hidden secret, however, and that is what happens to us as we age and the shifts are just as long; the shock, sadness and horror just as real; the world outside of the ED just as oblivious. My request to our academics, is to look beyond the recent trauma; look beyond the obvious signs of a stressed out colleague; start looking at what happens after 20, 30 or more years of life in the “pit”. I have known many emergency physicians in my career and truly believe a number of them carry some serious scars based on their career choice. They deny it and laugh, but there seems to be a melancholy about them that may be more than just my imagination. Our specialty is so young that we have limited experience with the generation that went before. I would propose that your research expand into the older members of our specialty and perhaps learn lessions that may help our young residents when they wake at 1:30 AM 38 years from now, reliving events of the distant past.

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