After an honorable discharge, he, his wife, and three sons moved to Thermopolis, Wyoming, where he joined a surgical practice (a fourth son was later born there). From 1968 to 1971, he was the only board-certified surgeon in the state. The demand for his skills, combined with his exceptional work ethic, resulted in exceedingly long hours, often causing him to forgo adequate sleep. He would drive back and forth over hundreds of miles from town to town, surgery to surgery.
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ACEP Now: Vol 38 – No 12 – December 2019On the road one night, he developed substernal chest pain. At 35 years old, he was having a myocardial infarction from coronary artery spasm that would end his career as a surgeon and help launch a new academic specialty.
A Career Shift
He later told me that he survived stunningly poor care in a local emergency department. At the time, care was provided in emergency rooms staffed by physicians without formal training. Emergency care was viewed by hospitals as a necessary evil, assigned in academic centers to the most junior house staff, usually without supervision.
Peter’s experience with the death of his father from poor emergency treatment and his own as a patient helped form his vision and conviction that patients in their most vulnerable stage of disease need the most-, not the least-, trained doctors.
After his recovery, he was told to cease surgical practice and find a less stressful occupation. He considered basic science, but the dean at the University of Chicago instead found him a restful, nonstressful position as the director of the division of emergency medicine. When he took the job, he imagined he would simply continue to practice as a surgeon and that emergency medicine would be an administrative duty. However, the responsibilities to his patients and his department soon led to adversarial relations with other specialties, including the chair of surgery, to whom he reported.
Peter perceived that there was a different way to think when managing emergency patients and a different set of responsibilities. As few others had at that time, he saw the need for a new specialty and began to advocate for it. Despite years neglecting emergency patients writ large, physicians from other disciplines who frequently staffed emergency rooms were suddenly threatened by the loss of turf and income that the shift of emergency care to these new-fangled “emergency physicians” seemed to represent.
Peter was joining a movement still in its early stages. He served as a member of the American Board of Emergency Medicine’s original Board of Directors (from 1976 to 1986), which created the certification process in place today. Only a few years earlier, James Mills had written about one of the first EM practices, the “Alexandria Plan.” Community practitioners were just beginning to identify as emergency physicians. The nation’s first EM residency had recently been inaugurated in Cincinnati.
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9 Responses to “In Memory of Dr. Peter Rosen, a Founder of Emergency Medicine”
December 14, 2019
R HouleI still remember Dr Rosen’s famous “Pretzel Hold Story”.
December 15, 2019
Paul Orcutt MD, FACEPDr. Rosen was the one person I have always respected and admired. My only meeting with him was many decades ago when he administered my oral board exam.
Thank God I chose to study chose textbook for my oral exam.
Paul Orcutt MD FACEP
December 15, 2019
John C JohnsonThanks for the wonderful biography of a legend in EM. Peter was on the ABEM Board and as such could not take the exam until he had been off for I believe 5 or 10 years. When he got around to taking the oral, as was the practice – all oral examiners had the ability to cross off candidates that they felt they had a conflict of interest. With Peter’s cantankerous reputation, NO ONE, wanted to be his examiner. I knew him, of course. Ben Munger CEO of ABEM, came to me the first day of the exam and told me I HAD to test Peter in the double scenario. I reluctantly agreed. When Peter came into my room, I felt like standing and saluting. (think George Patton to imagine the moment) One of the scenarios involved a pancreatitis and one of the critical points was to order an amylase. He did a perfect exam and ordered his KUB and lab, but did not mention amylase. Now what do I do. “Is there anything else you would like, Dr. Rosen” No thanks was the answer. When it later came time to reveal his x-ray and lab results, the amylase was on a separate page which I withheld. He asked – “where’s my amylase” – you didn’t order one my answer – “you caught that, eh ? I would like to order one now” – shortly he got his result. Catastrophe avoided – I would have had to fail Peter Rosen.
December 29, 2019
Donna HelgrenI was fortunate that a large portion of my nursing career was practiced in the ER of DGH. Dr. Rosen was a striking influence during those years. He promoted a team approach to provide the best care possible to all of the patients at every level of need.
February 6, 2020
Frank A MooreRIP.
We will carry on the fight in your honor.
February 8, 2020
Chris Hinson MDI had the chance to meet Dr. Rosen as a resident while at Cook County Hospital in Chicago while working with another Giant in medicine Dr. Quentin Young. He was indeed an impressive Humanitarian and dedicated to the proposition that Emergency physicians must be the best specialist outside of every other specialty and know every other specialty to a degree sufficient to do their job if necessary.
October 5, 2020
Marzieh Fathi“AS A WOMAN EMERGENCY PHYSICIAN IN A DEVELOPING COUNTRY, YOU SHOULD BE STUBBORN”.
I will never fotget your advice…dear Peter.
March 29, 2022
Terrence L. Jones MDAloha ‘Oe Peter,
Your guidance and influence have spread your mindset across the Emergency Medicine landscape, and it has been well appreciated. Mahalo my friend and mentor. You will be sorely missed, as well as Chinese food after the evening shift!
November 2, 2022
Rick PostOne of my life’s profound moments was when Dr Rosen pronounced an individual dead.
My dance studio was having a party at the Brown Palace hotel and when I walked into the hotel all my students were not in the restaurant they were in the hotel lobby. I was told an elderly man collapsed while dancing. Thinking it was one of my students I rushed to find it wasn’t one of my students, but this unknown woman grieving over her husband being worked on by EMTs. I volunteered to assist by driving her to the Denver General Hospital Emergency room, she was not in a condition to drive.
After 2 or 3 hrs Dr Rosen told this lady he did everything he could to save her husband’s life, but was unable to succeed.
I never experienced anything like this before. Speaking to this woman the way he did was so full of compassion and honesty that I will never forget this short conversation.
Dr Rosen left a memory with me that I’ll never forget.