Every shift begins with a deep breath.

I’m an emergency physician in a regional trauma, stroke, and cardiac center — the kind of place people arrive when time is measured not in minutes, but in heartbeats.

For over a decade, I’ve stood at the intersection of life and death. I’ve called time of death at 3 AM. I’ve restarted hearts. I’ve been someone’s worst day and their last hope. I’ve also hidden in the supply room to cry.

This newsletter — ROSC — started as a way to survive burnout.
Writing became a lifeline. A way to process the unspoken weight of the work, to make sense of the chaos, and to stay connected to why I chose medicine in the first place.

Now I’m sharing these stories with you.

Not just the high-stakes resuscitations, but the quiet, personal, and absurd moments that define emergency medicine. Some are tragic. Some are funny. All are true.

Whether you’re a trainee, a clinician, or someone simply curious about what actually happens behind those hospital doors, I invite you to come along.

Each week, you’ll receive:

• Stories from the frontline

• Reflections on medicine, mortality, and meaning

• A candid look at the emotional toll of frontline care — and the resilience it demands

No jargon. No filter. Just real medicine.

Thanks for being here.

— Dr. Mike Rubin