Few people have had such a varied and inspiring professional career as Joseph Epstein. Joe was a surgeon, emergency physician, one of the founding fathers of the ACEM (also later serving as its President), founding signatory of the International Federation for Emergency Medicine, director of the State Retrieval Service in Victoria and advisor to ministers and governments. In addition, he was an enthusiastic and generous teacher, wise mentor, inspirational leader, trusted advisor, force of nature, radical, philosopher and raconteur.

Born and raised in Melbourne of Jewish immigrant parents who narrowly escaped Poland before the war, Joe was intent on making the world a better place. He initially trained as a surgeon, where he observed the shortfalls of consultant-based medicine, and he used this knowledge to focus on the development of the new specialty of Emergency Medicine.

Joe described Emergency Medicine as a Janus-faced specialty, with one face towards the community and the other towards hospital-based healthcare. He was fascinated by its complex challenges and spent much of his professional life exploring them. In particular, he saw the opportunities to improve healthcare that working at this crossroads of the health system provided.

It may be hard to believe but within living memory, care in what was then called ‘casualty’ was delivered for the most part by junior doctors, with little training, experience or supervision. Despite their best efforts, the term ‘casualty’ became associated with second-rate medical care. Joe and a small band of like-minded doctors in Australasia decided to change that. The path to establishing a specialist college for Emergency Medicine in Australasia was difficult, but ultimately successful. It was not just about training a specialist workforce for EDs. It was also about standard setting, monitoring quality and performance, advocating for system change and being a voice for the vulnerable. The older, established medical colleges were not supportive and found the idea of a new specialty threatening. However, the public and governments demanded safe and effective care for emergencies. This could only be delivered through a specialty college and the College finally gained recognition by the medical councils of Australia and New Zealand in 1992.

The College that we see today owes a lot to Joe's vision, energy and persistence. Fittingly, Joe was honoured at the recent International Conference on Emergency Medicine held in Melbourne, where delegates from around the world acknowledged his contribution to improving care for emergency patients everywhere.

Joe was a skilled influencer, but not in the social media sense. He used his charm, charisma and sharp intellect to open doors and inform and persuade those in positions of power on both local and national issues. His intellectual agility, precise use of language and careful preparation rarely saw him leave such meetings without progressing his cause.

Joe prided himself on his use of language and the power of individual words. In the early stages of Emergency Medicine's development, the word ‘casualty’ was one of his pet hates. Unlike the UK College, in Australasia, the correct description of our work prevailed in the nomenclature. He also fought long and hard to make ACEM a college (and later IFEM) ‘for’ Emergency Medicine (for advocacy) rather than ‘of’.

Joe's concern for First Nations people, particularly expressed through the ACEM Foundation, has contributed to significant increases in awareness of health inequity in emergency care and efforts to increase the number of emergency clinicians of First Nations heritage.

In addition to his work at State and national levels, Joe was an inspirational local leader and mentor at Footscray Hospital (and its later incarnation Western Health). For many years the West of Melbourne was neglected. Its people were poor, working class, immigrant and of little political ‘value’. They also had high rates of chronic and preventable illness and workplace injuries. Joe was a champion for them and stayed with them despite attractive career opportunities at larger, more prestigious hospitals. He advocated for a greater share of health funding and more and better hospitals and services so that specialist care could be delivered where people lived.

At Footscray Hospital, Joe was a long-serving ED director and senior clinician. More importantly, he established Western Health as a leader of Emergency Medicine practice and education for both doctors and nurses and nurtured the diverse and dedicated team who work there. His mentorship has led to Western Health trained clinicians taking up senior leadership positions throughout the health system, carrying on his legacy of providing the best care for all, no matter what their personal circumstances. We are but two among them.

Joe was a staunch believer that quality of care and research are inextricably linked. He influenced young emergency physicians and the College to foster research to improve patient care. It is no accident that there is a Joseph Epstein Centre for Emergency Medicine Research. He also believed that to work effectively with, and influence, other specialist groups Emergency Medicine had to establish academic credibility through research. The Centre carries on Joe's philosophy of rigorous inquiry and change driven by evidence.

Perhaps above all Joe was a doctor, he cared passionately about people – each individual's real-world struggles, their fears, their pain and their hopes. In particular, he would spend time and really listen to them. All those who worked with him know of a time when he went above and beyond. For example, once over the Christmas public holiday period, he found a place in detox for a young man whose father had brought him to ED distraught and not knowing what else to do. Then, after his shift, he drove the young man there and saw him settled and safe.

Emergency Medicine flowed through Joe's veins. His passion and energy for Emergency Medicine as a specialty for doctors and nurses and his care and advocacy for his patients were second to none.

Personally, for both of us, he was an exceptional mentor and friend. There will never be another Joe.

Competing interests

A-MK and PAC are section editors for Emergency Medicine Australasia.

中文翻译：

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淡水河谷约瑟夫爱泼斯坦 AM FIFEM

很少有人像约瑟夫·爱泼斯坦那样拥有如此丰富多彩和鼓舞人心的职业生涯。乔是一名外科医生、急诊医师、ACEM 的创始人之一（后来也担任其主席）、国际急诊医学联合会的创始签署人、维多利亚州检索服务中心主任以及部长和政府顾问。此外，他还是一位热情慷慨的老师、睿智的导师、鼓舞人心的领导者、值得信赖的顾问、自然的力量、激进分子、哲学家和健谈者。

乔在墨尔本出生和长大，父母是犹太移民，他们在战前险些逃离波兰，他一心想让世界变得更美好。他最初是一名外科医生，在那里他发现了基于顾问的医学的不足，他利用这些知识专注于急诊医学新专业的发展。

Joe 将急诊医学描述为一门面向 Janus 的专业，一个面向社区，另一个面向基于医院的医疗保健。他对其复杂的挑战着迷，并在职业生涯的大部分时间里都在探索这些挑战。特别是，他看到了在卫生系统的这个十字路口工作所提供的改善医疗保健的机会。

可能很难相信，但在人们的记忆中，当时被称为“伤员”的护理大部分是由初级医生提供的，几乎没有培训、经验或监督。尽管他们尽了最大的努力，“伤亡”一词还是与二流的医疗保健联系在一起。乔和澳大拉西亚的一小群志同道合的医生决定改变这种状况。在大洋洲建立急诊医学专科学院的道路很艰难，但最终还是成功了。这不仅仅是为 ED 培训专业劳动力。它还涉及标准制定、质量和绩效监控、倡导系统变革以及为弱势群体发声。较老的、成熟的医学院不予支持，并发现新专业的想法具有威胁性。然而，公众和政府要求对紧急情况进行安全有效的护理。这只能通过一所专业学院提供，学院最终于 1992 年获得澳大利亚和新西兰医学委员会的认可。

我们今天看到的学院很大程度上归功于乔的远见、活力和坚持。恰如其分地，乔在最近在墨尔本举行的国际急诊医学会议上获得了荣誉，来自世界各地的代表在会上承认了他为改善世界各地急诊患者护理所做的贡献。

乔是一位熟练的影响者，但不是社交媒体意义上的。他利用自己的魅力、魅力和敏锐的才智打开大门，在地方和国家问题上告知和说服当权者。他的智力敏捷、语言的精确使用和精心的准备很少让他在没有取得进展的情况下离开这样的会议。

乔为自己对语言的使用和单个单词的力量感到自豪。在急诊医学发展的早期阶段，“伤亡”这个词是他最讨厌的词之一。与大洋洲的英国学院不同，对我们工作的正确描述在命名法中占主导地位。他还为使 ACEM（以及后来的 IFEM）“为”急诊医学（为宣传）而不是“为”而努力奋斗了很长时间。

乔对原住民的关注，特别是通过 ACEM 基金会表达的关注，有助于显着提高对急诊护理中健康不公平的认识，并努力增加原住民遗产急诊临床医生的数量。

除了在州和国家层面的工作外，Joe 还是 Footscray 医院（以及后来的西方健康医院）的一位鼓舞人心的当地领导人和导师。多年来，墨尔本西部一直被忽视。它的人民是贫穷的、工人阶级的、移民的，没有什么政治“价值”。他们的慢性和可预防疾病和工伤率也很高。乔是他们的拥护者，尽管在更大、更负盛名的医院有诱人的职业机会，但他一直和他们在一起。他主张增加卫生资金的份额以及更多更好的医院和服务，以便可以在人们居住的地方提供专科护理。

在 Footscray 医院，Joe 是一位长期服务的 ED 主任和高级临床医生。更重要的是，他将 Western Health 确立为急诊医学实践和医生和护士教育的领导者，并培养了在那里工作的多元化和敬业的团队。在他的指导下，Western Health 训练有素的临床医生在整个卫生系统中担任高级领导职务，继承了他为所有人提供最佳护理的传统，无论他们的个人情况如何。我们只是其中的两个。

乔坚信护理质量和研究密不可分。他影响了年轻的急诊医师和学院，以促进研究以改善患者护理。约瑟夫爱泼斯坦急诊医学研究中心的成立并非偶然。他还认为，为了有效地与其他专业团体合作并产生影响，急诊医学必须通过研究建立学术信誉。该中心继承了乔的严谨探究和证据驱动变革的理念。

也许最重要的是乔是一名医生，他热情地关心人们——每个人在现实世界中的挣扎、他们的恐惧、他们的痛苦和他们的希望。特别是，他会花时间真正倾听他们。所有和他一起工作的人都知道他有过超越的时候。例如，有一次在圣诞节公共假期期间，他为一个年轻人找到了一个排毒的地方，他的父亲把他带到急诊室，心烦意乱，不知道还能做什么。然后，下班后，他开车送年轻人去那里，看到他安顿下来，很安全。

急救药物流经乔的血管。作为医生和护士的专业，他对急诊医学的热情和精力以及对患者的关怀和倡导是首屈一指的。

就个人而言，对我们俩来说，他都是一位杰出的导师和朋友。永远不会有另一个乔。

利益争夺

A-MK 和 PAC 是澳大利亚急诊医学部的编辑。