Life on the Ground Floor: Letters from the Edge of Emergency Medicine - Softcover

Maskalyk, Dr. James

 
9780385665988: Life on the Ground Floor: Letters from the Edge of Emergency Medicine
Softcover
ISBN 10: 0385665989 ISBN 13: 9780385665988
Verlag: Anchor Canada, 2018

Inhaltsangabe

National Bestseller
Winner of the 2017 Hilary Weston Writers' Trust Prize for Nonfiction
Shortlisted for the 2018 RBC Taylor Prize
Shortlisted for the 2018 Trillium Book Award
Shortlisted for the 2018 Edna Staebler Award for Creative Non-Fiction
Longlisted for the 2018 B.C. National Award for Canadian Nonfiction
Finalist for the 2017 Toronto Book Awards
Canada Reads 2019 Longlist
Named a Best Book of the Year by Globe and Mail, National Post, CBC, Chatelaine

Masterfully written and artfully structured, Life on the Ground Floor is a celebrated humanitarian doctor's unique perspective on sickness, health and what it is to be alive.

Deeply personal in its scope, doctor and activist James Maskalyk--author of the highly acclaimed Six Months in Sudan--draws upon his experience treating patients in the world's emergency rooms. From Toronto to Addis Ababa, Cambodia to Bolivia, he discovers that although the cultures, resources and medical challenges of each hospital may differ, they are linked indelibly by the ground floor: the location of their emergency rooms. Here, on the ground floor, is where Dr. Maskalyk witnesses the story of "human aliveness"--our mourning and laughter, tragedies and hopes, the frailty of being and the resilience of the human spirit. And it's here too that he is swept into the story, confronting his fears and doubts and questioning what it is to be a doctor.

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Über die Autorin bzw. den Autor

DR. JAMES MASKALYK is a physician and bestselling author. He practices emergency medicine and trauma at St. Michael's, Toronto's inner-city hospital, and is an award-winning teacher at the University of Toronto. His first book, Six Months in Sudan, was an international bestseller. He directs a program that works with Ethiopian partners at Addis Ababa University to train East Africa's first emergency physicians and is a member of Medecins Sans Frontieres, an organization for which he has worked as both a journalist and a physician. In 2007, he was MSF's first official blogger. He practices and teaches mindfulness at the Consciousness Explorers Club in Toronto, and is passionate about its potential to encourage personal and social change.

Auszug. © Genehmigter Nachdruck. Alle Rechte vorbehalten.

G is for ground.
 
I’ve been cutting down my shifts in the last few years so I can spend more time on Ethiopia. I work about ten a month now. It’s just enough to keep my skills up. Fewer, and my fingers fumble.
     When I graduated, I did twice as many. During those months, being in the ER was simpler than it has been since. My flow was natural, my hands steady, and my patients’ faces grew as indistinct as the date or time. It was the hours outside of work that started to hurt. It is easy to ignore your own worries when there is a never-ending list of worse ones placed in front of you. My rela­tionship failed. Friends fell away. Beauty too. I felt fine.
     I wasn’t. Fatigue caught up with me and I slowed down for a minute, looked around, wondered where everyone was.
     If we in ER gather in community, it is to talk about how to resuscitate a baby, to poke needles into fake plas­tic necks, or to practise for poison-gas subway attacks. We don’t practise joy, how to stay well in the face of all the sickness.
     Doctor, Nurse, heal thyself.
     Or not. Those who work in the ER burn out faster than any other type of physician. I’m not sure if it’s the shifts or the long, steady glimpse of humans on their worst day.
     I think most of us would say that it’s not the sickest that affect us, that it is the minutes in contact with them when we feel most well used. In a macabre way, we hope for the next person to have something really wrong with them, but it is more rare than you’d imagine to see a criti­cal patient in Toronto, even in the trauma room, someone whose system needs the order the alphabet can bring.
     Most of the work here is in minor. ERs are open all hours, and since the service is free, people often come in early, instead of an hour too late. Sometimes there is nothing wrong with their bodies at all. There are so many measures in place to keep people well, or to catch them before they get too sick, I can go weeks without intubat­ing someone. Worried minds, though, latch onto subtle sensations that magnify with attention, and lacking con­text, they line up to be reassured. The two populations, the sick and the worried, mix together, and separating them keeps us up all night.
     Suffering souls, though, there is no shortage of them. They circle this place.
     Some sleep right outside, on sidewalk grates, wrapped in blankets, waiting. One is splayed in the clothes he lives in, face pressed against the metal grille in a deep, drunk sleep. Every few minutes, a subway passes below the grates, and a rush of warm air flutters his shirt like a flag.
     Businesswomen spin in and out of an office tower’s revolving doors. They cross the street, eyes dancing between their phones and streetcar ruts, pretending not to notice the figure on the ground. Shoppers with bags from the Eaton Centre dangling from their arms lean into the road looking for taxis, jump out of the way of rushing cars.
     A guy across the street notices the body. He glances at it, then at the hospital, makes a calculation that there must be no better street grate in the city, and moves on. Others step over him, as if he was downtown city furniture.
     Within a few blocks of my ER, there are a dozen shel­ters for abused women and the homeless. There are health clinics for indigenous people, gay men and women, refu­gees, detox centres, beds for kids who’ve run away from home. On my way to work I pass them, pierced, dyed, smoking. Sometimes I’ll see them in the ER, shyly pulling away a bandage from the cuts they made on their arms.
     Seaton House, a men’s shelter just up the street, holds more than five hundred. It has an infirmary for the old and the sick, a special floor where the most craven alco­holics are given brandy every hour, so they don’t die on those grates. A patient told me that the floors are patrolled by gangs, and if you’ve a bag, they will pin your arms from behind and rifle through it, taking what pills or dol­lars there are.
     “They call it Satan House.”
     He was new to Toronto, to big cities even. He sat on our bed, his bag empty and eyes wide.
     “I can’t go back there. Drugs. Bugs. Fights. Can I stay here? Just one night?”
     Sorry, man. Here’s a list of other shelters, a central access number, a sandwich, a prescription for the medicines you lost, a number for our social worker who can help you fill it, a bus token, a bandage for your foot. But I’m sorry, this ain’t no hotel.
     He held his backpack tight, under the sheets, shook his head, no fucking way. Security hoisted him from the bed, a guard on each arm, walked him down the hallway, out the door, into the night.
     We give out clean needles, single-use vitamin C sachets so people can dissolve crack or black tar heroin in its acid instead of sharing lemon juice and scarring their veins. Some people come in just for sandwiches, or to use the phone. Others, to sit in a chair.
     One of my colleagues rolled a man in a wheelchair out into a storm. The man had been pretending he couldn’t walk, but when Jeff’s back was turned, he would stand, grab hand sanitizer from the wall, and drink it down. He’d been doing it for hours before someone noticed. After Jeff pushed the man out, he sat back down at the desk in minor, began angrily filling out the man’s chart, paused, then slammed his pen down and, furious, snowflakes melting on his scrubs, wheeled the man back in. Our trust gets broken and broken and broken and broken, but underneath it is an even deeper caring.
     A few years ago, I heard an overhead page—“Dr. Maskalyk to triage”—and I walked out, to help decide which way to direct a stretcher I’d guessed, and instead saw a bailiff who touched me with an affidavit, dropped it, furled, on the ground.
     “Sorry,” the registration clerk said to me, bashfully. “I thought he was a friend.”
     I picked up the rolled paper. A lawsuit. It named many doctors. I couldn’t remember the complainant.
     I got his chart from medical records. It didn’t cue me. I’d met him once, two years before. I could remember the night. So busy, running from minor to major every few min­utes. I have a vague memory of his back, but not his face.
     The chart was mostly empty. “Flank pain” was his complaint, and I scratched in only a few physical findings. In the margin was a note from the nurse: “Verbal order, Maskalyk, morphine 5 mg IV.” You get calls like that all the time, from a worried nurse, asking for pain relief for someone writhing in a stretcher. Sure, sure, I would have said, after I asked a few questions, 5 milligrams.
     In the years that had passed, I had touched a hundred backs, seen many people in pain. This man was fine. There was no bad outcome. He had CT scans, MRIs, all negative. His charge to me was that I contributed to his opiate addiction. He named every doctor who had crossed his path.
     The case dragged on for years. My lawyers kept tell­ing me that it would go no further, but it kept limping. Every few months,...

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Verlag
Anchor Canada
Erscheinungsdatum
2018
Sprache
Englisch
ISBN 10 
0385665989
ISBN 13 
9780385665988
Einband
Taschenbuch
Anzahl der Seiten
272
Kontakt zum Hersteller
Nicht verfügbar
Verantwortliche Person
gpsr@phaidon.com
gpsr@phaidon.com

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Berlin
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