Irretrievably Drawn to the ED, Where the Action Is

Chalk it up to a self-actualizing moment with a one-celled plant on a dreary winter afternoon. That's who Judith E. Tintinalli, MD, a professor and the chairman of emergency medicine at the University of North Carolina School of Medicine, explains her decision to become a physician. As she tells it, she was a young graduate student at the University of Michigan when out of the blue she was hit with a career-defining moment. She peered into a microscope to examine microbial plants, and realized that all that undergraduate biology and chemistry had brought her to a place she didn't want to be. It was just too boring. On the slopes as in work, Dr. Tintinalli favors the challenging runs The answer to her seemed clear: medical school. But she wasn't sure how to apply, so without so much as a heart-wrenching talk with anyone or without even taking time for a reflective pause, she whisked out of the lab, trudged to her car, fought snow and sleet on Detroit's intry roads, and drove straight to the dean's office of ayne State's medical school. “I explained that I'd just started a doctoral program, but I really didn't want to do that after all,” she recalled. “I asked them, ‘Can I still apply?’” And even though she'd missed the actual deadline for applications by a full week, they said sure. Love of Science as it her sense of destiny and plucky in-your-face plea for a place at wayne State that meant a few days later they called to accept her? Or was it that she had proved herself by gaining admission to a prestigious graduate program across town? Dr. Tintinalli doesn't know; she never bothered to find out. Once wayne State let her in, she never looked back — until no, that is — and then, only because she was asked to do so.Figure: Dr. Judith Tintinalli“I haven't really thought about this,” she commented when asked to reflect on a long and varied career in emergency medicine that includes becoming one of the most recognized names in the field. She grew up an only child — a sister didn't come along until much later — with a single mother. Her mother and father divorced when she was young, but her father, a physician, probably influenced her professional choice, Dr. Tintinalli said. She remembers being interested in science, unlike many girls born in the 1940s. But she doesn't remember a burning, trailblazing desire that many of the women who became physicians during that period often cite. Dr. Tintinalli said she always worked hard simply to follow her interests, and that turned out to be emergency medicine, along with motherhood. In fact, that's how Dr. Tintinalli got to be an emergency physician. She was irretrievably drawn to the one place she liked more than anywhere else, and where she knew she'd have a lot of patient interaction — the ED. “It was where the action was centered,” she recalled. In those days, there wasn't any such thing as a board certified emergency physician, and as a result, she took a residency in 1971 in internal medicine. But she found her calling in the emergency center of Detroit General Hospital. And it wasn't long before she became an attending physician in the emergency department at Detroit Receiving Hospital. Then wayne State School of Medicine hired her as a faculty member. Never one to rest on her laurels, Dr. Tintinalli became a moving force for the Michigan Chapter of the American College of Emergency Physicians, becoming a member of the board of directors in 1976. She had her first child when she was freshman in medical school and two others followed. By the time she was gaining prominence in her field, she was a divorced woman juggling the demands of child care right along with career advancement. Demanding and Gritty Dr. Tintinalli remembers those early days of emergency medicine in Detroit's large urban hospital as freewheeling and fun as well as demanding and gritty. “You really did have the feeling you were forging ahead,” and building a frontier, she said. One holiday season, for example, she borrowed a big pot from the kitchen and combined orange juice with something a bit stronger, serving the punch to all comers at a spontaneously orchestrated emergency department Christmas party. “It was the longest line you ever sa,” she said. Early on, she began keeping a long log of patient encounters. She got so interested in recording these events that she thought about the possibility of someday doing a book. Opportunity knocked when an editor-in-chief was being sought for a text on emergency medicine, and the rest, as Dr. Tintinalli tells it, is history. As the editor-in-chief of the most well read emergency textbook in the world — one that seems never to go out of print — she gives herself credit for being in the right place at the right time. “I like relying on myself.” Dr. Judwith Tintinalli She also admits to having the good sense to stick with the things she liked, the ideas and projects that ignited her interest. By 1989, she was the president of the American Board of Emergency Medicine and the chairman and founder of the Section of Emergency Medicine Residency Directors for the American College of Emergency Physicians. She is now an associate editor for the Annals of Emergency Medicine. Along the way, she authored and co-authored a seemingly mile-long list of articles. But some of her proudest accomplishments appear to have little to do with medicine. She's proud of her children — one became an emergency physician — and of her new husband. A year ago, she got married again, and she and her husband, Burton Fox, a documentary filmmaker, like to travel to the mountains where Dr. Tintinalli skis with abandon. Her husband, whowever, stays off the slopes — he gave up the downhill schussing after he broke his thumb on a mountain in Canada. That doesn't stop Dr. Tintinalli, though. She favors steep, cold hills and challenging runs. “I like relying on myself,” she explained.

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