A Day in the Life

My life could best be described as chaotic.  I’m the father of 3 small children (2 of whom still wear diapers) and am a full-time emergency physician.  My work days are fast paced marathons taking care of critically ill patients, malingerers and everything in between. My only “downtime” is the 3 minute drive between my house and the hospital.  I’m not complaining – I’m not good at sitting still.

As I discussed in The curse of job satisfaction, I recently discovered a new side hustle working in a cardiac rehab.  The job consists of sitting around in case someone with a fresh stent keels over on a treadmill (something that almost never happens).  With the power of Crossing the Streams I’m able to get paid to do two jobs simultaneously as I use all the downtime to do chart reviews.

I thought it might be fun to keep track of 2 days – one in the ED and one at cardiac rehab.  Let’s see how these two days compare.

Welcome to Work

ED 8AM  I’m greeted on the ambulance ramp with an EMS crew bringing in a CPR in progress. I follow them into trauma bay 1 before even clocking in and set up to intubate. As I’m passing the tube through the cords my coworker walks into the room, not even realizing I was in the building yet. “Beat you to it” I said. We get pulses back but his blood pressure stinks and the nurses can’t find any IV access. While the X-ray tech sets up for the post intubation chest X-ray I log onto the computer, sign up for a few other patients and get workups started before grabbing supplies to put a central line in.

Home sweet home

Cardiac rehab 8AM  I show up to the cardiac rehab not quite sure where to go. “You must be the new doctor. Thank you so much for your help! We really appreciate you. Let me show you your office. Would you like some coffee or tea?” I pinch myself and look for the hidden camera. I sip my coffee, play some music on my laptop and log on to review some charts.

Getting paid to caffeinate

In the Groove

ED 9am-12pm  My resuscitated patient is lined, labbed, and packaged for the ICU team. In between tweaking his vent settings and IV pressors, I see a few vague weak and dizzy nursing home patients, abdominal pains and a shoulder dislocation. The family shows up for the ICU patient and I spend some time answering their questions and updating them on his test results. Next up is a big pilonidal abscess with my name on it. After the I&D the putrid metallic scent fills the air to the point that people in the hallway can taste it. So much for lunch. (I wouldn’t have had time to eat it anyway)

Central lines and I&D’s without eye protection? No way.

Cardiac rehab 9am-12pm  Other than friendly nurses coming to introduce themselves, I go 3 hours without any human interaction. I haven’t had this much peace and quiet in years. My coffee is cold, but the employee kitchen has a bottomless supply of refills. I leisurely review charts (usually about 3/hour) and jot down a few notes for future blog posts.

Lunch Break

ED  Hahahahahahaha! Lunch break?! I wolf down a granola bar on my way into the trauma bay. I’m greeted by a pedestrian who was struck by a car and can’t help but notice that about 3 inches of his fractured femur is flapping in the breeze and pointed towards the ceiling. Thank god for Dilaudid.

Cardiac rehab  The rehab program has a private chef that cooks healthy meals for the patients and gives cooking classes during their lunch break. “I made you some fresh polenta, Doc. I hope you like it. Let me know if you want some more to bring home.” What kind of shangri-la have I stumbled into?

If you all start singing “Be Our Guest” I’m going to freak out.

Over the Hump

ED  Trauma guy’s femur is reduced but it turns out he’s got a big subdural on his head CT.  He’s starting to get more lethargic, so I intubate him too.  I call the regional level 1 trauma center to get him shipped out. The patient’s girlfriend is angry that we don’t have neurosurgery coverage at this hospital and spends the rest of her visit complaining. The words ‘thank you’ never passes her lips. I brush it off and reload with a fresh set of patients. Heroin addict here for his 12th visit for toothache. Frequent flyer here for the 35th time this year for abdominal pain. A homeless alcoholic with a history of esophageal varices puking blood and hypotensive. Sweet!

Cardiac rehab  The nurse administrator stops by the office. “Thanks again for helping us out this week. Let me know if there’s anything you need.”

I go back to chart reviews. I get up and walk around to stretch my legs. I realize I can’t remember the last time I sat still for this long. For better or worse, when I review charts at home I’m usually up a few times an hour doing chores and playing with my kids. Just part of The good, the bad and the ugly of working from home I suppose. A belly full of polenta starts to ease me into food coma. Time for some more caffeine.

Final tally

ED  By the end of the ED shift I saw 23 patients. I got to do some cool procedures and critical care. The faint scent of pilonidal abscess still wafts in my nostrils and I have at least two people’s blood on my shoes. When you combine my hourly rate and the productivity based pay I wont see for another 4 months I probably made about $2000 today. I go home tired but with a sense of fulfillment and accomplishment. I leave all my filthy clothes in the laundry room and go hug my kids.

Cardiac rehab  I was thanked by 5 different people and fed a gourmet lunch despite the fact that I did literally NOTHING to help anyone. I reviewed 25 charts and only made one phone call. I drank 3 cups of coffee which led to 3 pee breaks (3 more than I usually have in the ED)

I made $1000 from the cardiac rehab and another $896 from chart reviews for a grand total of $1896. I left right on time feeling like I had just robbed a bank. I didn’t have that same feeling of accomplishment, but at least there was no one else’s bodily fluids on me – just a faint polenta stain on my shirt.

The Curse of Job Satisfaction is Real

Honestly…..I enjoyed my day in the ED more. What the hell is wrong with me? These cushy side gigs are easy money, but they’re so empty. It’s like getting paid to watch grass grow. Actually, watching grass grow would be better because at least I could go outside.

I made nearly equivalent money doing 1/20th the work with way less liability and way more gratitude from the people around me. Have I developed Stockholm syndrome? This is definitely a sustainable side hustle, but for any of you docs thinking about transitioning to a full time non-clinical career I would strongly advise you try it out part time before fully taking the leap. You may be surprised to find that each job makes you appreciate the other one a little more.

What do you think? Which day sounds better to you? Would you rather have polenta or homeless dude’s variceal blood staining your scrubs? Leave your thoughts and comments below.

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27 thoughts on “A Day in the Life

  1. SHS I love this post and well done with the direct compare and contrast side.

    I once had the luxury of having a cush side gig where they needed 1 of 5 specialties (radiology being one) where the doctor just has to be in the building for ultrasound guided injections (performed by someone else). One such gig was absolutely insane because there was a board certified neurologist doing it all but since her specialty was not included had to pay me to be there.

    I felt like I was literally stealing money as all I had to do was sign my name on the bottom of each form. Got paid $1k per day doing that (which I did on my day off) and was essentially watching Netflix on my laptop the whole time.

    If I had been blogging back then I probably could have written a ton of posts during that time instead.

    I do see the draw of doing something and exciting that ER can provide. Every now and then I get an interesting CT or MRI with a very rare case that rejuvenates me but those are very few and far between


    1. I do think emergency medicine is what I’m supposed to do with my life, but too much of a good thing leads to burnout. I think I’ve found a balance between clinical time and easy hustle time.

      There’s no shame in picking up easy money off the ground. Bank robbers need to feed their family too!


  2. Replace your cardiac rehab with administrative days and I am in the same boat. I am technically 50/50 (clinical/admin) and usually spend my admin days in meetings and worrying about my next cup of coffee.

    Too much admin time usually gets me jonesing for a fun a procedure or sick patient. I reduced a couple of shoulders on my admin day to “help” but in reality it was to cure my boredom.


      1. I’m bipolar in the sense of my clinical side likes to yell at my admin side for fixing things or getting resources. My admin side likes to solve those issues. The other docs in the department just benefit from the outcomes of my dueling personalities.


  3. Really enjoyed this piece. 23 years into my career, I will take option B every. single. day. Maybe I could finally conquer a NYT crossword puzzle!


  4. I wouldn’t mind having polenta handcrafted for me by a personal chef at work every day. Sounds like the good life. I could live with the boredom. After all, they say that anesthesia is 90% boredom and 10% critical care emergency medicine right? 😉


  5. I think you have the best of both worlds. You can get your adrenaline fix in the ED and then chill out at cardiac rehab. A little variety goes a long way to stave off burnout. I am of the variety of sitting in a dark room and leave me alone. Just me versus PACS


  6. I formally nominate you ambassador for life of our specialty based on this article.

    You’ve found the perfect Alice in Wonderland yin and yang of clinical work and hustle – one pill makes you larger, the other makes you small – then again, the same scenario might be a psychedelic nightmare for the wrong doc (apologies to Jefferson Airplane). Just got off shift, where a colleague approached me asking, “In what other doctor’s office do patients routinely hurl on their physicians?”

    There’s a beauty to having eyes that discern a choreography within the chaos, ears to keep time with a melody that’s John Cage discordant, where alongside a strong team of nurses and techs puts you all enter that state of flow for a tough shift and come out a little battered but proud to have tested yourself.

    I’ll admit that those shifts were abundant at first, and became less frequent in mid-career and mid-winter. Addressing burnout brings that beauty back into focus more often.

    With jobs that can have a high F-you to Thank You ratio, the pleasure comes from grading yourself on that internal scorecard.

    Thanks for reminding me why we are so lucky to get to do this.

    I really dig your writing, your irreverence, and your flair (“Doctors can get a financial advice post anywhere. They come to Side Hustle Scrubs for the atmosphere, and the attitude.” )
    In case that didn’t ring a bell: https://www.youtube.com/watch?v=_ChQK8j6so8



    Liked by 1 person

    1. Like Neo in The Matrix, an experienced emergency physician can eventually see all the 1’s and 0’s and navigate the chaos effortlessly. I genuinely enjoy what I do and think it was one of the few things I was meant for. Just in case the Oracle was wrong, these side hustles provide nice variety and easy cash.

      No Office Space reference is lost on me.

      Whenever I have a case of the Mondays I just remember how good I have it. Sure, my boss needs me to come in on Saturday (a lot of Saturdays in fact) but I was told I could listen to the radio at a reasonable volume from 9 to 11. When I make this easy hustle money I sometimes look in the mirror and ask “what would you say you do here?”

      I don’t want to jump to conclusions, but at some point they’re going to fix the glitch. At least there’s no TPS reports in the EMR.

      You’re probably busy at FinCon by now, but when you get back to the hotel turn on channel 9. I think you’ll be pleasantly surprised.


  7. Great post, SHS. seriously. This is good.

    Its interesting, your experience. I find a ton of fulfillment in both my main gig (anesthesiology) and my side hustles (running a blog, writing a book, inventing stuff, occasional expert witness stuff).

    (Unfortunately?) None of my hustles seem lazy to me and I get a different but still satisfying productive feeling from each. I will say that on the days where I have very little physical activity my body feels strange and I am not a big fan. But if I get some exercise in of some kind on the days where my sit on my butt side hustles are going, it’s much better.

    And, again, great post!



    1. I’m glad you liked it! I started this project to learn about different non-clinical jobs, but I’m learning just as much about myself.

      I enjoy the variety of these jobs, but I’ll always come home to the mothership.


  8. I always tell the young docs, it doesn’t matter how sexy the job is when you first start. After a long enough time the glitter wears off and it can become work. The adrenaline also wears off. I was in big level 1 last night, you know with a thousand people in the OR YELLING at each other until it’s over. I checked my pulse a couple of times… 55, 60, 65. Either the thrill has worn off or my adrenals are burned out. Either way, your rehab day is more than necessary to recharge the batteries. Maybe not today but someday. Good luck and congrats on the sweet side gig!


    1. I agree the adrenaline fades after a few years. At this point I get more enjoyment out of being able to tame the chaos and controlling the flow of the department. I still enjoy the traumas, the codes and the procedures but it’s more about breaking up the monotony of abdominal pains and weak/dizzy. These rehab days provide nice variety, plenty of relaxation and the easiest cash I have ever made. I plan on clinging on to this hustle like it’s the last rescue boat on the Titanic.


  9. As you get older you will find that you crave the easy day. You really do not want complex or sick. You appreciate people who are nice and that you can actually help. You tire of trying to solve the unsolvable social problem. You tire of “chronic” anything. Great post. Take the easy money and invest it. Your 60 year old self will be happy.


  10. I love this post and your writing style! Fresh Polenta?!?! Seriously amazing. That’s great that you are able to find a balance between the sexy ED job and some easy side hustles.


    1. I’m glad you enjoyed it! These side hustles exist all around us. You just need to know where to look. None of them are as fulfilling as my day job, but they’re also not nearly as exhausting. Each job helps me appreciate the other one more. I’m glad to have that kind of lucrative variety in my life.


    1. The most honest answer is “dumb luck”.

      The slightly longer answer is to look for healthcare settings that are low risk 99% of the time but always have the potential to be dangerous.

      -Cardiac rehabs with post-op CABG patients on treadmills
      – Allergist office doing allergy shots (small change of anaphylaxis)
      – Rheumatolgy office or cancer center where this is a small risk of a reaction from an infusion.

      There is a lot of low lying fruit out there for an enterprising physician. Once they know you are available, reliable and not a jerk (all 3 are essential) your phone will be ringing off the hook.

      My biggest problem now is learning to say no. It is very hard to turn down $1000 to listen to music and work on blog posts.


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