Discussions

There were nights early in my career when I’d finish restocking the truck, close the back doors, and sit down on the stretcher in the dark. No monitor alarms. No radio traffic. No partner talking. Just me, sitting where my patients sat. I’d look around the back of the ambulance and try to see it from their perspective. The bright overhead lights. Cabinets packed with equipment they didn’t understand. Strangers in uniforms speaking a language that sounded more like a foreign d

Every profession has a culture. Firehouses. EMS. Infantry. Special operations. Even the offices full of people who’ve never touched a patient or a weapon in their life. They’ve got one too. Culture is what shapes how you think, how you act, how you treat people, and how you perform when it actually matters. The Lie We Tell Ourselves: Burnout = Experience Somewhere along the way, we started confusing burnout with credibility. The salty medic. The pissed-off firefighter. The gu

How we Turned a Physiology Concept into a Checkbox You walk in on another “dizzy” patient. Vitals are “normal.” Your partner says, “Let’s get orthostatics.” We’re about to waste time collecting numbers that feel clinical… but don’t actually help you make a better decision. Let’s clear this up. Myth #1: Orthostatics Diagnose Hypovolemia They don’t. The classic teaching says a drop in systolic BP ≥20 mmHg or a rise in HR ≥20 bpm = volume depletion. Sounds clean. Sounds scientif