Credit: Photo by Michael Ventura

Breathe. That one simple action is what helps Bethesda resident Tara Coles stay sane.

Coles, 45, is an emergency medicine physician. She works for MEP, a Germantown-based company that staffs emergency rooms, including the one at Adventist HealthCare Shady Grove Medical Center in Rockville, and has been treating ER patients for more than 10 years. She works eight- to nine-hour shifts—sometimes so nonstop that it’s hard for her to fit in a bathroom break. “It’s very sensory overload, it’s very tactile, it’s very loud, it’s very everything,” she says.  

The job requires Coles to handle it all—the woman with a dog bite, the man having a stroke, the toddler with an unexplained injury. She deals with a steady stream of rashes, fevers, asthma attacks, sore throats, nosebleeds, bug bites, fractures and cuts.

“The ER is an interesting place, because one minute you are dealing with a broken toe, and the next minute someone rolls in the door having a major heart attack,” Coles says. “You get these life-and-death moments filled with emotion and drama, and then you go back to an earache.”

After work, Coles goes home to her husband, John, and her four children—Zoe, 10, twins Phoebe and Noah, 8, and Lila, 4—which she says can sometimes feel as chaotic as the ER. At work or at home, she’s learned that taking a few deep breaths helps her stay calm and focused. “There’s no glory in running around like a chicken with your head cut off,” she says.


“Some of the quieter shifts are when there’s a big game on, like the Super Bowl. …In the ER, you never say the ‘Q’ word, though, or that it’s ‘really quiet.’ We’re a very superstitious bunch, and it means that you’ve screwed everybody and it’s going to be the shift from hell because you said the ‘Q’ word.”



“When I was pregnant with my first child, a sudden infant death syndrome baby came in. For me, it’s just so unexpected and catches my deepest fears as a person and a mother.”


“Sometimes it feels like: Wow, the world is struggling too much and the world is not good to itself and people are not good to each other. Then there are also moments of transcendence. You see people taking care of their family members with such love and devotion, or going the extra mile so that people feel loved and safe.”


“We see a lot of random, crazy stuff. There was a girl that came into an ER where I was training, a 17-year-old, somewhat overweight, with stomach pains who ended up delivering a 4-pound baby in the ER. She didn’t know she was pregnant.”



“I can treat someone having a massive heart attack, where 50 years ago they would have just died, and…days later they are discharged from the hospital healthy. That is a pretty unbelievable feeling.”


“Sometimes my body is buzzing and I feel like I’ve just been at a Metallica concert. I’ve probably been in a fight or flight state for hours, so I consciously slow my heart rate down and go from head to toe and try to relax every muscle.”


“The car is a no-phone zone. Kids need to know this stuff when they are young, because by the time they are teenagers they have formed habits and it’s too late. I’ve identified
my lines in the sand: You don’t go swimming without an adult nearby; you don’t eat mushrooms or berries while hiking. I have an awareness of certain things some people may never think about.”



Leah Ariniello lives in Bethesda and frequently writes about health. To comment on this story or suggest subjects, email