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Not long ago our charge nurse, Shawn, wrote my name on our emergency department dry erase board. Next to it she jokingly wrote, "Old Man." As a 59-year-old, grey-bearded father of four adult children and husband of one wife for 33 years, I thought that was actually pretty appropriate. I'm embracing my old-man persona, wise curmudgeon and all. But then Shawn's sister, Erin, our unit secretary, erased it and wrote "ER Dad." The truth is, I love being the emergency department dad, even the old man, if it means I get to be a source of stability and safety for all of my "ER kids."

Actually, there are only one or two nurses and physicians in my workplace who are older than me, and not by much. I'm easily old enough to have been the father of many of the "younglings" who work with me.

Although my own children are ages 22, 24, 26, and 28, I adore them as if they were still toddlers, climbing on my lap at bedtime. We continue to talk, have dinner when we can, laugh, and take walks. We discuss ideas, books, and memories. They share their dreams. They are incredible human beings and my involvement in their lives has changed but has in no way become less relevant. No matter our age, our parents matter. No matter our age, our children matter.

Among the roles of the father of older children is to be a sounding board, offering comfort and encouragement in the trials of moving into adulthood. Mind you, it has to be done with a light touch. There are no more curfews or ultimatums; there is dialogue and love -- always love.

But it occurs to me that many of my medical colleagues across the country and across specialties could also be my kids, or at least my younger siblings. This is especially true for medical students and residents. And because of that, I think a good word for all of them is in order. So here goes.

"Hey kids, Dad here.

I just want you to know that I am so very proud of you! I know you've worked hard to get where you are. (I mean, you don't even answer my texts so I guess things are busy ... just saying.)

You have chosen a very noble and challenging path. Medicine is a rocky road, from college to medical school and residency. And when you graduate, it's still rocky but you understand the rocks a little better. (And patients sometimes seem to throw them at you.) But I just know you're doing a wonderful job. I also know your heart. Which means I know that you care so much for the people you treat. Speaking as a dad, they're lucky to have you! And if any of them says otherwise, you let me know.

Whenever I see photos of you, or read about what you're doing, or when you tell me patient stories, my dad heart just nearly bursts with joy. I have always known you were destined for great things in medicine.

Of course, I know that these days it's a really hard job. The house of medicine is the place where pretty much every problem in society seems to land, from mental health to addiction, from violence to pandemics, from heart disease to stroke, and everything in between. All of this takes a toll.

I also know there are situations that break your heart. And others that frustrate you to the point of madness. I realize that the whole healthcare system is a hot mess right now and that you feel powerless to make any changes for the better. It's easy for exhaustion to set in, physically, emotionally, and spiritually. I can see it in your face when we are together. You can't hide it from me, my dear.

So just let me say this, to help you keep moving forward. Every day at work, every single, exhausting day in the hospital, office, emergency department, or operating room, you make a difference. And this goes for all of my kids in this wild world of healthcare, whether physician, nurse, medic, tech, clerk, and all the rest.

That may sound trite, so let me explain. Every day you become part of a story bigger than yourself. You become a character in a tale in which you save a life and ease suffering, or in which you did your very best to bring comfort in the midst of trouble or loss. Those are grand things, divine things, no matter how hard they are.

Now lean in and put your head on my shoulder. Listen closely, my child. Even on your worst day, even in your worst year, you did more good that most people will have done in an ordinary lifetime. The hard things you endured to get there? Those were the price of admission. And the chance to be a character in 10,000 epics? Well, Kiddo, that's the real payout.

It isn't the money. The real compensation is the immersion in the lives of patients, their families, and even the coworkers who count on you. The real payout is the chance to get your hands dirty and your heart broken while living life and caring for those most wonderful and frustrating creatures: human beings.

But here's the other thing. If you've had enough and don't want to do it any more, I won't love you one bit less. I will still be proud of you. Sometimes your job is just too much. And the world, and the system, expects too much. So, if you want to walk away, it's cool.

Anyway, I'm getting all emotional and misty-eyed because I think you're just incredible. I know you have to get back to work, so give me a hug around the neck and head on down the road.

There's a waiting room full of people who need work excuses and azithromycin (Zithromax), just waiting to see you. So go grab some leftovers from the fridge, and here's $20 for some coffee and snacks for work. I know, I know, but I want to do it.

Keep up the great work.

Know that you are so loved.

Oh, and Happy Thanksgiving! I'm so thankful for you.

Your ER Dad"

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