Now, we can confirm the diagnosis of cholecystitis and tell the surgeon, while the antibiotic runs, the width of the common bile duct.

In the past, a 45-year-old who suffered chest pain climbing steps would be admitted to rule out MI and get a stress test the next day.

Now, we can quickly rule out myo­cardial damage and also order a chest CT to rule out pulmonary embolism, aortic dissection, and coronary artery disease.

These are just two of the many examples of how our specialty has adapted to and embraced the changes that have occurred in other specialties. Any advance in the acute care of patients in a given specialty becomes our advance and our challenge as well. This is exciting stuff, and it explains why we remain the most nimble specialty of all.

The other thing I like is that we are the last true generalists. Name one other specialty where in 1 week you could place a chest tube, deliver a baby, convert atrial fibrillation, do an LP on an infant, remove a corneal rust ring, close a complex laceration, reduce a dislocated shoulder, diagnose and treat sepsis, recognize scabies, treat acetaminophen poisoning, remove a bug from an ear, council a patient about sexually transmitted disease, nasally intubate someone in respiratory failure, diagnose Bell’s palsy, and coordinate nursing home placement for an elderly man with dementia.

Most other physicians won’t admit it, but they really do rely on us in the ED, and we make an enormous impact on the care of the patients that we share. I also believe that many are secretly envious of all the skills we have. They may not enjoy the chaos of our workplace, but they would love to have our skill set.

I think students gravitate to EM because we practice the way that country doctors used to practice. In that day, you were required to do everything for the patient. Luckily, most of us are not as completely alone as many old-time country doctors were; but the can-do mentality still lives in EM. A wide knowledge base, years of experience, and a large portion of humility served those doctors well.

Us too.

Dr. Baehren 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.