1.

I work at a university hospital in Seoul. In exchange for my labor, I am paid a salary that I use to cover my rent and living expenses as a Seoul resident. However, my job is somewhat peculiar—I work in the emergency room, the busiest part of a university hospital. My contract with this institution as an emergency medicine specialist and clinical professor requires me to spend thirty hours a week in the ER. While I have other additional duties, my primary responsibility is patient care. Upon fulfilling these terms of my contract, I receive a fixed salary. 

      It may seem unusual, but to me, the ER mainly represents a workplace. Treating patients is how I earn my livelihood. I’m nothing more than a cog in the machine of society, made up of many different parts. My role just happens to be in the emergency room. Night or day, holidays or not, the lights in the ER are always on, so I work even when others are resting. The grievances of my workplace are similar to those of firefighters, police officers, restaurant workers, and convenience store clerks—we all serve citizens. While their customers are people in emergencies or who have been involved in a crime, or people in search of a meal, mine are sick patients. As customers, they have the right to make complaints, which need to be handled. Being part of an organization also means you must be mindful of your superiors. In my case, there is the ER director, the chief of medical staff, and the hospital director. In this sense, then, my work life isn’t that different: like everyone else, I experience the stress of working night shifts and holidays, dealing with customers, and answering to my superiors.

      There is a common misconception that doctors working in the ER are bombarded with emergency calls. If I meet someone who’s not in the medical field, they ask me how I can be out and about when surely there must be some patient in urgent need of care. What they don’t know is that the responsibility for ER patients lies with the doctor currently on duty. Working in the ER is very intense—we don’t get weekends or nights to ourselves and if we also had to answer emergency calls at all times, our health would be at risk. So, while other physicians who have inpatients must pick up calls from the hospital even when they’re not working, emergency doctors like me are free to use our time off as we see fit: we can take our kids on a day trip to the amusement park, play golf, or go get groceries. We can also travel if we wish to. My main job might be demanding, but it leaves me the flexibility to have a side hustle. In my spare time, I usually read books and write. 

      Nevertheless, my job in the emergency room is different from others for many reasons, as it is with any profession that deals with accidents and disasters that might occur in our lives. Firefighters and police officers are in the same field as I am. They handle citizens who have faced the most horrific situations, and usually, their last destination is always my ER. While this is my job, patients would rather avoid the experience of ending up in the emergency room. I’ve witnessed many deaths in my workplace and let me tell you: there are certain incidents that only emergency medicine specialists can handle. I’ve been the bearer of critical, tragic news, and effectively communicating with caregivers and bereaved families can take an emotional toll on you. We as doctors have a lot of responsibility in our hands. However, what truly sets a specialist apart from any other profession is the lengthy, challenging education required to reach this point. 

2.

My path to emergency medicine was almost predestined, so allow me to retrace the steps that led me here. I was born in 1983 in Anyang, just two subway stops away from Seoul. I spent my childhood on the first floor of a three-story apartment building that was later part of an extensive redevelopment project. My father worked in a company, and my mother was a Home Economics teacher, but after she had me, she quit her job to be a full-time mom and manage the household. It was very normal for families back then to choose this option. In the morning, my father went to work, and my mother did house chores. I have a brother, two years younger than me, and we used to go outside to the playground and play with the many other children in the neighborhood, without supervision. I started taking the subway by myself in elementary school. In those times, children were very independent. When I was in third grade, my parents made an important decision: we would be moving to Gangnam. 

      Gangnam is now one of the most affluent areas in South Korea. It is known for its wealthy residents, luxury department stores, high-end restaurants, and astronomical housing prices. In this piece, however, the term Gangnam extends beyond the area south of the Han River to encompass the neighborhoods of Gangnam, Seocho, Songpa, and others, which are all included in the Eighth School District. It is the enthusiasm for education that gave birth to Gangnam as we know it. When I speak about education here, I don’t mean learning for the sake of learning, but studying to be granted a spot in the most prestigious universities, a door that opens the path to maintaining or elevating your social status. People gather in Gangnam in the hopes of getting into a ‘better’ university, bestowing the area its current fame as a status symbol. When my parents decided to move there in 1992, it wasn’t only in search of a better neighborhood—it was an investment in their children’s education. 

The Gangnam I lived in was a bit different from today. For starters, real estate prices were similar to other areas. My parents sold our Anyang house, and they only needed to add around 10 million won to afford a place in Gangnam. The neighborhood didn’t differ much from the one we had left behind. When prices started to rise in 1998, my family purchased a standard-sized apartment, which at the time cost around 200 million won. Nowadays, the same apartment in redeveloped Gangnam is priced at a staggering 3.5 billion won. (In case you’re wondering, my family sold the place a long time ago.) Meanwhile, the apartment we left in Anyang is now worth around 550 million won. Over the years, the price gap between Gangnam and other areas increased dramatically. When we moved there in the early 1990s, it was certainly a hub of ambition, but it wasn’t the impenetrable fortress that it is now.

      My school experience in Gangnam was nothing out of the ordinary. I endured the corporal punishments that were the rule back then, the bullying, and the monotonous classes—a mandatory rite of passage. I too had a rebellious phase during my teenage years, but eventually, I adjusted and managed to get through it. As I grew up, Gangnam gradually became the hot spot for education. On the other hand, college entrance exams required no creativity, and success depended on who best endured the dreary routine of shuttling between school and private academies and the strenuous tests they were given to solve. As a result, the academies didn’t hide their use of corporal punishments, grouped classes by test scores, and large institutions with tens thousands of students became the norm. The fairness of entrance exams has always been a huge issue. To address this issue, in 1993 the government introduced the Suneung, a nationwide college admission test that students would take on the same day at the same time, letting the results decide their future. At the time, it was surreal to witness thousands of students flooding the streets on the same day to take the test they had been preparing for twelve years, from elementary school through high school. My family had also moved to Gangnam for that very exam, a decade before it was my brother’s and my turn to take it. This system isn’t much different now.

      Throughout middle and high school, I never thought about my future career. In fact, this was true for almost all college-bound students. While your career choices are heavily influenced by your university and major, there’s no guarantee you’ll be admitted to the institutions you apply to. During career counseling sessions I received in high school, all the counselors would say, “First, get the highest possible Suneung score, then you can think about what to do,” making those sessions meaningless. For high schoolers taking the Suneung, universities are ranked in a clear hierarchy. Except for a few campuses in Seoul, adults don’t hesitate to refer to the other universities as ‘crappy’ and label their graduates as failures. Both careers and universities are divided into good and bad—everything categorized by social standing. At the top of the pyramid stood medical schools. With no set retirement age and a guaranteed high income, it was inevitable that specialized professions like this would be the most sought-after. Medical majors are still highly desirable today, but as the competition for admission has become fiercer, but as the competition for admission has become fiercer, the debate over these exams has turned into a contentious and exhausting societal issue. As a student, I followed a conventional path and didn’t receive any special early education, nor did I attend an elite high school, leaving me oblivious to the intense battles of this world. Regardless, I was terrified of becoming a failure, so I listened to my parents and attended school and academies. I was lucky enough to get a good score on the Suneung, which ended up being the only exam I excelled at in my entire life. 

      During my teenage years I dreamt of becoming a writer. However, my career path was decided solely based on my exceptional science score on the Suneung. It was rare for students with a score like mine to give up medical school. So, at nineteen, I enrolled in university having no understanding of how it worked or what career opportunities lay ahead of me. Seoul is home to eight medical schools, and the lower your score, the further away from the city you have to go. My university was in Gangbuk, and I commuted every day from my house in Gangnam. While the latter was in a newly developed area, Gangbuk was the old downtown where many prestigious universities are located.

3.

My future was set—I would become a doctor. Among those who entered medical school, very few chose to deviate from that career path, especially given the difficulty of securing one of the 3,500 spots available amid millions of applicants. Six years of rigorous, rote learning awaited me. Getting to that point had required family efforts and sacrifices, and medical schools had the most expensive tuition fees of all universities. Given all the expectations and financial stakes involved, it was impossible to consider a life outside of medicine.

      Graduating from medical school was no small feat either. In just six years, universities must completely transform inexperienced high schoolers into full-fledged professional doctors, equipped with both theoretical knowledge and practical skills. Medicine is a vast field, and you can’t treat patients without actual clinical practice, which was the reason you could end up failing the entire program if you got an F in just one subject. The inhuman amount of memorization required, exam questions that seemed to have answers only the professors knew, the senior-junior hierarchy akin to that of military ranks, and the pervasive drinking and smoking were entrenched in the culture. Although I was at university, the schedule was predetermined, so I couldn’t choose which subjects I wanted to study. Classes that started at eight-thirty in the morning didn’t end until four or five in the afternoon. There was no room for creativity or serious contemplation about the future, let alone time to understand the meaning of the words I was memorizing. I poured all my energy into studying and passing to the next phase—disappointing my parents was out of the question. 

      After graduation, I entered a year-long internship at a university hospital. I was responsible for handling all sorts of menial tasks and although I learned a lot thanks to the monthly rotations, it was often felt more like labor exploitation. The pay was ridiculously low compared to the hours I worked, and I never really left the hospital. Isolated from society, I did whatever task I was assigned. The university hospital I worked at was infamous for its strenuous internship program, and truth be told, just by looking at the schedule and the intensity of the work, it could be compared to medieval slavery. To this day, the debate continues over whether internships should be retained since, from a rational standpoint, they are not essential. Once my internship was over, I applied for residency. My specialty was determined based on my grades, my exams, and interviews. I had long given up competing for top grades and thought I needed to focus on practical skills. My dexterity was good, so I considered a career in surgery. Instead, I applied for emergency medicine—I wanted to gain experience in different fields and see more of the world. I was twenty-six at the time. 

      My four-year residency began. If I’d felt like a medieval slave as an intern, being a resident felt like being enslaved during Ancient Egypt. During that period, I spent as many nights awake as I did asleep. I had roughly the same responsibilities as any emergency medicine specialist, but in addition, I had to work under professors to gain (excessive and hard) clinical experience, while reading numerous papers at the same time. After what felt like an endless residency, I had three years of mandatory military service. I went off to boot camp, wore my uniform, practiced close-order drills holding a spoon in my mouth at a right angle, fired rifles, and threw grenades. If you were a Korean man, you were supposed to be able to march in a line and handle a firearm in case of war. (Though I still wonder why the spoon had to be held at a right angle.) I served my time in a provincial area, and after a total of fourteen years since I started this journey, I finally secured a job at a regional emergency medical center in Seoul. Here, for the past eight years, I have been working as a cog in the system, treating people who have fallen from Han River bridges, been stabbed, hit by cars, or caught in explosions. 

4.

In hindsight, becoming an emergency medicine specialist came about through chance and unavoidable circumstances. My upbringing and academic environment, the rampant competition and hierarchical dynamics, my dreams, and societal pressures all shaped my career path, leading me to my current role at the regional emergency center. It is true that I invested most of my life into doing this, but I don’t regret it. Thanks to these decisions, I became independent in my late twenties, managing to pay rent while juggling my personal life and work. I’m glad that my job, although demanding, is valuable to society. Living a life where I can use my professional knowledge to help the sick and those in discomfort is a privilege that is not easily attained. Working in a specialized field can also lead to many diverse opportunities: as for me, I write, people invite me to give lectures, I am a university professor and occasionally I also offer advice on  hospital policies. When there are unfortunate accidents, the media often seeks out emergency medicine specialists, adding another dimension to my responsibilities. Some of my colleagues from university devote themselves to research, others set up start-ups, and some get a job at a regular company. All roles that contribute to society’s needs. Today as well, I will go to work and meet my many patients, each with their own inevitable story. It is my job and my duty to understand them. 

Translated by Giulia Macrì