Every month, our editorial team meets to discuss, plan, and choose content to be published on the pages of ACEP Now. Several of our Editorial Advisory Board members have joined these meetings for a chance to peek behind the curtain of ACEP’s newsmagazine. As they can attest, much thought and deliberation goes into every single piece of content—solicited or unsolicited, accepted or denied, and all of those we eventually publish. In the August 2022 issue, you will read a thoughtful clinical case study from Dr. Trent Stephenson on thoracic outlet syndrome as well as our usual menagerie of columns including Dr. James Augustine’s reflections on emergency department operations and Dr. Lauren Westafer’s review of the data on frequent pulse checks during CPR. Additionally, please peruse ACEP Senior Content Manager Jordan Grantham’s highlight on ACEP’s new Strategic Plan and hear directly from ACEP’s 2022 Board candidates.

But you may also notice a theme emerging from some of the other pieces in this issue: they touch on controversial issues. This is both a symptom and side-effect of our current social, political, and professional climate. The topics discussed here are meant to highlight the work, and the worries, of our profession. Dr. Atsuko Koyama et al. and Lauren Paulk, Esq. discuss the clinical and legal impacts of the recent Supreme Court ruling and because we published one of these articles online already, we’re also able to include rapid-fire commentary from our readers in this print issue. Editor Danielle Galian explores the wide-ranging opinions on personal firearms in the emergency department. And Dr. Vidya Eswaran challenges emergency physicians to address gun violence in our own communities.

In our profession we are not immune to difficult discussions. We do not shy away from talking about code status with people who were strangers only moments before, nor should we shy away from talking about abortion or guns when it impacts our patients or the practices of medicine. No matter which side you take, each topic affects us all professionally and personally.

I believe that every emergency physician not only has a right to have an opinion, but also to substantively express it. As Medical Editor in Chief of ACEP Now, my goal has been to share what’s happening in emergency medicine, curating both the clinical and cultural aspects of our lives. It requires a balance in perspective that is at the core of my editorial philosophy—representation and respect for all. Unlike psychiatry or general surgery, emergency physicians have been historically split down the middle of the aisle politically.¹ Because of this, no one should expect consensus from emergency physicians on the difficult questions outlined in this issue. Our diversity of experience and opinion is what makes emergency medicine, the American College of Emergency Physicians, and America itself enriching. I hope that you will enjoy reading this issue, and most of all, learn something new from what you find inside.