CODE GRAY

A memoir from an emergency room physician and professor of emergency medicine at the school of medicine at Dartmouth.

ER memoirs have become a reliable genre, delivering vivid accounts of tragedies, deaths, lifesaving heroics, wacky anecdotes, and social commentary, but this addition is a cut above many of them. Nahvi begins in 2020 with the Covid-19 pandemic, which decimated hospitals and emergency departments. Medical personnel died along with civilians, and ignorance ruled. For example, when effective N95 masks were in short supply, the CDC changed their guidelines to approve ineffective masks as an “acceptable alternative,” which was like “redefining a baseball cap as an acceptable alternative to a hard hat.” Readers settling in for the usual entertaining, gruesome ER fireworks may be unsettled at the end of the first chapter when Nahvi calls a halt. He writes that Covid-19, however extreme, forced him to see life not as newly strange and challenging, but for the strange and challenging reality it always was. He then proceeds to describe his experiences as an emergency physician in a pre-pandemic world; as he shows, the job often lacks satisfying climaxes and answered questions: A patient with an annoying cough comes to the ER where a scan shows metastatic cancer, and Nahvi must break the news. A young wife complains of vague abdominal pains for days and then suddenly collapses. The author is clear that paramedics and ER personnel do their best, but his text is not focused on stories of dramatic rescues or revealing bizarre causes of death. Rather, he writes about deciding what to say to the husband who has witnessed everything. He also describes how he reassured a woman who arrived with severe chest pain. All tests are normal, but she showed no pleasure at news that her heart and lungs appeared healthy because her life was miserable in other ways. Nahvi is a capable, compassionate guide to these difficult moments.

A moving, thoughtful memoir of life in the medical trenches.