Mike Mostrenko is an emergency room physician who has been working at Royal Columbian Hospital for more than 15 years. The Record caught up with Mostrenko to find out what it's like in the ER.
Can you describe your role?
Answer: Basically, it's to provide a clinical service. So, I work in the emergency room approximately 15 or 16 shifts per month; varying shifts, evenings and nights.
How is an ER doctor different from a regular physician?
They're quite a bit different. .It's quite an exciting environment where you've got very unstable, unwell psychiatric patients. We get violent patients, and just these really cute, sweet little old ladies who come in just feeling weak and dizzy, and from one stretcher to the next you really don't know what you're going to get.
What's the most common reason for people to come to the ER?
The most common, though I hate to say it, is probably patients looking for narcotic prescriptions. In my own opinion, there's probably a significant amount of narcotic prescribing out in the community, and eventually patients become quite dependent on it and so we see a fair bit of that.
What's the most dramatic experience you've ever had on a shift?
That would probably have to be a Christmas house fire that three children were burned (in). It was a late-night thing about a decade ago. We had two children perish in our hospital from that fire and (we were) trying to save these three children simultaneously that had all gone into cardiac arrest.
It was just so difficult on the hospital staff; our senior ambulance attendant, you could tell was just so disturbed by the whole event in our hospital, and you know, nurses, our critical-care teams.
The pediatrician came down, who was quite a senior pediatrician, and he was very bothered by the whole thing. It was just such an experience outside of what a normal human should experience. But everyone performed amazingly well, and we did the best we could.
We saved one child and two passed away, but it was just one of those terrible human stories that happen at Christmas that I'll just never forget.
What's the best part of your job?
Well, there are the great stories of the patients that come in and nobody gives them a chance, and they just think there's no way they're going to survive. But then you see them three weeks later and the little grandma comes over and gives you a hug and a box of chocolates and she walks out of hospital and everyone gave up on them and you tried so hard and you saved them. Those don't happen very commonly, but there's probably, in 15 years, at least 15 cases of the unexpected survival where you just took it a little bit further than maybe you had to and then it paid off. It's really rewarding, and I always remember those.
That's what gets you through the ones where you try so hard and you can't make a difference, which unfortunately happens from time-to-time, but now we're seeing some amazing survival stories that really make it worthwhile.
What are the most common trauma cases you see?
We see a lot of highway trauma and industrial accidents because we're situated in an area where we're in a catchment of the freeway and the industrial areas of New Westminster and Surrey. So there's often many terrible traumas that we see there and helicopter transports and sometimes we can get three or four critical traumas at the same time. We can get four or five very unwell patients from a single car crash, and that's where it can get where you're really running from one patient to the next and stamping out fires until people get stable.
What's the most satisfying part of your job?
The most satisfying part for me is making a connection with the patients. I just really enjoy talking to the patients, serving them. We have this amazing gift of a job where we go to work and we really do try to help people. It's a job, but for me, it's more than that.
What do you wish you could change about your job?
I think in all aspects there are demanding individuals that have unrealistic expectations. We can't change those people, certainly, but we have some patients, regularly, that don't want to wait, even though we have a very busy department with overcrowding issues.
What did you want to be when you were a kid?
When I was really little I don't think I had a plan for my future. My parents really wanted us to be educated but I had no pressure to go to medical school.
When I was training at university I briefly played soccer at the professional level and I really enjoyed my sport, so for much of my adolescent life I was very serious about my athletics while still performing well at school. When I went to university I wanted to be a marine biologist and so I did a fair bit of training in ecology. I got a degree in ecology and marine biology and I had a specific interest, too, in entomology - bugs and insects - and so I worked briefly in a biochemical lab that was quite a scientific lab that was looking at insect pheromones, and it was very interesting for me. I took a couple of pre-med courses and performed really well and I thought, well, maybe I'd like to do med school because it was something that was in the back of my mind, though I'd never told anybody.
Do you wear scrubs?
I've always worn jeans and a scrub shirt. I don't think it's ever become an issue. We do have a lot of patients who have white coat syndrome; they just don't like doctors in white coats with ties and starched shirts. It makes them nervous.
I chose, at the beginning of my career, to dress down in the department.
