The ER is a dangerous place for healthcare workers. As an emergency medicine physician, I routinely come to the medical, psychological, and emotional aid of patients during what can be one of the worst times in their lives. I enjoy doing that, but I didn’t know when I embarked on a career in healthcare that I would routinely be subjected to an environment that fits the definition of workplace violence, as outlined by the U.S. Department of Labor. Suffering verbal and physical abuse at the hands of patients is common.

70% of healthcare workers across America’s Emergency Departments have been subjected to verbal and physical violence, harmful intimidation, and even threats of murder by patients and their disgruntled family members.

I am the 70%.

I am a survivor of physical violence, bullying, physical intimidation, as well as racial, religious, and sexual harassment, all while working in service toward the health of my community. The internet is teeming with articles outlining the causes of workplace violence in the ER which cite ER overcrowding, understaffed hospitals, and patient frustration. I humbly believe it’s far more than that.

There is this “part of the job” mentality, that is as inherent to ER culture as CPR.

This environmental complicity is most assuredly dangerous and re-traumatizing. I’ve been punched and bitten, shortly after being called a kike, by an angry man who did not struggle with an underlying mental health diagnosis. I have watched my colleagues endure similar experiences and appear to move on to the next patient with ease and I ask myself: Why can’t I just drop it? Why do I need a moment to take a breath before I move on? Why do I want to cry? Why is my heart racing? Why am I afraid?

I don’t find it easy to simply accept these traumatic events as “par for the course”

and because of that, I frequently spiral into a drain of self-shame, embarrassment, and internalized anger. And yet, the shame should be on a culture that accepts physical violence inflicted on a pregnant nurse as something she “should’ve known what she was getting into.” The shame is on male healthcare workers who make excuses for the violent behavior of other male patients.

As a survivor of workplace violence, I’ve frequently found myself having to deliver compassionate care to men who’ve referred to me as a “fucking faggot,” a “fucking sand nigger,” a ‘spic, and “a jew.” The most recent incident prompted the writing of this article. A man angrily yelled and belittled me stating,

“Doesn’t this ER have anyone else besides this faggot-ass doctor?”

He threw objects at me, physically intimidated the staff, and yelled racist and homophobic slurs for over an hour. In the moment, I set aside my feelings and delivered an Oscar-worthy performance as if the incident had no effect on me. But later, I cried for a half hour.

In the midst of a global health pandemic, where doctors and nurses are stretched beyond measure, who would inflict such crass, homophobic, racist, behavior on a healthcare worker and then ask for help? Abusers; and apparently there are many, if 70% of ER healthcare workers have endured this.

I reject ER overcrowding as an explanation for this phenomena. Men are socialized to perform feelings of displeasure through anger, violence, and intimidation. And yet it needs to be said that white men are afforded the privilege of lashing out in ways that men of color are killed for. We encourage men to fraternize in homophobia and condemn the men who stand up, through misogynist insults like “being a sissy” or “acting like a bitch.” So we force the good ones into silence.

There is no reward for good etiquette.

This is more than understaffed hospitals. Forcing me to serve someone who has bitten, kicked, and threatened my life, as if nothing happened, is akin to a battered spouse being forced to tend to the wounds of their abuser. A healthcare worker, obligated to clean the backside of a patient who refers to her as a “stupid nigger,” is parallel to whipping a wet nurse and then expecting her to breastfeed the master’s child.

My prayer is that we explore the in-depth sociological causes and impacts of workplace violence on patients and healthcare workers alike. Let’s look at the systems currently in place to prevent workplace violence and be humbled enough to acknowledge where we’ve failed. We can re-imagine an environment that is safe and healthy for everyone, including the frontline healthcare worker.