Joseph Epstein

A memorable case
A patient was brought by
AV with impending airway
obstruction. It was a man
who was working in a cherry
picker under a factory ceiling
who had accidentally hit the
‘up’ button. He was pinned
with his neck against the
ceiling by the rail of the
basket he was standing in and
sustained laryngeal trauma.
One of the ED physicians
attempted intubation and
quickly stated that there was
no discernible airway anatomy
on view. Joe stepped in,
asked for a plastics tray, gave
the skin hooks to a random
registrar standing next to
him – ‘hold this here and
don’t move’ – and performed
a formal tracheotomy in
about 90 seconds and
secured a surgical airway.
The patient survived without
neurological damage.
1My favourite quote from Joe:
‘Emergency medicine is all
about filtering the noise.’
Hans Hollerer | emergency
physician and former
registrar, Western Health
n As a young emergency physician, unscarred by the
battles our predecessors fought over decades, I was most
impressed by the passion that Joe brought to the table. I
remember one annual scientific meeting in Canberra in 1990,
I think, where Joe gave a presentation about epistemology
and other things in emergency medicine, challenging
as he always did much of the sloppy language that we
emergency physicians tended to use around our work.
Quite rightly he pointed out the way we systematically devalued
our workplace by calling it ‘A&E’, or worse, ‘Cas’. I was to take
up this cause over the rest of my career as a result. But it was
the passion over something that was seemingly so innocuous
that really struck me. In his inimitable way, Joe spoke into
the microphone as if he was eating an ice-cream, almost
swallowing it as he growled out his battle cry intonations.
It was more than figuratively a call to arms, as Joe reminded
us that we were at war, and that the fight for specialty turf in
our hospitals was just that; that our colleagues were happy
to go along with us in the devaluing of our workplace if
we let them; that we needed to get our hard hats on and
get out of the trenches and fight this war in every forum
that we encountered. Joe actually used the word ‘war’!
Joe had a profound effect on me, an effect that lasted all my career.
George Jelinek | emergency physician
and academic, Melbourne
Joe had a profound
effect on me, an effect
that lasted all my career.
20 | A tribute to Joseph Epstein