Our program at the University of Toledo graduated its first class of emergency medicine residents this year. Like all graduations we experienced the bittersweet feelings of the joy of accomplishment and the sadness of saying goodbye to men and women who have shared an important part of our lives for 3 years.

Saying goodbye to our first class was especially difficult because they blazed the trail with us and we shared new and exciting experiences. Subsequent children after the firstborn are never photographed as much nor are the memories quite so vivid. (We did not bronze anyone’s shoes.)

We did share memorable times in and out of the emergency department. There were outings to Mud Hens baseball, EMS days, and dinner at faculty homes. We remember the sad and tragic stories and the funny ones as well. Who can forget the psychiatric patient waiting for transport who wore a T-shirt that said, “I’m not the commitment type.”

Time scampered away as each month of training passed. And now that these residents have scattered to far off cities in states such as Florida, North Carolina (where a Southern accent does not seem out of place), and Nevada, I wonder if I was able to pass on the really important pearls of wisdom for medicine and for life.

There so many morsels to pass on. There are the simple and practical lessons on par with “Don’t eat yellow snow” and more profound teachings regarding balance in life and the traps of owning too many big people toys. I wonder if the speaking of these gems really sinks in. I believe many of these lessons need to be learned through personal experience. Sometimes you need to step in it to prove to yourself there has been a horse in the yard. People, to some degree, need to attend the school of hard knocks for a while to bring these lessons home. I must have a PhD by now.

Like most programs, we have a diverse collection of clinical and core faculty who practice and live in ways worthy of emulation. I’d like to think that we have passed on more than just the core curriculum. Did they get the part about empathy and respect, about ethical behavior, about being well rounded, and about being a good citizen of their community? I believe these are lessons learned from watching behavior, not listening to a lecture.

I learned quite a bit from Dr. Sam Kiehl when I was in residency and when I worked for him. Three things that he told me have stuck with me over the years. The reason these endure is that he lived them as well. Don’t let people’s actions dictate your reaction. Never do anything just for an extra charge on the bill. Don’t try to be a hero – admit people who have chest pain (this was before troponin).

I hope that part of me sticks with these new emergency physicians and that they recall my words and actions many years from now. Time and many new classes will pass before I know. Now I’m content to have marvelous memories and satisfaction that eight doctors are well-prepared and energized to begin their careers.

And the wheel turns on.

Be happy.

Dr. Behren lives in Ottawa Hills, Ohio. He practices emergency medicine and is an assistant professor at the University of Toledo (Ohio) Medical Center. Your feedback is welcome at David.Baehren@utoledo.edu.