Lots of smart people like to offer their view of life's niceties and lunacies "from the 30,000-foot level." I came across one by a doc from a specialty near and dear to my heart -- emergency medicine.

Dr. William Mallon is the new president of the California Chapter of the American College of Emergency Physicians. (You'll find wildly knowledgeable life-saving docs and Cal-ACEP members at Fresno's Community Regional Medical Center, home to the only combined burn and level 1 trauma centers between LA and Davis.)

Mallon said emergency medicine in the state is "under siege," adding that it is the Chernobyl for the specialty on a national level. He notched a "dirty dozen reasons for sphincteric spasm and anxiety," in his July column of Lifeline, the group's newsletter.

These include:

• California is 46th in the US in acute-care bed capacity with 1.94 beds per 1,000 population.
• CA is dead last in numbers of Emergency Departments per 1 million population with 6.16 EDs.
• So few physicians are willing to be on-call that many ED docs "face nearly impossible transfers when we see neurosurgical emergencies, complex hand injuries or psychiatric emergencies and burns."
• CA's proposed 10% cuts in physician Medi-Cal reimbursement rates will make an abysmal situation worse as docs stop seeing patients. "We are taking the legal Rottweilers off leash (trust me, these are not legal beagles) and seeking an injunction."

Says Mallon: "If you were up in that satellite looking down, you would say, 'Don't land here.'"

He hopes his colleagues will use passion, data and will power to avert a meltdown.  Maybe we also need another viewing of the movie, "China Syndrome."

For more information on Mallon and Cal-ACEP, go to www.calacep.org -- and keep ER docs and nurses in your good thoughts/prayers.