‘Riled up’ by systemic dysfunction, Caroline Cox seeks to reshape the future of emergency medicine
Caroline Cox, M.D. has become a regular face around VACEP meetings during the past year. A nominee for VACEP Councilor, Cox has taken a seat at the table to advocate for and against decisions impacting emergency medicine in Virginia and across the nation.
While she loves her specialty, “a lot of the things that frustrate us in the ED can’t be fixed at the individual or hospital level, so we need advocates at the state and federal level to make sure regulations aren’t hurting doctors and patients,” Cox explains. “Joining VACEP makes me feel like I’m doing something to fight back against the things burning me out.”
Board certified by the American College of Emergency Physicians, Cox works at Carilion Medical Center in Roanoke. She is a graduate of the University of Virginia School of Medicine and followed it with a residency at the University of Cincinnati.
Tell us about your path to emergency medicine.
I was a scribe in an emergency department in Williamsburg during college. The physicians there had such different, rich personalities and were all phenomenal doctors. It was inspiring to see the way they worked. The variety of each shift made it fly by, the staff at the hospital were great people, and I knew wanted to spend my career in a place like that.
Though our job of course involves a range of emotions for patients and families, I love the unpredictability of the work. If I know what is coming through the door, I’ll just worry about it, so I love being able to show up and do the best I can with the hand the shift deals me. I have a willingness to listen and a curiosity that has served me well in this career.
Who was your biggest influence growing up?
My father. He hated his job but did his best anyway. He always tried to bring joy to those around him.
What is your hope for the future of emergency medicine?
I’m excitable — both in a good and bad way. I get pretty enthusiastic about medicine and I’m always happy to be with my coworkers in the ED. But I am also very easily riled up by dysfunctions in our system. During my career, I would love for physicians to be able craft their care around what would be best for a patient and community, instead of lawsuit fear, misguided pay for performance dictums, and hundreds of clicky boxes on the EMR.
What’s something you’ve learned as you’ve grown up?
When I was younger, I was surprised by how terrible people can be to each other. Now I take that for granted, and am surprised and humbled by the grace and goodness some people show in the face of horrible circumstances.
I am always impressed by those people who take time to learn about others and are genuinely interested in others’ lives, making them feel special and noticed.
As for me, I recognize that I am too self-conscious and have limited myself because of it. I’d like to be brave enough to take on projects to make things better in my hospital and community. VACEP is helping me get there.
What is your philosophy on work?
I just try to make someone’s day better — whether that is a patient, a family member, or a member of our staff. The medicine might be routine, and there are horrible things happening to nice people, and there are systemic failures we don’t have control over, and people can be mean. However, there are still moments where you can fix a problem or make someone laugh or feel better about themselves, and that makes it easier to get through the rest of it.
What was the happiest day of your life (besides a great ED shift, of course)?
When I was 10, I won a gingerbread house-making contest at the local nursing home. The prize was a $100 U.S. savings bond and I felt so rich! I still have it. That day, we got a Christmas tree and got to go to a restaurant for lunch, I had a good book to read, and the world felt like a wonderful place.
Who was the best teacher you ever had?:
Mr. Gillespie. He was a crusty math teacher I had for geometry and precalculus. He had motto: “DWYGD,” or Do What You Gotta Do. When there was a complex problem, he advocated for just digging in, going through the steps to get it done.
I still use that in difficult patient care situations to prevent myself from getting paralyzed by difficult logistics. I jump in and do what I need to do to fix the next thing. DWYGD, people.
