The Fourth of July is celebrated with fuel and fire: booze, barbecues, fireworks.
It makes for an indulgent and explosive celebration of America's independence.
But for some, it goes a touch too far.
From children who've lost fingers to fireworks to heatstroke from drinking in the sun, doctors have seen it all.
'So many of them start to blend together because it's a similar story,' Sharon Evans, a trauma injury prevention coordinator at Cook Children's Medical Center in Fort Worth, Texas, told DailyMail.com.
'A parent accidentally turns their back, someone's drinking too much. One little thing goes wrong and it's a terrible cascade of events.'
But four ER physicians do remember specific cases and shared with DailyMail.com the worst injuries they've seen on the Fourth of July.
Four emergency room physicians spoke to DailyMail.com about the worst injuries they've seen over Independence Day (file image)
LOSING FINGERS AND HANDS TO FIREWORKS
Unsurprisingly, accidents with children and fireworks are among the most common.
Dr George Chiampas, an assistant professor of emergency medicine at Northwestern Medicine, said he remembers a case from 2008 when an 11-year-old boy got his hands on a firework.
'His father had tried to securely lock up the fireworks and he got his hands on an M80,' Dr Chiampas told DailyMail.com.
M80s were designed by the US military in the early 1900s to mimic explosions during training exercises, according to Dynamite Fireworks.
Now sold as consumer fireworks, you are required to obtain a federal explosives license before purchasing them.
'If I remember, correctly, [the firecracker] had a short wick and it blew up in [the kid's] right hand,' said Dr Chiampas.
Impulsive actions, for lack of a better term, more often occur in men than women
Dr Samir Doshi, an ER physician who has seen many firework injuries
When the boy got the emergency room, his ring finger and pinky finger had partially been blown off, and needed to be amputated.
He also had burns on his hand and extending up to his forearm.
'Fireworks are highly flammable things and most emergency physicians have all seen the scary occurrences of what that can be,' Dr Chiampas said.
Dr Samir Doshi, an emergency room physician for St Luke's Health System In Kansas City had a similar incident.
About 10 years ago, a man in his 20s lit a