SOMETHING FOR THE PAIN

Memoirs of an emergency-room doctor—his personal life as well as his professional challenges.

Austin pursued a roundabout path to a medical degree and emergency medicine. After dropping out of college to spend nine years as a full-time firefighter and a part-time carpenter, he returned to college at age 27. Enrolled at the University of North Carolina at Chapel Hill, he took a job as a nursing assistant in the ER at North Carolina Memorial Hospital, which introduced him to his chosen field. He vividly tells all the usual stories of ER crises: men and women with heart attacks or strokes, gunshot and accident victims, violent, vomiting drunks. (Some tales are definitely not for the squeamish.) What is unusual is the degree to which Austin shares the details of his personal life. He writes frankly of his reaction to the birth of his first child, a girl with Down syndrome, and of the difficulties raising her. Getting a good day’s sleep after a night on duty was a major problem in a house with (eventually) three young children; the author recounts with candor and just a dash of dry humor coping attempts ranging from sleeping in a motel or at his mother-in-law’s house to building, and briefly setting fire to, a garage with a soundproof room above it. The stress of his job, which he carried home with him, eventually led him to a therapist who helped him recognize that he had been suppressing negative emotions until they burst out as anger at patients and family. In an epilogue, Austin examines the diametrically opposed perils of cynical detachment and overemotional involvement, pondering the question of just how empathetic a clinician can be and still be competent.

An ER physician gives serious thought to what he does, how he does it and what it does to him.