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EMERGENCY
One Year of Recovery and Heartbreak in the Chicago Emergency Department
by Thomas Fisher
254 pages. a world. 27 dollars.
Thomas Fisher’s memoir “The Emergency” is about being an emergency room doctor on Chicago’s South Side; A busy book about a busy man.
The doors open and they come in: mostly poor patients with fat burns, heart failure, broken bones, unexplained bleeding, sexually transmitted diseases, ectopic pregnancies, feet rotting from diabetes, untreated mental illness, head wounds, bullet holes.
Fisher has an average of three minutes with each injured person before removing them or sending them home. Makes quick decisions; Observing him is like watching the starting quarterbacks of an elite basketball team, the clock is always ticking.
This book reminds us how permanently interesting our bodies are, especially when it goes wrong. Fisher’s account of his days is gripping. As we read, we are all helpless medical voyeurs.
Local newspapers print police letters; They should print short summaries of emergency room visits with unfiltered details, corrected names. he is It will be a public service. We can learn something, and our own troubles are put in context.
What Fisher writes about the patient flow is what gives this memory its immediacy, its pulse. “The beauty of emergency medicine,” he writes, “is that the entire team can get into a state of flow – excellent immersion and focus with no gaps between thought and action.”
The book takes its depth and tone from its arguments about the inequalities of American healthcare. Fisher was touched and enraged by the death of so many African Americans at a young age because they did not have access to proper insurance and treatment.
His frustration, his angry wit are evident on every page of “Emergency.” Fisher grew up on the South Side; his father was a doctor. He knows how well cared for white spaces are throughout the city. About the war against drugs and looting loans, he expands the roots of Black poverty.
He’s like Orwell in the euphemisms hospitals use to manipulate the poor in favor of fewer, richer patients. One is, “We will shrink into difference”. Another: “Restricting resources will improve flow.” They make him want to cough.
Someone once suggested that politicians wear sponsor jackets like NASCAR drivers so we know who owns them. Fisher thinks similarly about greedy health managers.
Waiting times in the emergency room of his own hospital at the University of Chicago Medical Center, where he has been working for 20 years, can reach six hours. When patients move into a private room, the wait isn’t always over. Fisher describes how frustrated people with jobs to do and lives to lead just walk away “with blood pressure cuffs, aprons and beeping monitors behind.”
As Anthony Bourdain discloses in “Kitchen Confidential,” meal prep is not unmasking the emergency room. He is proud of his job, his hospital, his medical advances, even if he goes home every night feeling psychologically burned out.
Fisher resolves her aggravation by writing letters to some of her patients explaining why she can’t spend more time with them and why the healthcare system is so dismal for so many patients. These are long letters and they appear in this book.
Sorry to report that they are not working; not exactly. The letters feel artificial, like movie dialogues full of arrogance and narration.
Fisher remains a somewhat distant figure in “Emergency.” He quickly skips over his own biography: childhood, Dartmouth (where he felt isolated as a Black man), med school, his time in academia, working as a health insurance administrator, and serving as a member of the White House during the first term of Barack Obama.
More than impressive and I would read more about all of that. His fond list of Black businesses his parents patronized during his youth and Black-owned brands they sought after is a high point.
We no longer learn much about his private life, neither the small, mundane details, nor the things that seem really important. What Fisher provides is the best explanation I’ve read about working in a busy hospital during Covid. It takes us back to the early, frightening days when almost everything was unknown, and as he wrote, “every cough is like an exploding bomb”. His hospital prepared the negative pressure chambers left over from Ebola scares.
He expected himself to be infected and was afraid of infecting his family and others with Covid. He told his loved ones that he could not see them, that he lived alone, that he did not go out except for work. He writes: “I got my affairs in order – set up direct debit for my mortgage, filled my freezer, and cashed out like I was gone for six months. My will was up to date.”
Maybe beauty, wrote the poet Lucia Perillo, “is the medicine that trembles in the spoon.” Fisher places beauty in a different part of the medical process. The most meaningful parts of “Emergency” may be those in which she mourns not being able to spend more than a minute with distressed people. “It is said that patients who have a doctor are in the act of being. seen,” he writes. He doesn’t have time to see them properly. He writes that people need to have a doctor who has time to tell their stories and listen.
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