Usually, the first thing the emergency medicine intern does when he introduces himself to a new patient is turn off the TV. But the dead horse stops him in his tracks.

"Is this 'Lonesome Dove'?" he asks. "I'm sorry. ... I'm from Texas, so that's, like, our national movie."

Jorgensen works in the emergency department at UNC Hospitals. Thirty years old with a round, open face and "Leave It to Beaver" haircut, he has an easy confidence with his patients.

About a year ago, Jorgensen says, he and his wife decided they had become too negative. "No more Eeyore - that's our family motto," he says, referring to the glum donkey in "Winnie-the-Pooh."

Often using humor to lighten serious situations, Jorgensen projects the upbeat, affable manner of a youth minister. In fact, he once considered going into the church, before discovering his calling in medicine.

"He's very devout," says Brian O'Neal, a chief resident in the emergency department. "He's extremely courteous and well-mannered, but not uptight in any way. He's a loose enough guy that you can hang out with him, have a drink with him, which is refreshing."

Compassion and his faith are a big part of what propels Jorgensen through his 12-hour shifts. "I got into this thing out of a desire to help and love people," he says. "I try to pray before I come to work that I will love my patients and show them God's love."

For Jorgensen, showing God's love is not confined to a church.

On a recent Sunday, Jorgensen ran into the boyfriend of a patient he'd treated about a week earlier. The patient was a woman with a gallstone and a kidney stone too large to pass, a double-whammy causing her serious abdominal pain.

The boyfriend told Jorgensen that they were waiting in the hospital lobby until the woman's follow-up appointment, even though it was still five days away. They were on the verge of being evicted from their trailer - the power and water had already been cut off - and they figured that, at least in the hospital's waiting area, they would have water and cable TV.

When the man admitted to Jorgensen that they had no money for food, Jorgensen suggested a few places they might go for local support. He also handed the man a couple of his own voucher cards for food from the hospital cafeteria.

It's not in Jorgensen's nature to run away from difficult situations.

"Tyler is one of my favorites," says O'Neal. Where some young doctors might try to avoid the difficult cases, like those with psychiatric problems, "he always just jumped on the patient; he's very upstanding."

Jorgensen is particularly passionate about improving care for the destitute.

"So many homeless people have mental health issues and other health issues. In whatever community I'm in long-term, I'd like to help mobilize resources to help [those] people," he says.

UNC Hospitals accepts all patients, regardless of ability to pay. The woman who was waiting in the hospital lobby for five days said she had walked 2 1/2 miles from another county to the Orange County border before calling paramedics, because she knew that from there, EMS would take her to UNC Hospitals.

But she has no health insurance, and doesn't qualify for Medicaid, the government's health program for the needy. When doctors prescribed her an antibiotic and a painkiller, she said she couldn't afford the medications.

The nurses took up a collection in the waiting room so she could get the antibiotics. She managed without the painkiller.

Improving health care for the uninsured is a priority in the health care reform efforts. But Jorgensen, who leans libertarian, is wary of government taking a bigger role.

"I was raised in Texas," he says. "That might be all you need to know about my opinion on government involvement in health care."

One might call him a bleeding-heart conservative.

"Our system is not the best," he says, but he admits he doesn't have the solution. The free market has led to some of the greatest medical innovations, he says, but not the healthiest outcomes for the most people.

"If we eliminated fast-food restaurants and cigarettes from the face of the Earth, that would make the biggest difference," he says. "There's so much self-induced disease."

Restricting what people can eat or who can smoke would conflict with his libertarian views.

But perhaps not his cowboy sensibilities.

What Jorgensen likes most about "Lonesome Dove" is that "the good guys are good, and the bad guys are bad."