You don’t have to be very smart to work in emergency medicine. If you know the first four letters of the alphabet, you’ll be fine:

A Airway – a month of anesthesia first year helps us learn to intubate

B Breathing – several months in the ICU teach us tricks to open up airways and keep lungs working.

C Circulation – a couple months of cardiology prime these skills

D Disability – trauma surgery hones your skills of physical exam for other injuries.

However, now that i am facing graduation, I reallize that there is one very important twist in the fundamentals of ABCD. And that is, D comes first. As a Senior, my thinking tends to thusly:

D – Disposition. When I pick up a chart, the first thing that instinctively flashes through my mind is “is this person sick, or not sick? Will they go home, or admit? WHo will I admit to?” This all happens in a flash now whether I am conscious of it or not. Only after I’ve considered D to I get to A, B and C again…