" Every day," I said, " every day I go to work and I see my granddad. I see the drunks and the addicts, the people who have fallen right off the edge of the earth. I see people who have made every bad move anyone could make, made every major mistake there was to be made, and by the time I see them, they are paying for it, sometimes with their lives. That's why they came to the ER. " When you work in emergency medicine, you are seeing patients who are the least common denominator as far as human beings go; people who are heartbreakingly stupid and ditty and drunk and high and obnoxious--unbelievably obnoxious. These people have all flowed out of the darkest side of life. And when you are finished with them, that's mostly where they'll return. So each of you who is thinking you want to go into emergency medicine will have to ask yourself, 'Do I really want to do this?'" I tapped my chest. " I know the answer for myself--every day I work I'm taking care of someone who is just like my grandfather, someone just like my mother. But everyone in this room needs to ask himself or herself, 'Do I want to spend the rest of my life with addicts and idiots and drunks and psychotics? Is this what will make me happy?'" I peered at all of them over the top of the microphone. " Very few sane people answer yes. "