OVERVIEW
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Residency SpotlightAn Interview with Stephen Cantrill, MD
Tell us a little about your life before coming to Denver? I grew up in the California, the Bay Area. I had a pretty normal high school experience, and I was a state champion in wrestling. When it came time to go to college, I decided I wanted to see what was going on in the rest of the country and headed East to attend Brown University. I decided to go into medicine pretty early on, but I also got involved in computers and had some extraordinary opportunities in that field while at Brown. For instance, I was able to take over the entire university computer system to work on a medical diagnostic program. After college, I wanted to pursue a career in both medicine and computers. After two years at Case Western Reserve, I transferred to the University of Vermont to continue medical school and do grant work for the hospital application of computers and electronic medical records. What did that work entail? Through our work, we transitioned an entire hospital ward to computerized order entry and tied the ward into the lab and pharmacy via computers. We also created a system for electronic progress notes. Keep in mind this was way back in the early 1970s! I finished medical school at Vermont but continued with the research for another five years before starting internship. How did you choose emergency medicine? After medical school, I did a surgical internship and was considering vascular surgery. I was approaching my mid-30’s, however, and the prospect of another seven years of training was not appealing. A surgeon whom I worked with had a son in emergency medicine residency at Hennepin County. After talking to him, I realized the breadth of the specialty and the opportunity to perform procedures. Also, the practical application of medicine appealed to me, so I applied for an emergency medicine residency and was fortunate enough to be accepted into the program in Denver. I started in 1979 and finished in 1981, since back then it was a 2 year program after internship. At the end of my residency, I was asked to continue on as staff at Denver Health. What was the program like in its early years--was it drastically different than it is today? Back then, the curriculum was not as well delineated or as well organized as it is today. In terms of the practice of medicine, with the exception of the technology, many of the aspects of the practice of emergency medicine are exactly the same. You could walk into the ED back then and practice emergency medicine exactly like you do now. What memories stand out from your residency? I remember specific patients, both the tragic and the humorous. Some have become Denver Health legend but are, in fact, true. I remember one unruly patient who was in restraints on the medicine side of the ED. When unsupervised, she got out of her restraints, removed her gown, and crawled up into the false ceiling. She proceeded to crawl around the false ceiling until she fell through it and landed naked on the floor by the bio-phone. I can also remember a New Year’s Eve night shift when by seven o’clock in the morning we had so many intoxicated patients that they lined the entire edge of the department on the floor. We had them all lined up on their sides so that they wouldn’t vomit or aspirate. There just wasn’t any place to put them all. What are some of the changes you have seen in emergency medicine? The biggest change early on was that emergency medicine became a formal specialty. Back then, people tried to talk you out of becoming an emergency physician. I remember one of the surgery attendings saying to me as an intern, “Steve, be a real doctor, be a surgeon.” So, the creation of the specialty and the evolution of the specialty outside of our physical department has been the biggest thing. What challenges do you see for emergency medicine in the future? As you know, our healthcare system nationally is severely broken, and we have politicians who are not motivated to fix it. Until this is fixed, we will continue to see many of the problems that currently plague emergency medicine. One of the main challenges is the delay in getting maintenance care for patients. Eventually something catastrophic happens to them, and it ends up costing more to treat them as a result. Your career has been incredibly diverse—from working with hospital-based computer systems, to consulting for NASA, to your current national work on disaster management. Can you tell us a bit more about some of these pursuits? One of the advantages of emergency medicine and of working at Denver Health is that I have had the opportunity to pursue various interests. Early on, I was involved with the ACEP national Council and the Clinical Policy committee. I also serve as an oral board examiner. As for NASA, I was asked to serve as a consultant for the space station and a future Mars mission to evaluate their medical equipment and technology and the medical training of the astronauts. NASA even offered me the chance to go up in the “Vomit Comet” used by the astronauts for training, but I never took them up on it due to other obligations. In 2000, during the Summit of 8 Conference in Denver, we became a kind of test bed for national weapons of mass destruction training. We became involved with this training when few were interested in the field and those who were involved were considered quite odd. I was following my nose because I found the topic interesting. Currently, I’m finishing up on a national computerized system for hospitals to use to monitor bed availability during times of national need. Having the flexibility and freedom to do all these things has really been marvelous. You never quite know where your career will end up. If you were to tell me 15 years ago that I would be teaching weapons of mass destruction courses, I would have told you that you were crazy. You’re known for wearing bow ties in the ED. Residents have always speculated as to why. Is it really because of a rectal exam that went terribly wrong? No. I have told a joke about a guy ruining his tie by doing a rectal exam, and people who were intuitive assumed it was me-- but it happened at Strong Memorial in Rochester. However, one time I did end up dragging my tie though a guy’s chest during a thoracotomy. Nurses eventually began to question me why I had a regular tie on at work, because I wore both, so it was easier to switch completely to bow ties. How do you plan to spend your time during retirement? I have been at work every day since my “retirement.” I am currently finishing grant work with the BNICE [Biological, Nuclear, Incendiary, Chemical and Explosive] training and HAvBED [Hospital Available Beds for Emergencies and Disasters] program. Additionally, I am working on a grant dealing with alternative mass medical care sites, a project that grew out of hurricanes Katrina and Rita. Once these are completed, I plan on picking up the occasional ED shift. I miss the clinical work and resident contact. To me, that is really what it is all about: caring for patients and teaching residents. Additionally, I would like to do more traveling, woodworking and gardening. I am also looking forward to time to get through about five stacks of books that I have not had a time to read. Do you have any recommendations about preventing burnout for those of us in the early stages of our careers? Everyone is different, and we are still learning about physician burnout. One of the things that really protected me was the ability to do so many different things in medicine. It wasn’t just putting in shifts day in and day out. It was working with residents, serving on committees, and being an examiner. All of these things brought great variability to my career, so boredom never really set in. If you are starting to get burned out in one area, try something else within the field for a while. It was really that flexibility that kept me going in the field. |
