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Emergency medicine and acute care surgery: a modern “Hansel and Gretel” fairytale?
  1. Aristomenis K Exadaktylos1,
  2. George C Velmahos2
  1. 1
    Department of Emergency Medicine, Inselspital, University of Bern, Bern, Switzerland
  2. 2
    Trauma, Emergency Surgery, Surgical Critical Care, MGH, Harvard Medical School, Boston, Massachusetts, USA
  1. Dr A K Exadaktylos, Department of Emergency Medicine, Inselspital Bern, University Hospital, 3008 Bern, Switzerland; aristomenis{at}exadaktylos.ch

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ONCE UPON A TIME…

Hansel and Gretel, guided by innocence, youth and curiosity, were lost in the dark woods, taken hostage by an evil witch, left to suffer and eventually saved by their own ability to improvise, collaborate and seize the right opportunity. Teamwork, optimism, perseverance—and some good luck—emerge as timeless values in this classic German folk tale; the same timeless values are imperative for those involved in the ongoing struggle for change, improvement and the creation of new concepts in patient care.

LOST IN THE WOODS OF SURGICAL EMERGENCIES, BUT WHERE IS GRETEL?

The discipline of emergency medicine (EM) has faced significant challenges from its inception to its successful establishment in many countries.1 By design, EM has to interact with multiple other specialties and the results have been rewarding, disappointing, or questionable in nearly equal proportions. One of the most consistent frustrations of EM physicians—second only to the constantly overcrowded emergency rooms—is the inability to receive expeditious and dedicated help from subspecialists. Time and energy is wasted as EM physicians make endless calls, trying to negotiate a consult or arrange urgent care. Surgical emergencies are a prime example. Surgeons with busy elective practices …

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