Tornado of Life

Stories from the ER: a doctor shows how empathy, creativity, and imagination are the cornerstones of clinical care.

To be an emergency room doctor is to be a professional listener to stories. Each patient presents a story; finding the heart of that story is the doctor’s most critical task. More technology, more tests, and more data won’t work if doctors get the story wrong. When caring for others can feel like venturing into uncharted territory without a map, empathy, creativity, imagination, and thinking like a writer become the cornerstones of clinical care. In Tornado of Life, ER physician Jay Baruch shares these struggles in a series of short, powerful, and affecting essays that invite the reader into stories rich with complexity and messiness.

Patients come to the ER with lives troubled by scales of misfortune that have little to do with disease or injury. ER doctors must be problem-finders before they are problem-solvers. Cheryl, for example, whose story is a chaos narrative of “and this happened, and then that happened, and then, and then and then and then,” tells Baruch she is “stuck in a tornado of life.” What will help her, and what will help Mr. K., who seems like a textbook case of post-combat PTSD but turns out not to be? Baruch describes, among other things, the emergency of loneliness (invoking Chekhov, another doctor-writer); his own (frightening) experience as a patient; the patient who demanded a hug; and emergency medicine during COVID-19. These stories often end without closure or solutions. The patients are discharged into the world. But if they’re lucky, the doctor has listened to their stories as well as treated them.Table of Contents:

Chief Complaint

Not the Beginning

Vulnerability

Tornado of Life

Backstory

Why Medicine Needs More Not-Knowing

Ambassador to Nightmares

Catheters

When Loneliness is an Emergency

Trust as Protection

Upside Down

Waiting for the Surge

Narrative Risks: Shape, Place, and Gutter

Zebras

Hug, or Ugh

Constraints

Moving on

Compassion at the Crossroads

Pain: A Story That’s Hard to Treat

There’s Dying, and Dying Now

Holding On, Letting Go

When Waiting Feels Immoral

Benefit Paradox

Unsafe Discharge

Big Incision

To Err is To Be a Physician

When Sensitivity is a Liability

Why Won’t My Patient Act Like a Jerk?

Wheelchair

Possibility

Caring for the caregiver

Oktoberfest

Dr Douchebag RW

In defense of cheaper stethoscopes

The appendix: ancient organ for the modern age

Judging patients

A knock on the door

Paper scrubs

The Ashtray

The patient who wanted nothing

Can we write a better story for ourselves?

Not an ending

One more thing, writing stories of medicine

Acknowledgements

Notes

Index

Jay Baruch, a practicing emergency room physician, is Professor of Emergency Medicine at Alpert Medical School of Brown University and the author of two award-winning short fiction collections, What's Left Out and Fourteen Stories: Doctors, Patients, and Other Strangers.