D’Onofrio practiced nursing for many years before getting her medical degree in 1987. She chose emergency medicine, she said, for the excitement of making a radical difference in patients’ lives, literally in seconds. She calls her practice one of “controlled chaos” and acknowledges that it takes a particular personality to cope. In addition to her clinical work, she has done research on using the emergency department to move alcohol and drug abusers into treatment. She recently received a $3.6 million grant from the National Institute on Alcohol Abuse and Alcoholism to test a counseling intervention with harmful and hazardous drinkers. Half of all major traumas are alcohol- or drug-related, so addressing substance abuse can prevent visits to the emergency department.In her dual roles she manages emergency departments on-site and at a satellite clinic in Guilford, Conn., and conducts research, teaches medical students and is responsible for emergency physicians in residency. She is also medical director of Women’s Heart Advantage, a New Haven-based program aimed at educating patients and clinicians about the risks of cardiovascular disease in women. And she heads Project ASSERT, a program in which health promotion advocates screen emergency department patients for drug and alcohol abuse.