It was another riveting week of Grand Rounds here in Cincinnati! Drs. Kate Connelly, Shawn Hassani, Allie Hunt and Eddie Irankunda kicked us off with a high stakes simulation case and discussion of aortic and vascular emergencies. Dr. Irankunda then reflected on his journey through residency via the filter of the 1990's classic TV show, ER, with many life lessons along the way. After a brief operations update with Dr. Fermann, we finished up with a case-based discussion of evaluation of vomiting in pediatric patients during our monthly combined conference with our PEM colleagues from Cincinnati Children’s Hospital.