Emergency Physician | Disaster Med | Ultrasound | Pain | EM Fellowship Director @emergmedottawa | Writing “ROSC” on Substack — raw stories from the frontlines
Ottawa, Ontario
Joined October 2018
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Posted my 100th article today. Thank you readers for keeping this initiative growing.
mikerubinmd.substack.com/p/t…
#ROSC #emergencymedicine
Gender inequity in emergency medicine #medicine #physician #emergencymedicine
open.substack.com/pub/mikeru…
I thought I understood the emergency department.
Then I became the patient.
It wasn’t what I expected.
When the Emergency Doctor Became the Patient open.substack.com/pub/mikeru…
Most people think the hard part of emergency medicine is the decisions.
It’s not.
It’s what you carry after.
open.substack.com/pub/mikeru…
Not a missed diagnosis.
Not a bad outcome.
A complaint about wait times.
Something completely out of my control.
And yet—mine to answer for.
open.substack.com/pub/mikeru…
Curious how others experience this—
If you work in high-stakes environments, do decisions ever follow you home?
Or is that just medicine?
open.substack.com/pub/mikeru…
We don’t discharge patients because we’re certain.
We discharge them because the risk feels low enough.
That’s a very different thing.
open.substack.com/pub/mikeru…
Gender inequity in EM isn’t personal failure—it’s structural.
open.substack.com/pub/mikeru…
The system does not flex; women do.
In emergency medicine, that quiet accumulation of friction shapes careers, burnout, and who gets to stay.
On gender inequity, family life, and design failure.
open.substack.com/pub/mikeru…
PTSD isn’t something we think happens to us.
In emergency medicine, we call it the job.
That’s why we miss the injury.
New piece ⬇️
PTSD? No—Not Me open.substack.com/pub/mikeru…
Moral injury isn’t burnout.
It’s what happens when clinicians are held responsible for system failures they don’t control — and then blamed when patients are understandably frustrated.
I resurfaced an essay about this today.
open.substack.com/pub/mikeru…
Why Emergency Physicians have the shortest life expectancy
open.substack.com/pub/mikeru…