ST. PETE BEACH — Anthony Acosta, the former medical director of the emergency room at Bayfront Health St. Petersburg, spent more than four decades in an ER he was remembered for loving second to only his family.Mr. Acosta, 67, died Nov. 19 after a two-year battle with cancer.The oldest of three boys and the grandchildren of immigrants — three from Sicily and one from Spain — to Ybor City, Acosta grew up on Davis Island. Though he was five and a half years older than his brothers, who were twins, he was seven years ahead of them in school because he started early."He was kind of precocious," his brother Rudy Acosta said. "He was a serious student. He was never was the type to get in trouble." The first in his family to go to college, Rudy said Anthony inspired him and their brother, David Acosta, to pursue medicine. "He always made medicine sound so exciting, my brother and I kind of caught the interest," Rudolph said. After receiving degrees from the University of Florida and the University of Miami School of Medicine, Anthony came back to the area and did a residency at Bayfront’s emergency room. His brother David said most people stop at the ER to bide time until they figure out a speciality. But Anthony stayed for 43 years, going on to become the medical director of the emergency room."Tony was the ER," said Connie May, a nurse practitioner and close friend who worked with him for more than 20 years. "Most people, if they last 20 years in ER, that’s remarkable. You’re burnt out. You see tragedy, the most negative things in society, the hatefulness. People comes to you with all their burdens. You have to tell people’s families when they lose someone. Most ER physicians retire or do something else. But that was his life." Of all the brothers, David said Anthony loved medicine best. His family was baffled when he continued to work even after finding out he had Stage 4 cancer. He loved what he did and wouldn’t mind taking extra shifts here and there, and even after receiving the diagnosis was taking courses and testing to be recertified. "Even when he got too sick, he kept saying maybe he could get well enough to go back to work," Rudy said. "It was a driving force for him." May said Mr. Acosta was referred to as "the Godfather of the ER." The ER was his life, she said, but only after his family. He lived on the beach, so said he didn’t see the need to travel much, though his brothers speculate traveling would have gotten in the way of work. He had a soft spot for Porsches, getting a new one every five to 10 years, but he lived simply, his family said, and enjoying a beer on his balcony after work was his way of unwinding. He enjoyed spaghetti dinners with his family at his mother’s house on Sundays and spending time with his children, Nicholas and Kristina.Thirty-two years ago his wife, Mary Frances, his high school sweetheart, died of a sudden aneurysm, when their kids were less than 5 years old. He was a private person, his son Nick Acosta, 37, said, and kept his emotions to himself mostly, but said he thought his dad was devastated until the last day over the loss."I think then he knew he just had to keep going, and he just never stopped," May said. May said through the years, Bayfront and the field of medicine has seen much change from computerization and switching to a for-profit model, but Mr. Acosta’s methodology and love for what he did stayed consistent. He encouraged doctors to go with their instinct and listen to the patient. "I’m very happy I learned from him instead of today’s medicine," May said. "It’s a different world now. Now you’re worried about who’s paying the bills and if you’re allowed to order this test or that. He just treated the patient. He never judged people. He always treated people with respect, whether it was a homeless person who was drunk or the drunk person who was a millionaire. He just treated why they were there, not who was there." He was also the comic relief of the floor, May said, lightening the mood of what could be a somber and stressful environment with wisecracks to try to make people laugh. Once a patient whose head was numb came in. He looked at their chart and said he had to go see "a numbskull," May said. Other times, he would notice nurses having a rough day and go to another floor to buy Hershey’s bars to slip to them, she said. "He could make light of any situation," May said. "He was supportive if we had to tell someone they lost a family member. Even with his own cancer diagnosis, I was with him the day he was diagnosed. He told me, ‘You just need to calm down.’" Nick said his dad always put him and his sister first. He remembered once falling off his bike as a kid in Pass-a-Grille. "He took me to the hospital and stitched me up," he said. "He took care of me as a father and a doctor. He protected us and guarded us from the world." As his cancer progressed, his 86-year-old mother, Mary Caltagirone Acosta, moved in with him and his brother David in Miami visited during vacations. Rudy, who lives in Tampa, saw him on weekends. "That was the kind of loyalty he inspired," Rudy said. "He was more about others than himself. He was always a humble kind of guy, never tried to impress. He didn’t have a big ego. He’s someone who serves an example for the self-centered times we live in." Contact Divya Kumar at [email protected] Follow @divyadivyadivya.