Emergency medicine was approved as the 23rd medical specialty in 1979, shortly after a young Elsburgh Clarke, MD, discovered the burgeoning specialty.¹ Just one year prior, Dr. Clarke had begun an emergency medicine residency at what was then known as LA County–USC Hospital, Los Angeles.

“I was about two months into a family practice internship when I went to visit my uncle whose neighbor happened to be an ED resident,” Dr. Clarke said. “I spoke with him and said to myself, ‘This may be something that I want to do.’”

The specialty, he said, spoke to his interest in surgery and EMS in a way that family medicine did not. A phone call to LA County–USC revealed that the emergency medicine program had one spot left for the following year.

So, about one year after graduating medical school, Dr. Clarke was set to begin a decades-long career in emergency medicine … and he brought along his camera.

Firsthand Account

An ambulance bay at the LA County-USC Hospital in 1978. (Click to enlarge.)

The photos that Dr. Clarke took from 1978–1980 provide a glimpse into working in an emergency department in the years the specialty was being established. At first glance, one might notice the clothes—nurses in white dresses and doctors in wide ties or bellbottom jeans—or the hair—afros, sideburns, and mustaches aplenty. A closer look, though, also shows the technology of the day—a bulky, two-way radio for communicating with EMS, metal gurneys, glass saline bottles, and portable ECG monitors the size of a small shopping cart.

Less obvious to the eye is the experience of the people working in the photos.

“Emergency medicine was fairly new then, and most attendings were not emergency physicians,” Dr. Clarke said. “In fact, the director of emergency medicine at the time was head of OB–GYN, and the assistant director was a psychiatrist.”

Dr. Clarke is a part of a generation of physicians who shaped the specialty. They learned by doing, he said, by falling down and getting back up.

ED attendings Dr. Gerald Whelan and Dr. Shumary Chow supervising a full arrest in “C” booth—the main trauma room—with an ED tech administering CPR. (Click to enlarge.)

“We learned a lot by ourselves,” Dr. Clarke said. “Some of the residents who graduated in those first classes came back to be our mentors, but as far as attendings go … there weren’t any at that time.”