Dr. Brian Goldman

I tell the story about that.

He describes emergency departments as the canary in the coal mine.

And, you know, whenever he wants to to post pessimistically on X, he shows a photograph of a dead canary on on the road.

I don't know why we.

laugh at that.

It's very poetic.

But, you know, that's that's what I mean.

It's the place where when you have no other place to go, you go.

And it's also supposed to be the place that's that's supposed to be open when you're critically ill or critically injured.

The emergency department is the place, the first place where the crisis in health care will visit.

And all of the things that we can talk about, the lack of beds, acute care beds in the hospital system, the lack of long-term care beds.

Family doctors, the lack of nurses, etc.

Whenever you have those compounded problems, compounded by 30 years of either underfunding or outright neglect,

then you're gonna see it in the way emergency departments function.

And so that's what we mean by an emergency department.

Now, the picture of the ER today, 15 years ago, I wrote about hallway medicine and we've had hallway medicine for decades.

What we now have is waiting room medicine where the lack of stretchers means that we have to make up stretchers in hallways, in broom closets and photocopy rooms.

repurposing them as patient care areas.

And when we run out of those spaces and we do all the time, then we have no other place to go but the waiting room.

And sometimes you even have patients that are still waiting on a stretcher, on a gurney in the back of an ambulance because they can't be offloaded into the emergency department because there just is no room.