THE EMERGENCY

A memoir from an emergency department doctor on Chicago's South Side.

Fisher, who graduated from medical school in 2001, started working as an attending physician in the University of Chicago Medical Center in 2006. Beginning his first book with a dramatic account of how the emergency room faced its first Covid-19 cases in February 2020, he moves back and forth through time, alternating between tightly focused sections on the cases he sees on a given day and letters ostensibly directed toward some of those patients and others. The author’s discussions of the initial impact of Covid-19, which “smashed through the South Side's multi-generational homes” and where standing near unmasked patients left him feeling “like being in the same room with someone holding a gun,” are the most compelling. But the book, clearly started before the pandemic, is not so much about the effects of the pandemic—when the emergency department was less busy than usual (due to “social distancing orders and fear” of the virus), populated mainly by the victims of gun violence or drug overdoses—but rather the inadequacies of health care for Black citizens in the South Side and other urban areas. In the chapters about particular days in the emergency room, Fisher delivers sharp portraits of individual patients. However, like the doctor who treated them, typically only for a few minutes, we have no idea what happens to them following the visit. The essays between these chapters of reportage chronicle the author’s life and his frequent frustration with a medical system that cares more about making money than caring for patients, especially those on Medicare. His indictments of the system are consistently convincing, but framing them as letters to patients is an awkward literary device, making the narrative disjointed. Nonetheless, the text is well written and compassionate and exposes countless problems within the American medical machine. Ta-Nehisi Coates provides the foreword.

A persuasive, sympathetic, scattered insider’s report on a broken system.