Dr. Angela Mills and Dr. Brenna Farmer both oversee high-volume emergency departments in New York City. They tell stories about the unique triumphs and challenges of working in some of the most diverse, high-intensity emergency medicine environments in the country. Then, they discuss the processes that have been implemented to optimize operations, so that their teams can successfully manage the curveballs that come with the immense breadth, volume and complexity of patient cases day in and day out.