Compassion emerges from the conditions we work in

Beardsell's description of work in emergency medicine strongly resonates with me.1 We have both worked in a system that once functioned well and then watched its ability to cope erode. I argue that, at times, those of us working in emergency medicine have been unwitting partners in that decline.When I started in emergency medicine, days of near overwhelm were rare. They demanded intense focus, teamwork, triage, and rapid diagnosis and treatment, while still seeing the human being in front of us. At the end of these days, we were exhausted but proud of what had been achieved under pressure. They were like snow days at school: exceptional, memorable, and unusual.Over time, however, we have moved from the occasional snow day to living in Alaska. Our response has been understandable: we have been trying to make unsafe systems safe. But, as Beardsell argues, we have also become inured to standards slipping....