Business

ON THE JOB

ER doctor ‘hard-wired’ for high-stress job

Bryan Canterbury is a longtime emergency medicine physician, and works at Newton-Wellesley Hospital.
Josh Reynolds for The Boston Globe
Bryan Canterbury is a longtime emergency medicine physician, and works at Newton-Wellesley Hospital.

Bryan Canterbury is a longtime emergency medicine physician, working in ERs from inner city Cleveland to the outback of Australia.

He’s now at Newton-Wellesley Hospital, where 60,000 patients annually come through the door for everything from an ear infection to life-threatening injuries.

While all emergency rooms have something in common, it’s hard to capture the true essence of the operation, Canterbury says. “It can be hours of boredom followed by minutes of sheer terror. It’s the bizarre that you cannot make up. We’ve often said we should write a book, but no one would believe it’s real.”

The shift work and intensity of work lead to a high-burn out rate for these physicians; Canterbury admits that a few years ago, he was on the verge of burnout, fantasizing about getting his MBA and becoming a mergers and acquisitions banker.

But, as he explains to the Globe, he realized he was “hard-wired” for the ER:

“Nothing makes me itch quite like a patient with lice. Or maybe scabies. Maggots are no big deal — they’re actually taking care of dead tissue and can be a benefit. I once had a patient with a tracheostomy (hole in the neck they breathe through) that was coughing up thick yellow gunk. That kinda got me. But anything can happen at any moment in the ER, and that’s why I love it.

“Mondays are the busiest day in every ER I’ve worked in except Alice Springs, Australia; there’s it’s Tuesday — it takes an extra day just to travel to the distant clinic. Playoff and Pats games are when we are least busy; full moons can be busy, but I’ve seen those go both ways.

“The most common complaint is chest pain and shortness of breath, but I’ve taken care of mass casualty wounds to dental pain, blisters, and the occasional sunburn. I’ve delivered babies and held the hands of the patient as they take their last breath.

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“One of the strangest things I’ve seen was a patient who was stuck in handcuffs; the fire department wasn’t able to cut them off, so they sent him to us and I was able to pry them open. I also once had to remove a Red Sox World Championship ring the owner couldn’t get off his finger. I didn’t try to cut it off because I knew I’d be run out of town very quickly if I did that, so I took a piece of string and wound the ring off.

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“The best part of emergency medicine is the shift work; this is also the worst part. You go in, work and go home. No on-call, no follow-up on lab results, no dealing with the paperwork that goes with prior authorizations. But you do lose on the longitudinal aspect of medicine that you see in primary care and there is a certain level of stress — people don’t come in for well-visits.

“At Newton-Wellesley, there are 20 ER docs as well as physician assistants and a slow day might be six patients in seven hours; an extremely busy day could be 35 patients in eight hours. Once I came in and there were eight ambulances in the bay. That was a very hectic day.

“I also often work at Newton-Wellesley on Marathon Monday; as a triathlete and runner myself, I know how disappointing it is to end up in the ER. But even though my wife is a pediatrician and I’m an ER doc, our kids still end up in the ER from time to tie; once it was for severe coup, and another time, a knee injury from a trampoline. And there’s nothing more embarrassing to go to my own ER to for something silly, like cutting myself with a steak knife.

“But I always try not to take myself too seriously and decompress with laughter. That’s why for years, I’ve put this line as my e-mail signature: ‘ “If there are no dogs in heaven, then when I die I want to go where they went.” — Will Rogers.’ It helps me keep things in perspective.”

Cindy Atoji Keene can be reached at cindy.atoji@gmail.com.