Description
“BRIEF, TOUCHING” STORIES FROM THE ER: An emergency room doctor shows how empathy, creativity, and imagination are the cornerstones of clinical care (New York Times Book Review).
To be an emergency room doctor is to be a professional listener to stories. Each patient presents a story; finding the heart of that story is the doctor’s most critical task. More technology, more tests, and more data won’t work if doctors get the story wrong. When caring for others can feel like venturing into uncharted territory without a map, empathy, creativity, imagination, and thinking like a writer become the cornerstones of clinical care. In Tornado of Life, ER physician Jay Baruch shares these struggles in a series of short, powerful, and affecting essays that invite the reader into stories rich with complexity and messiness.
Patients come to the ER with lives troubled by scales of misfortune that have little to do with disease or injury. ER doctors must be problem-finders before they are problem-solvers. Cheryl, for example, whose story is a chaos narrative of “and this happened, and then that happened, and then, and then and then and then,” tells Baruch she is “stuck in a tornado of life.” What will help her, and what will help Mr. K., who seems like a textbook case of post-combat PTSD but turns out not to be? Baruch describes, among other things, the emergency of loneliness (invoking Chekhov, another doctor-writer); his own (frightening) experience as a patient; the patient who demanded a hug; and emergency medicine during COVID-19. These stories often end without closure or solutions. The patients are discharged into the world. But if they’re lucky, the doctor has listened to their stories as well as treated them.
Table of Contents
1 Chief Complaint 1
2 Not the Beginning 3
Part I: Vulnerability
3 Tornado of Life 11
4 Backstory 19
5 Why Medicine Needs More Not-Knowing 27
6 Ambassador to Nightmares 37
7 Catheters 47
8 When Loneliness Is an Emergency 49
9 Trust as Protection 55
10 Upside Down 61
11 Waiting for the Surge 71
12 Narrative Risks: Shape, Place, and Gutter 75
13 Zebras 85
14 Hug, or Ugh 87
Part II: Constraints
15 Moving On 99
16 Compassion at the Crossroads 107
17 Pain: A Story That's Hard to Treat 115
18 There's Dying, and Dying Now 125
19 Holding On, Letting Go 135
20 When Waiting Feels Immoral 139
21 Benefit Paradox 149
22 Unsafe Discharge 159
23 Big Incision 161
24 To Err Is to Be a Physician 171
25 When Sensitivity Is a Liability 179
26 Why Won't My Patient Act Like a Jerk? 183
27 Wheelchair 189
Part III: Possibility
28 Caring for the Caregiver 193
29 Oktoberfest 201
30 Dr. Douchebag 203
31 In Defense of Cheaper Stethoscopes 209
32 The Appendix: Ancient Organ for the Modern Age 217
33 Judging Patients 221
34 A Knock on the Door 227
35 Paper Scrubs 229
36 The Ashtray 235
37 The Patient Who Wanted Nothing 241
38 Can We Write a Better Story for Ourselves? 247
39 Not an Ending 253
40 Writing Stories of Medicine 261
41 One Last Thing 265
Acknowledgements 273
Notes 279
Index 299
