Three Years in the ER

A job I absolutely loved, except when I hated it.

Photo credit: martin.mutch, CC BY 2.0.

Like many of my Facebook friends, I joined in the #firstsevenjobs meme a few weeks ago. I wrote up short descriptions of my first three jobs — library assistant, Kohl’s salesperson, payroll processor — pretty easily. But then I got to the fourth and tried to figure out what to say. After considering the blinking cursor for a few minutes, I typed:

ER registrar and unit secretary, St. Agnes Medical Center (2001–04). A job I absolutely loved, except when I hated it. Learned a lot about humanity at its best and worst. Only got vomited on once. The money I saved funded my first trip to China.

All of that is true (including the vomit), but it’s an inadequate summary of a job that still reverberates through my life. More than a decade after working my final ER shift, I continue to have occasional dreams in which I’m back there; I can summon up clear memories of its sights, sounds and, unfortunately, smells.

I started working in the ER in late September 2001, at the beginning of my sophomore year in college. I had spent the summer bouncing between dwindling shifts at Kohl’s and a part-time position in the hospital’s payroll department, which I couldn’t continue once classes began. When I heard that the ER was looking for additional registration clerks, I applied, eager to trade in the minimum wage and erratic schedule at Kohl’s for $10.25 an hour and consistent shifts.

I didn’t get off to an auspicious start at the ER; I drove home from my first night of work in tears. It was a Monday night—and Monday nights, I learned later, were always especially busy, making them the worst time to train a new employee. Patients with minor complaints waited for hours, while one ambulance after another brought more urgent cases in, filling up the emergency room bays with patients. None of them was in truly critical condition — we were a community hospital, not a trauma center — but the sheer volume of people waiting to be seen put all of my new co-workers on edge. As I followed one of them around to learn the ropes of registering patients, I felt perpetually underfoot. I couldn’t remember anyone’s name and was incapable of performing a single task correctly, even after I had observed it multiple time. The nurses yelled at me, the doctor on duty ignored me, and my fellow registrars seemed to wish I would just go away and let them do the job that I clearly couldn’t handle.

It took me longer than it should have to realize that my first night in the ER was extra horrible because everyone — the doctors, nurses, other clerks, even the patients, it seemed — was hazing me. They hazed all the new employees, wanting to weed out the weak as quickly as possible. I just got hazed worse, because they didn’t think I belonged there.

The biggest strike against me wasn’t my age (not quite 19) or lack of time in the ER trenches. It was my father, who was the hospital’s CFO and, everyone assumed, the reason a college kid majoring in history had been hired for a demanding position with a high turnover rate. I know my father didn’t ask anyone to hire me — he didn’t even know I had applied for the job until after I’d received it — but it’s entirely possible that the head of the registration department felt like she couldn’t say no when my application landed on her desk.

“We never thought you’d stay,” a nurse who became one of my closest friends at the hospital told me several years later. Neither did I. I’m not entirely sure how I managed to go back after my first disastrous night, but I think it was a combination of that $10.25 an hour, not wanting to embarrass my father, and a desire to prove that I was tougher than anyone, including myself, thought.

I decided to make myself indispensable: an employee above reproach, someone that no one could accuse of having a job simply because her dad literally signed the paychecks.

The thing is, once I made it through a week or two of hazing from my co-workers, I loved the ER. I thrived in it; I felt more comfortable and more confident there than I did in college.

I grew up in that ER. I learned how irreparably broken the American health care system is, and how little most people knew about their bodies. I became able to identify meth addicts from the condition of their teeth, and shrank from the howling agony of men who had been maced by the police. I rolled my eyes at the drunk suburban boys from New Jersey who came into the city to party and wound up puking their guts out and begging us not to call their parents.

I learned what it looks like when someone is about to die: the breathing tubes, the chest compressions, the relatives huddled in the waiting room — often, I suspected, knowing that the end had come for their loved one, but not yet ready to hear it.

I worked days, evenings, weekends, holidays, overnights, snowstorms — any shift I was asked to take or could grab for myself. During the summer between my junior and senior years of college, I pulled down so much overtime that Dad eventually told me to work less; he was trying to get the nursing staff to reduce their overtime hours and I was undercutting his position. When I was hired, I said I could fit in 20 hours a week around my class schedule. By the time I was a senior, I was regularly clocking 40 or more hours a week.

In part, I worked so much because I genuinely enjoyed it, and I liked impressing people at college by telling them that my “after-school job” was in an ER (not that it was anything like ER most days, but I didn’t dispel them of that notion). But I’ll be honest: a not-insignificant reason for why I grabbed so many shifts was that I was raking in the cash.

That $10.25 an hour was my base wage, but I rarely earned just that. I got a percentage on top of it (a “differential”) for working evening and overnight shifts. Add in time-and-a-half on holidays and for overtime hours, and after taxes I could take home $500 or more a week sometimes. I had a third of my paycheck automatically diverted to a savings account that I tried not to touch. I wish I could say that I spent the rest of the money wisely, but I didn’t; I lived at home and my parents paid the portion of my tuition that a scholarship didn’t cover, so the balance of my paychecks went toward a steady stream of clothes, books, and nights out with friends.

Not really having a post-college plan, I went into my senior year assuming that I could always stay in the ER after I graduated, maybe even move into a full-time position with benefits. But the economics of the American health care system intervened. A few days before Christmas, Dad and I were driving to work together and he broke some news that within a few weeks all my co-workers would know: in a plot straight out of Grey’s Anatomy, the bigger hospital down the street — our chief rival — was going to acquire us and shut down several departments, including the ER. Some employees would be offered jobs at the other hospital, while the rest would be laid off.

I knew I wasn’t going to be laid off. By that point, it wasn’t about my father; I had made myself the indispensable ER employee I had set out to become more than two years earlier. I worked more hours than any other registration clerk and had a minuscule error rate. I was good at what I did. When the larger hospital handed out job offers that spring, I received one, and for a few weeks I thought I would accept it. But the path of least resistance didn’t feel right; something in me said that the ER’s closure and my college graduation taking place within a month of each other wasn’t just a coincidence.

It was time for me to move on, or else I might never leave.

I didn’t take off right away. After the hospital takeover was completed at the end of June, I hung around Philadelphia for a few months, first collecting unemployment, then working as a cashier in my college bookstore for much less than $10.25 an hour. I began to eat into my savings account, which had passed the momentous threshold of $10,000 just before the ER closed. But I was treading water, and I knew I needed to start swimming in a new direction.

Eventually, I made my move: to Beijing, where I studied Chinese and decided that I wanted to spend my life learning more about China. The money I had saved from my ER years made that first trip financially possible; the confidence I had gained in the ER made me certain I could deal with a country that was, like an emergency room, sometimes overwhelmingly stressful and chaotic.

The rest of my #firstsevenjobs were uncomplicated: perform a task, receive a paycheck. But that fourth job — wonderful, horrible, rewarding, challenging as it was — transformed me. On both practical and emotional levels, it helped me get started on my current career as a China scholar and writer. My old ER and the savings account I built up while working there are both long gone, but they set me off on a path I could never have imagined when I walked through its doors for the first time.

Maura Elizabeth Cunningham is a historian and writer in Ann Arbor, MI. Follow her on Twitter @mauracunningham and Instagram @mauracunningham82.

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