Possibly I was just paying attention more than usual, or it was just the odd collision of random events that flashed a bright light on our existence as emergency physicians. During a busy evening shift, I encountered two events that made me look both inward and outward to gain a better understanding of what we do and how we are viewed by others.

WE STILL PRACTICE IN A WORLD WHERE SPECIALISTS DESCEND FROM ABOVE AND BARK ORDERS LIKE WE ARE THEIR INDENTURED SERVANTS.

I received a phone call from a prominent person (more in his own mind) at my institution to tell me he and his partner would be arriving soon for treatment of his colleague's back pain. I told him we would leave the light on for him, and I proceeded to care for the sick and those who think they might be sick.

When I finished suturing the victim of a kitchen mishap, I learned that royalty had arrived 10 minutes prior, and they awaited me.

I made a quick note in the EMR, answered two phone calls, and discharged the boy with the laceration. To his highness, it seemed that I was doing nothing at all, when in fact I was providing important discharge instructions, speaking with the radiologist about a carotid aneurysm, and accepting a patient with a crushed hand in transfer from an outlying hospital. I actually packed quite a bit into those 5 minutes.

However, to this person–who should know better–I was sitting on my butt.

You can imagine the tirade that followed, with the threats to make trouble for me, and the storming off to radiology to handle the problem himself. At moments like that I recall the scene in "Top Gun" when Maverick has created trouble and his co-pilot, Goose, suggests to him that they could consider going to trucking school.

At the time, I was angry–and I even told this doctor that I thought he was being a … well, you know. Believe it or not, that did not help. Who knew?

While it was satisfying at the time, I later remembered the sage advice of Dr. Sam Kiehl: Don't let someone's actions dictate your reaction. That piece of wisdom has served me well over the years–except, of course, when I forget it.

Not long after that wonderful experience, a breathless nurse asked me to check on the quite elderly man in Room 9 who had a sudden turn for the worse. He had arrived intubated earlier in the evening and was awaiting ICU admission. The man had taken a large overdose of sedatives and pain meds and had been stable on the ventilator. The physiologic stress was too much for him, and he developed v-tach.