33 Brutally Honest Confessions From An ER Doctor That Changed The Way I Think About The Hospital

Recently, on Reddit, an emergency room doctor hosted an AMA, inviting users to “ask me anything” about their profession.

They started the thread by writing, “Hi Reddit, I’m an ER doctor with 5 years of experience working at a busy community trauma center. I’ve seen a wide spectrum of human experience come through those doors—car crashes, gunshot wounds, overdoses, and the truly bizarre. Some nights it’s nonstop controlled chaos; other times it’s quiet until it suddenly isn’t.

Ask me anything about what really happens behind the scenes—wild cases, ethical gray areas, tough conversations, dealing with patients who don’t want help, etc. I’ll answer as openly and honestly as I can, while respecting privacy and patient confidentiality. Let’s talk.”

Here are some of the best questions and answers from the AMA:

1.Q: What led you to become an ER doctor, and what part of your job could drive you away from wanting to continue to be one?

A: I was drawn to emergency medicine because I loved the variety, every rotation in med school had me thinking, “I want to do this,” and the ER let me do a bit of everything. I also really like the shift work. When my shift ends, I’m done. A full-time schedule is around 120 hours a month, so most days I still get to enjoy life outside the hospital.

I don’t really know what would make me leave. A lot of ER docs do burn out eventually, but so far, I still really love it.

2.Q: How much money do you make?

A: Right now, I make around $500K a year before taxes. It depends a lot on location, schedule, and whether you’re doing extra shifts or working in high-volume or underserved areas. Emergency medicine can pay well, but it definitely comes with its own stress and intensity. I have colleagues who make less and others who pulled in over a million last year.

3.Q: What would you keep at home if you really wanted to not die from anything that’s sometimes immediately fatal (ie, stroke, pulmonary embolism)?

A: If you’re thinking about true lifesavers for sudden, potentially fatal events, I always keep Narcan (naloxone) in my car; it’s easy to use and can absolutely save a life in an opioid overdose. Beyond that, though, most things like stroke or pulmonary embolism need rapid recognition and emergency care; you can’t really stock your way out of those. The best “kit” is knowing the warning signs and not waiting to call 911.

4.Q: One health tip for the general public given your position and experience?

A: If I had to give one health tip based on what I see every day: wear a seatbelt, don’t drive drunk, and stay off motorcycles. I’ve seen too many lives changed — or ended —because of those exact things. Simple choices, but they make a huge difference.

5.Q: I imagine you must have lost a patient at some point. How do you handle informing the family, and how do you make sure it doesn’t affect you personally?

A: Breaking bad news is something you learn to do over time; it’s never easy, but I try to approach it with honesty and compassion. I actually feel lucky to be able to sit with families during those moments and help guide them through it.

There are a few things I consider essential when it comes to delivering bad news.

First, make sure the entire team is on the same page. It’s important that no one gives conflicting or confusing information. Second, I always start by gently finding out what the family already knows or understands, which helps guide the conversation. Then I’m honest and direct. I try not to use vague language. I tell them clearly what happened, give them a moment to process, and then ask if they have any questions.

It’s also important to reassure them that we did everything we could, and that their loved one was treated with care and dignity, like we would treat our own family. You don’t need the perfect words; what people remember most is that you were present, honest, and kind.

6.Q: Recently, a wonderful younger doctor took care of us in the ER, and I would like to give him something to show our appreciation, but I’m not sure what. Any suggestions? Thanks for helping other humans survive!

A: Great question! Most of us can’t accept personal gifts, but sometimes people bring cookies or snacks for the whole staff, which is a kind gesture, though even that can be a bit delicate depending on hospital policy. Honestly, the best gift is to reach out to the hospital and share your appreciation directly, an email to leadership, a kind note, or even a Google review mentioning their name if allowed. That kind of recognition really does get back to us and means a lot.

7.Q: What’s the craziest case you saw?

A: One of the craziest cases I’ve seen was a young patient who had a massive pulmonary embolism (blood clot in the lungs) and was bleeding heavily into her abdomen at the same time. She was literally dying from clotting too much and bleeding too much at once. Treating one made the other worse — it was an incredibly tough balance and a real challenge medically.

She had a thrombectomy, then emergency surgery, and was placed on ECMO. Amazingly, she walked out of the hospital a few weeks later.

8.Q: What was the most surreal/bizarre situation you experienced during a shift?

A: A psych patient once escaped through the ceiling. Literally climbed up and got into the ductwork. Security had to call the police, and it turned into a full-on manhunt in the hospital. Definitely one of the more surreal nights.

9.Q: Have you seen The Pitt? If so, what does it get right and what does it get wrong?

A: Yes, I’ve seen The Pitt and honestly, it’s incredibly accurate when it comes to showing the emotional weight and chaotic pace of emergency medicine. It captures the human side of the job better than any other medical show I’ve watched. What it gets wrong is the frequency of rare procedures; they stack dramatic, once-in-a-career cases back to back, when in reality, some of those things might only show up every few years. But overall, it’s surprisingly true to the experience.

10.Q: How often do you think people in extreme pain, perhaps not from an obvious source, are denied pain medication by doctors suspicious of their claims?

A: The only times I hold off on giving pain meds are when someone is so sick that the pain might actually be helping keep them alive, or when we need to address something more urgent first, like stabilizing them or protecting their airway.

Otherwise, I take pain seriously, even if the source isn’t obvious right away. Just because we can’t see it doesn’t mean it’s not real.

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11.Q: Why do emergency doctors tell you what is wrong with you and to follow up with your doctor for further testing, instead of doing the testing while you’re in the hospital?

A: Good question. The ER’s main job is to rule out emergencies and stabilize people —we’re not really set up for full diagnostic workups like MRIs for chronic back pain. Every test we order ties up a bed, delays care for others, and pushes us further behind. That said, if it’s a slow shift or someone really struggles with outpatient follow-up, I try to go the extra mile when I can.

12.Q: When people come through and they have health anxiety and they are talking way too much because that’s how they cope, does it annoy you?

A: Haha, not at all. I’ve gotten pretty good at gently redirecting the conversation so I can get the info I need while still helping people feel heard. I know health anxiety is real, and if someone’s talking a lot, it usually means they’re scared. My job is to help them feel safe and supported while making sure nothing serious is going on.

13.Q: What are common issues that are right on the border of needing to go to the ER vs Urgent Care and vice versa? Like, where you say, “Yeah, I can see why you thought to go to urgent care vs. the ER, but you really should have come to the ER,” and vice versa.

A: That’s a tough one; there’s no perfect line between urgent care and the ER. Minor things like small cuts, sprains, or basic infections are usually fine for urgent care. But anything more serious, like chest pain, trouble breathing, bad abdominal pain, high fevers in neonates, or anything that could be life-threatening, you should head to the ER.

14.Q: Have you ever seen signs of obvious terminal cancer that were a complete surprise to the patient being seen?

A: Unfortunately, yes. We see that more often than you’d think. There’s a saying in the ER that the nicer the patient, the worse the diagnosis.

15.Q: As someone who gets panic attacks, what do you think when someone shows up with one?

A: I’m always happy to help. Panic attacks can feel terrifying and very real, so I never judge anyone for coming in. Part of my job is to make sure it’s not something more serious, and then help calm things down from there. If you’re scared enough to come to the ER, that means you need care, and that’s what we’re here for.

16.Q: Your answers have been very empathetic and thoughtful—do you think most of your colleagues have a similar attitude toward patient care, tolerance, etc?

A: Thanks. Everyone’s a little different, but in general, I do think most people in this line of work, like doctors, nurses, techs, etc., choose it because we genuinely want to help.

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17.Q: My 17-year-old just graduated from high school and got through an EMT program in her senior year. She is going to college in the fall, doing pre-med. Her end goal is to be an ER physician. I want my kid to reach her potential, and she is for sure cut out for it, personality-wise, but would you actually recommend the profession to others? If you had a chance to do over and pick a different career (or specialty), would you?

A: That’s a great question. Being an EMT is an awesome way to get started in medicine. I did it myself and really loved it. It gives you a sense of the pace, pressure, and human side of healthcare early on.

As for recommending the profession: yes, if it fits. Emergency medicine is intense, but it can also be incredibly rewarding. The best advice I can give your daughter is to go into med school with an open mind. Every specialty has its own lifestyle, culture, and challenges, and what you think you want going in might not be what grabs you once you’re in it.

One of the things I love about EM is the schedule. Full-time is about 12 shifts a month, so I have a lot of time to do things I enjoy outside of work. If she’s got the personality for it, it can be an amazing fit. But she should explore everything before locking it in.

18.Q: I’m extremely phobic about needles and blood. If I came in in distress, what would your staff be able to do to make things less traumatic for me? I’m really afraid that if I thought I was having a heart attack or something, I would genuinely think twice about going in for help.

A: You’d be surprised how many people come in with similar fears. If you ever think you’re having a life-threatening emergency, please don’t let the fear of needles stop you from coming in. Our job is to help, not to judge.

19.Q: Knowing what you know and having seen what you’ve seen, what advice would you give us?

A: If there’s one thing I’ve learned, it’s that family is the most important thing. At the end of someone’s life, no one talks about the news, politics, or work. It’s all about the people they love — holding hands, saying goodbye, being surrounded by family. Those moments make everything else fade into the background.

20.Q: What is the FUNNIEST thing that has happened?

A: One of the funniest things to me is when people get “cured” in the lobby before they even make it back to a room. My favorite is kids with nasal foreign bodies, like a bead or a piece of food, who suddenly sneeze it out while waiting. Instant fix, everyone’s surprised, and half the time the kid acts like nothing even happened. Happens more often than you’d think!

21.Q: Is there any particuliar kind of accidents you prefer not to see?

A: Anything involving child abuse. I can handle all the gore — blood, trauma, even death — but when it’s clear a child was intentionally hurt by someone, it hits different. That stuff stays with you.

22.Q: Are there days or times of year when the ER is a lot busier?

A: Mondays are usually the busiest, and we also see spikes right after big storms or bad weather clears.

23.Q: Does work provide any resources to help you recover from any trauma you experience as a result of being exposed to intense scenarios?

A: Yes, we do have access to support resources like counseling and employee assistance programs. But honestly, one of the most helpful things is making sure we debrief as a whole team — nurses, techs, everyone — after especially tough or traumatic cases.

24.Q: What’s the funniest story behind an injury you’ve treated?

A: We once had a guy come in with a penile fracture (yep, it’s a real thing), and he absolutely refused to say how it happened. Total mystery until his wife walked in wearing 5-inch stilettos and just gave him a look. No one said a word after that, but we all kind of got the picture.

25.Q: Do you enjoy working with paramedics or do they bother you?

A: I really enjoy working with paramedics, especially the ones who are engaged and curious, and I always try to follow up with them when I can so they know how their patient did. We’re all part of the same team. The only thing that can be a turn-off is when someone’s overconfident to the point that they miss something important, like a STEMI, or ignore a patient’s pain. There’s no room for ego in this work; we all need to stay sharp and humble because lives depend on it.

26.Q: I went to the ER recently for upper GI pain (it was bad). Turns out I was severely dehydrated and needed to pass some good ole material. I was kinda embarrassed about it. How many people come to the ER because they are backed up?

A: It’s honestly not uncommon at all. Bad constipation can be really painful and can mimic a lot of serious conditions, so it’s always better to get it checked out if you’re unsure. No need to be embarrassed, we see it all the time, and you’re definitely not the only one! Glad you’re feeling better.

27.Q: I had a severe injury a couple of months ago and was scared of going to the ER due to the costs. Is that a genuine fear? I fear that if my life is in danger, I’d be too scared to call an ambulance or go to the ER because of costs.

A: Sadly, I totally get it, and I share your concerns. The cost of care in the US can be outrageous, and it’s not uncommon for even healthcare workers like us to avoid the ER unless it feels absolutely unavoidable. The system needs serious change. No one should be afraid to get emergency care when their life might be on the line.

28.Q: What’s the common thing you see children under 10 come in for? The most severe cases and the less severe cases?

A: Most common reason kids under 10 come in? Definitely fever or upper respiratory infections — especially in the winter. We see tons of those. On the more severe end, things like allergic reactions, accidental ingestions, and trouble breathing.

29.Q: How often do patients not believe your diagnosis? Got some fun examples?

A: It happens, especially with patients experiencing psychosis. Trying to convince someone that the spiders they see crawling on them aren’t real can be really tough. But every now and then, someone surprises you. I once had a patient tell me there was a bug walking in their ear. At first, I assumed it was drug-related paranoia, but sure enough, there really was a bug in there. So you always stay alert and never assume.

30.Q: Whats the craziest thing someone has put in their butt?

A: The wildest one I’ve personally seen was a huge sausage, like, way beyond what you’d think is possible. The surgeons ended up taking it out in the OR, and their official report literally just said, “VERY large foreign body removed.” One of those cases where no one needed to say much… we all just nodded.

31.Q: Do all the staff sleep with each other like in movies, or is that, like, just in movies?

A: That’s mostly just in the movies, but every hospital definitely has its fair share of drama. When you work long hours in a high-stress environment, relationships and gossip happen. It’s not like Grey’s Anatomy, but yeah, things go on.

32.Q: Whats the worst thing you have seen someone (mostly) recover from?

A: I’ve seen people come back from the brink of death more times than you’d think. Human resilience is incredible. One of the worst recoveries I’ve witnessed was a patient with alcoholic liver failure who had massive variceal bleeding. They were in the ICU for months, with complication after complication, and somehow pulled through.

It’s rare, but being young or just having a strong body to start with can really tip the odds.

33.Q: What is the best way to advocate for yourself if you think the doctor or nurse has it wrong?

A: The best thing you can do is speak up, respectfully but clearly. Share your concerns, ask questions, and don’t be afraid to say if something doesn’t feel right. I’ve had patients or family members correct me before, and they were absolutely right. That input matters.

At the same time, remember that getting to be an ER doctor takes a lot of training and experience. Most of the time, we’re making decisions based on patterns we’ve seen over and over. But we’re human too — and a good doctor will always listen. You’re part of the team when it comes to care.

Do you work in an ER or a similar medical setting? Tell us about your experiences in the comments or via the anonymous form below:

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