A tour de force that diagnoses the structural root of the violence that plagues us all
Trauma surgeon and professor Dr. Brian H. Williams has seen it all, from gunshot wounds to stabbings to traumatic brain injuries. In The Bodies Keep Coming, Williams ushers us into the trauma bay, where the wounds of a national emergency amass. As a Harvard-trained physician, he learned to keep his head down and his scalpel ready. As a Black man, he learned to swallow the rage when patients told him to take out the trash.
Just days after the tragic police shootings of two Black men, Williams tried to save the lives of police officers shot in Dallas in the deadliest incident for U.S. law enforcement since 9/11. Thrust into the spotlight in a nation that loves feel-good stories about heroism more than hard truths about racism, Williams came to rethink everything he thought he knew about medicine, injustice, and what true healing looks like.
Now, in raw and intimate detail, Williams narrates not only the events of that night in 2016, but the grief and anger of a Black doctor on the front lines of trauma care. Working in the physician-writer tradition of Atul Gawande and Damon Tweedy, Williams diagnoses the roots of the violence that plagues us. He draws a through-line between white supremacy, gun violence, and the bodies he tries to revive, and he trains his surgeon's eye on the structural ills that manifest themselves in the bodies of his patients.
What if racism is a feature of our healthcare system, not a bug? What if profiting from racial inequality is exactly what it was designed to do? Black and brown bodies will continue to be wracked by all types of violence, Williams argues, until something changes. Until we transform policy and law with compassion and care, the bodies will keep coming.
The bodies keep coming. A shocking visual, a war-time image–except when you realize this isn’t a wartime movie or a scene from Chicago Med, just an average shift in a big-city hospital. “They prepare to swarm a teenage boy–another gunshot victim, the eleventh since I began this shift nearly twenty-four hours ago.”
Williams is a Black trauma surgeon, working in some of the U.S. busiest safety hospitals (who are we kidding; if you are a safety hospital, there’s no way you aren’t busy) and as a trauma surgeon, he starts to wake up to the damage gunfire causes and how the burden is upon the young, Black and urban. Williams came to national attention in 2016 after a Black man in Dallas targeted and killed five White police officers at a Black Lives Matter march. Williams was the surgeon on duty that day, and his position was ultimately leveraged by the hospital system into calls for peace. This book is his effort to interject his voice into the national dialogue on healthcare inequity.
Williams describes this book as having “three main threads in this story: a narrative account of my experiences inside the hospital, my personal story, and a critical look at healthcare inequity.” It is a thoughtful, well-written work, with tightest focus on the Dallas shootings and on healthcare inequity. The factual information is woven into the story well, so the reader does not feel overwhelmed by statistics. I will note that as he descends into the personal, his writing is very careful to not accuse any particular person or system of any misbehavior.
While thought-provoking, it doesn’t feel overwhelming or cumbersome, the way other non-fiction works can be. Divided into 19 chapters, the 235 pages flow by quickly. I found myself taking breaks just because I wanted to reflect on what was being shared, not because I was overwhelmed. In fact, if I learned anything, it’s that I didn’t learn enough about Dr. Williams. Although he goes into some detail about his Air Force experience, it is all positive, as is residency at Brigham and Women’s Hospital. His pre-MD life is essentially dispatched in four chapters. Chapters specifically devoted to racial inequity in Medicaid and to gun violence are terribly interesting (in the most literal use of the words; they are both ‘terrible’ and ‘interesting’ in their content.)
One of the eye-opening pieces is his chapter on Medicaid. The historical creation of Medicare and Medicaid, which seem so positively intentioned, was actually a political compromise. In getting Medicare passed, LBJ had to compromise with the Dixicrates on Medicaid, allowing “the states to retain power over how they would deliver care to the poor–a category that was, and still is, a proxy for being Black.” This essentially means fifty-six different Medicaid programs, and surely remains one of the ways certain states can continue to dehumanize their poor and ensure barriers to class mobility remain entrenched.
We should know by now the lasting harm of gun violence, both in PTSD to the survivor, and to the community. “But the intangibles can be just as lethal. Like the cavitary destruction a single bullet causes, the epidemic of gun violence creates damage far beyond the location of the violence.”
We Americans have been content to live in a horribly unjust system, and instead of being brave enough to imagine or implement something new, we double-down on the broken. I didn’t think about the newer ways we continue to codify racism against Black bodies even as we try and hold police accountable for their own role. It was with horror that I realized the accuracy of Williams’ statement: “There are few more egregious examples of racialized gun legislation than defensive gun laws, also known as Stand Your Ground Laws.” It makes me sick just reading about it. A U.S. DOJ study noted that a white-on-Black homicide was 11% more likely to be ruled ‘justified’ than a Black-on-white homicide.
The challenge to evaluating memoirs, of course, is that feels a little like evaluating a person. Treading that line, I will say that he stays curiously away from both the operating room and his innermost demons, the two things that interested me most. Occasionally we visit a patient, particularly in the beginning when he talks about the details of an emergency thoracotomy, the ‘Hail Mary’ of procedures. The writing there is flawless, covering the enormity of the action, its futility, his hope, the procedural details; everything I could want… except, and this is perhaps a telling side detail, he never goes into why he continues to do this ‘Hail Mary’ procedure when it hasn’t worked the 22 times he’s been a part of it, though he admits “I would not want a thoracotomy done to me or a member of my family for MRB. To this day, it is a dichotomy I have not reconciled.” Like so much of medicine, I wonder at our hubris. (I have to wonder how many pigs died to prove this could work).
But to me, as a former cancer nurse and general human, I always think about the ongoing trauma the medical system causes to our patients’ bodies and spirits in the pursuit of life. One of my measures of how thoughtful a practitioner of any sort is, whether neonatal nurse, trauma surgeon, or nephrologist, is how willing they are to recognize this systemic conundrum. Williams sort of gets there, albeit on a systemic level, as he recognizes he is just ‘fixing’ bodies to return them to the streets, or reducing a diabetic’s quality of life as he amputates one body part at a time. “During the early years of my career, saving the life of a gunshot victim–or trying to–was exhilarating…But now I kept thinking: by the time patients are lying on the gurney in front of me, it’s too late. I might be able to save them from immediate death, yes. But what about the circumstances that led them to my trauma bay?… Did my work as a trauma surgeon truly help transform the communities I served?”
Selfishly, I was looking for more of that struggle, because I think that’s part of the core of our individual caregiver fatigue, and I am working through my own nearly every week, it seems. Surgeons have always seemed immune to this, as they rarely get personal with the patient, particularly in trauma. I don’t envy him his struggle, though I’d take issue with his conclusion that “How could I participate in an unjust healthcare system that was part of the problem?” He is not a perpetrator as much as a piece within it, capable of independent thought and hopefully, reform or subversion (you may now quote Audre Lorde at me). It’s worth noting he’s largely left active medicine and is running for Texas State Senate.
I met Brian several years ago through a Christian racial unity discussion group. He is a man of integrity and character and I'm thrilled to read his accounts of the tragic events of 7/7. His book is available for pre-order now through Barnes & Noble online. Get your copy and let's discuss together!
This book was unlike any I've ever read. I've read plenty of biographies, autobiographies, memoirs, and accounts of true crime events. However, this was.... all of those? None of those? I'm not sure how to classify it, honestly, but it was definitely a wonderful read.
I suppose I've never really thought about the disparity between the number of white surgeons and black surgeons out there, but this book opened my eyes to it in a way I've never imagined. It also presented some eye-opening facts about the horrible and unwanted role people of color - particularly black people - have played in the advancement of healthcare over the years.
I knew about the Tuskegee Airmen. I even knew that black women were forcibly sterilized in order to "advance the practice" of hysterectomies and other similar procedures. But I didn't realize the extent to which black people are used as guinea pigs in the medical field.
This book was insightful, eye-opening, and a must-read for anyone who wants to learn more about race relations and the injustices people of color have suffered in America. I can't say I "enjoyed" it because this isn't the kind of book you read for enjoyment. But I'm certainly glad I read it.
Loved this book and the unique perspective it provided into the systemic racism in America. There were moments reading this where I felt absolutely sick to my stomach. The author is a strong, intelligent, successful trauma surgeon and his way of telling his story and the story of his patients (and how they all weave together systemically) is both thought provoking and maddening. It’s perfect reading for black history month, or any month really - it’s loaded full with anecdotes and backed up with statistics and historical facts that will leave you speechless and eager to transform the world around you.
Interesting and personal look at the intersection of race and healthcare in America through the life and experiences of a Black trauma surgeon. Dr. Williams doesn't shy away from the brutal realities of how racism and white supremacy shaped both medicine and his own life, and how his unique position of being a Black trauma surgeon treating fallen police officers during a mass shooting perpetrated by a Black suspect thrust him into the spotlight and helped guide him towards advocacy.
A moderately compelling read. To see a powerful excerpt of Dr. Williams' press conference (he treated three of the Dallas police officers who were shot to death in a mass attack in 2016 and was tortured by his inability to save them) -
The book itself, Williams' writing style, doesn't quite match the compelling tenor of that clip.
The most interesting passage for me was one where he, a black trauma surgeon, described treating a white man, "Jared," brought into the ER (an event completely unrelated to the officer shooting). Jared is undergoing "an exploratory laparotomy, the classic emergency operation for a gunshot wound to the abdomen."
"I supervised the trauma fellow who made a midline abdominal incision, whereupon entry into the abdomen released the acrid concoction of partially digested alcohol, food, and stomach acid that would curl the hair in your nostrils. A bullet had caused a tangential wound on the front of his stomach and the contents of the night - beer, tequila, and an assortment of Mexican food - floated freely in his abdomen.
First, we controlled the active hemorrhage and checked for retroperitoneal hematomas (he had none). Second, we controlled spillage of gastrointestinal contents (he had a lot). We then placed several temporary clamps along the stomach wound, four on wounds to his small intestine leaking milky green contents that looked like dark radiator fluid, and two on injuries to his large intestine which leaked stool like brown toothpaste. Next, we performed a thorough exploration of the abdomen, searching for injuries to solid organs like the kidneys, liver, and diaphragm. We repaired the colon wound without giving him a colostomy, repaired the linear tear in the stomach, and resected the injured segment of small intesting, repairing it with a primary stapled anastomosis. We conducted another thorough exploration to double check for injuries we may have overlooked, confirmed our repairs were sturdy, and washed out the abdomen with several liters of warm sterile saline.
Usually after closing the fascia, the leathery tissue that holds your abdominal muscles together, I'd scrub out and allow the trainees to finish the closure. On that night, I chose to close the swastika-branded skin myself. As team members, Black and white, joked about purposely defacing the patient's body art, I dismissed everyone except the scrub nurse, circulator, and the anesthesiologist. I carefully aligned the edges of that swastika to ensure that his skin would heal properly. How easy it would have been to staple the skin off-center, knowing it would heal askew. Yet I aligned the inked edges with the same attention to detail I used to prepare my Air Force blues for inspection, attending to small imperfections that might escape the untrained eye.
I felt something akin to compassion mixed with pity for this stranger, who was clearly consumed by such hate.....
Jared would leave the hospital six days later, with a well-healed midline abdominal scar bisecting his perfectly aligned swastika tattoo. Since I checked on him daily until he was well enough for discharge, I was a routine presence in his hospital room with him and his family. Every day they were reminded that I was the one who had saved both his tattoo and his life."
I knew a solid amount about the content of this book, but having it written out in front of me with statistics and personal accounts really helped emphasize a lot of it. As I read this, I thought about how much the policy in place affects how each person lives, despite their circumstances. The fact that if you don’t feel how the policy is working it probably isn’t working heavily against you is something that I hadn’t truly considered until I read this.
About halfway through, I looked up Dr. Williams and found he is running for office in Texas. Which may be a factor in his writing this book. I liked the first 2/3 best, where he talks about his childhood and eventual graduation from the Air Force Academy. I also found his discussions of his training to become a trauma surgeon to be interesting. After "7/7"-the date when he is at the Parkland Hospital ER when multiple police officers are shot by a Black man, Dr. Williams describes the difficulty in being a Black doctor and the balance between taking care of so many Black gunshot victims and also caring for the police who, it is well-documented, are responsible for the deaths of many Black men. Although much of the factual pieces of the book are not new- Black people being shot, working in trauma care being stressful, being Black and educated and being the victim of racist patients- I feel Dr. Williams' first-hand insight to all of these things is an unheard voice, at least to me. I loved the story he told when he was speaking to the public after 7/7, where he addresses the police: "I support you, I respect you, and... I fear you." It must have been very hard for him to try so hard to save the officers after they were shot and worry that some people might think he, as a Black surgeon, wouldn't do his best for them. He struck me as a man of high integrity. The problem was the last third, where he begins to rattle off all of the ways Blacks are part of systemic healthcare inequity. Not that he's wrong. From inadequate preventative care to poorer outcomes for many diseases to trauma center "deserts" in major cities, there is definitely deliberate neglect contributing to healthcare racism. The problem is, it's a huge, monstrous thing to fix, and so the last third seemed really discouraging, without a lot of hope that things will change. Maybe that's the pessimist in me. He advocates for universal healthcare, which I fully support. What kind of world-leading nation doesn't provide healthcare to all it's citizens, employed or otherwise?
A very important and timely book that gives us a rare glimpse into the difficult decisions and environment that emergency surgeons operate in. It reads like a dissertation and memoir combined but without a clear thesis. The statistics, policies, and history referenced in the book are insightful but don’t always match the memoir aspect of the book and distract from what otherwise could be an engaging book.
Superb memoir and call to action. Dr. Williams has an enrapturing writing style and the audiobook performance brings out the lyrical nature of the prose. As a physician and as a reader alike, could not more highly recommend.
Thanks to NetGalley and the publisher for the audiobook ARC in exchange for an honest review!
Williams says that his motivation to write this book is to dismantle structural racism, end the epidemic of gun violence, and create health equity. I cried multiple times reading this book, even though I already knew how unequal healthcare is. Reading this book, written by a black trauma surgeon, really underlines all the work that still needs to be done in this area. Excellent read.
"The Bodies Keep Coming" by Dr. Brian H. Williams is a thought-provoking audiobook that deserves a solid four-star rating. My experience with this book left me with a whirlwind of emotions and reflections. Dr. Williams, a trauma surgeon, opens his life story with raw honesty and courage, offering readers a glimpse into his upbringing as an army brat, which provided him with stable housing, healthcare, and a good education. His journey from the military to medical school and ultimately into trauma surgery is inspiring.
One of the most captivating aspects of the book is its exploration of the history of medicine in America. Dr. Williams delves into topics such as the placement of hospitals, the closure of black universities, and the intricacies of Medicaid and Medicare laws. These discussions shed light on the systemic disparities that have persisted over time, leaving a lasting impact on marginalized communities. The history lessons in the book are eye-opening and shed light on the roots of healthcare inequality.
I also found the concept of the redlining policy during the Great Depression to be particularly fascinating. Dr. Williams effectively conveys how this practice perpetuated inequality and hindered the development of black neighborhoods. It's a stark reminder of the lasting consequences of discriminatory policies.
The book shines when Dr. Williams shares his personal experiences and reflections on his surgeries. These poignant stories provide insight into the complexities of trauma surgery and the toll it takes on both patients and surgeons. These narratives are not only engaging but also deeply moving.
However, I did encounter some challenges in the book. While Dr. Williams passionately discusses the social changes he envisions, there's a lack of concrete strategies or plans for implementation. It feels like he paints a compelling vision but doesn't delve into the practical steps needed to achieve it. This leaves readers wanting more substance in terms of the "how" behind his vision.
Additionally, the book occasionally veers into political territory, especially when Dr. Williams' aspirations for political office become apparent. This shift in tone, while understandable given his passion for change, makes the book feel somewhat self-serving and political at times.
Despite these minor drawbacks, it's evident that Dr. Williams genuinely cares about his community and aims to make a positive impact. His perspective is valuable, and he could be a formidable advocate for change in a political role.
Reading this book also prompted me to reflect on my own healthcare system, as I'm in Australia where we have universal healthcare. It raises essential questions about the effectiveness of different healthcare models and the need for constant improvement.
In conclusion, "The Bodies Keep Coming" is a book that challenges your thinking and stirs your emotions. It offers a unique perspective on healthcare disparities and the journey of a dedicated trauma surgeon. I'd like to extend my gratitude to NetGalley and the publisher for providing me with the opportunity to review this thought-provoking audiobook. It's a valuable addition to the discourse on healthcare and racial inequality.
In the book The Bodies Keep Coming we learn from Dr. Brian Williams who is a board-certified trauma surgeon, a Harvard train Doctor, a military officer, a father, a husband and a black man and he was the only trauma surgeon and certified doctor at Parkland Hospital in Dallas the night cops were shot during a protest for those protesting the violence against black men in America by the police. He narrates his own story the emotional toll it took the night someone decided to take the lives of police officers not just the sadness of the ordeal but the things that were said from an ignorant nurse who’s misguided hatred was for BLM and she had no qualms in saying it to a hallway full of people to a father who lost his police officer son and had nothing but praise and admiration for Dr. Williams who saw his son to the end. The emotions were mixed and Dr. Williams being a very smart man felt it all and although he didn’t go into this in his book it was a parent but it didn’t stop him from saluting the police officers when attention was called when the deceased bodies left the hospital. That is not until the middle of the book in the beginning we find out verbatim what it’s like when Dr. Williams has to tell a mother the sun she loves and who she nursed as a baby it’s now dead and the trauma that comes after I think a lot of times when people watch the news the thing they forget is that these people were someone’s baby irregardless of how you feel about that person if someone dies there’s someone else who will be heartbroken and I think Dr. Brian did a good job conveying that there’s so many sad moments in this book he even talks about going to see his own therapist and what that looks like this was a great book and I have nothing but the upmost respect and admiration for Dr. Brian who has been treated as a janitor a cafeteria worker and many other jobs that although may not be demeaning isn’t what he was trained at Harvard to do and is only done to insult and try to put him in his place but being a smart man he is it seems he takes it all in stride because at the end of the day those peoples opinions don’t matter and so I think they should keep them to their self so many people are intimidated by others who are smarter better looking have more money or whatever and I think that’s ridiculous like Dr. Brian‘s wife likes to tell him deal with your own shit because Dr. Brian has lives to save. I want to thank dreamscape media and Net Galley for my free arc copy please forgive any mistakes as I am blind and dictate my review.
Who better to advocate for gun violence reduction than a trauma surgeon serving on the front lines of said violence? This book cemented the immense respect I feel toward healthcare workers because they deal with some serious shit (both literal and figurative) every single day and we as a collective people should listen when they try to speak up.
This book combines memoir with investigative journalism to tell the story of how healthcare is ground zero for race and class disparity and its manifestation in the safety of Americans.
I gave this book four stars because the memoir/storytelling portion of this book is lackluster. Brian Williams uses his personal experience to frame and substantiate his claims of institutional racism, but his personal journey from child to USAF officer to big-time surgeon was murky at times and hard to follow. It makes me so sad (borderline cynical) that in 2023 we are still dealing with racism that *should have* ended with the Civil Rights Act of 1964, but if we are not educated on the insidious ways it shows up in legislature and policies we cannot work to change it.
This book does the important job of calling attention to the racism still plaguing America and its confluence with gun violence that threatens primarily black neighbors across the nation. This book was a fairly easy read with a plethora of recommended resources at the end, and I recommend it if you are interested in dipping your toes into the water of systemic violence.
Because of the clunky narrative, this book earns its place as a solid four-star read.
Dr. Brian Williams is the ideal person to write this particular book- an airforce vetran turned trauma surgeon, he is on the front lines of the gun violence epidemic, and witness to the tragedy of 7/7, operating on sevral of the officers who lost their lives. He is also a black man who has faced structural racism and seen its effect on his patients. This book is effortlessly readable and incredibly impactful, and i think it is incredible that dr. Williams took his trauma and accidental celebrity and has attacked the problem of gun violence and health inequity by writing this story and working ceaseless to protect his patients.
Also made me maybe want to be a trauma nurse, up until the point they said they were putting in 14gauge ivs (GIRL WHERE!?)
Brian H. Williams for President please! In all seriousness, he is an extremely intelligent and well spoken man that communicates his story in a thought provoking manner that flows wonderfully. He is a black surgeon in the trauma bay in hospitals and tells his personal story growing up black in the USA, joining the air force, then becoming a surgeon where he sees the inequality of healthcare and its impact to families, especially the poor and black of this racist country. His chapters on gun violence and gun laws were super impactful. He ends his book with "The bodies, they just keep coming, we have to make them stop." Smarter gun laws in this country are desperately needed and Williams's eloquent prose makes an amazing argument. All leaders of this country should be forced to read this book and spend some time in trauma bays.
Thank you to @DreamscapeMedia and #NetGalley for the audio ARC of #TheBodiesKeepComing. The opinions expressed here are entirely my own.
Behind the scenes/medical memoirs are a favorite of mine and this didn't disappoint. Williams was raised in a military family, moving every 3 years. He ended up in the Air Force himself where he decided to go into medicine. As a trauma surgeon in Dallas, he saw first hand how gun violence impacts black lives daily. A mass shooting which took the lives of 3 police officers forced him to confront his emotions and find another way to make a difference. This book is part history lesson, part public policy critique and part medical memoir and it works, delivering a strong message we all need to hear.
I had the pleasure of meeting the author on a plane ride and was excited to read his book. It was fascinating to learn about his story growing up in a military family, traveling around the world, and how he became a trauma surgeon. The topics of racism, violence, and his own injustices were quite heavy on the heart and eye-opening to learn.
3.5/5 First half of the book had me hooked. Brian has an amazing way of sharing his story, but I got a bit lost in all the statistics towards the second half of the book.
Very transparent view of the intersection of medicine and racism written in a way that one can empathize with regardless of race- a must read before med school