What do you think?
Rate this book
The Casino Shift: Stories from an ER on the Edge
The Casino Shift has descriptive copy which is not yet available from the Publisher.
336 pages, Hardcover
Published February 17, 2026
About the author
Brian Goldman
11 books33 followersBrian Goldman, MD, is one of those rare individuals with great success in not one but several adrenaline-pumping careers. Goldman is a highly regarded emergency physician at Mount Sinai Hospital in Toronto. He is also the host of the Canadian Broadcasting Corporation’s award-winning radio show “White Coat, Black Art”, where he takes listeners behind the scenes of hospitals and doctor’s offices. Goldman unpacks and demystifies what goes on inside medicine’s sliding doors – with edgy topics that include the whistle blowing in health care, burnout among health professionals, racism in health care and how to getting to the head of the line in health care.
Goldman is on a lifelong campaign to confront medical errors and create a culture of safety for patients. He has proven unafraid of using his own medical mistakes for examples on how doctors can improve. His TEDtalk – “Doctors Make Mistakes. Can We Talk About That?” has been watched by close to a million viewers, and has been featured in The Huffington Post and NPRs TED Radio Hour.
Dr. Goldman has worked as a health reporter for The National, CBC Television’s flagship news program, for CBC-TV’s The Health Show, and served as senior production executive during the launch year of Discovery Health Channel, Canada’s only 24-hour channel devoted to health programming.
He is the author of the bestselling book The Night Shift: Real Life in the ER, which takes readers through giddying heights and crashing lows as Goldman works through a typical night shift in one of Canada’s busiest ERs. His book The Secret Language of Doctors – published by Harper Collins in 2014 – is a biting look at medical slang. The book cracks the coded words doctors use in hospital elevators and hallways that reveal what the doctor really thinks about your mother’s obesity, your grandfather’s dementia or her colleague’s competence. Often funny and always revealing, The Secret Language of Doctors reveals deep flaws in modern medical culture, and how to fix them.
Goldman is on a lifelong campaign to confront medical errors and create a culture of safety for patients. He has proven unafraid of using his own medical mistakes for examples on how doctors can improve. His TEDtalk – “Doctors Make Mistakes. Can We Talk About That?” has been watched by close to a million viewers, and has been featured in The Huffington Post and NPRs TED Radio Hour.
Dr. Goldman has worked as a health reporter for The National, CBC Television’s flagship news program, for CBC-TV’s The Health Show, and served as senior production executive during the launch year of Discovery Health Channel, Canada’s only 24-hour channel devoted to health programming.
He is the author of the bestselling book The Night Shift: Real Life in the ER, which takes readers through giddying heights and crashing lows as Goldman works through a typical night shift in one of Canada’s busiest ERs. His book The Secret Language of Doctors – published by Harper Collins in 2014 – is a biting look at medical slang. The book cracks the coded words doctors use in hospital elevators and hallways that reveal what the doctor really thinks about your mother’s obesity, your grandfather’s dementia or her colleague’s competence. Often funny and always revealing, The Secret Language of Doctors reveals deep flaws in modern medical culture, and how to fix them.
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 30 of 37 reviews
March 6, 2026
I have an admiration for the nurses and physicians who work in the ER.
The stress level is high and despite saving someone’s life, they often get little appreciation.
Canada and The United States have different healthcare systems, and sadly both have many flaws.
In the US we have an affordability crisis.
It already had flaws, but as a result of the “Big Disgusting Bill”, we have people who are now trying their best to get by without health insurance, because the premiums have gone up so much that they can’t afford it.
I believe that basic routine healthcare should be a RIGHT, and not just a privilege for those who can handle the costs.
At the beginning of every year, my dad has to spend $300 per month for ONE medication.
The good news is that because of the cost he quickly meets his deductible, but for a senior on a fixed income, that is a big monthly expense.
He has two heart conditions, so the medication isn’t optional.
(I will be so happy when their patent expires and people will be able to get generic Eliquis).
In Canada, depending on where one lives, they can have trouble finding a primary care physician (and sometimes getting appointments can take a few months).
Without that access, they can’t preventively notice medical issues that are often manageable when noticed early enough.
They end up in the ER, which puts a lot of pressure on the staff, as it’s designed for unpredictable conditions like car crashes or cuts and scrapes that require sutures.
In this book, I felt like I got to follow Dr. Brian Goldman (an ER physician who works the overnight shift) around.
If I were working with him I’d call him Dr. Goldman, but I appreciated the fact that he said that as he’s approaching retirement he’d rather just be called Brian.
In some ways it reminded me of The Pitt, because on that show each episode is one hour working in the ER and in this book each chapter is roughly the same.
I don’t think that you need to work in healthcare to enjoy this book.
Even when using medical terms, he explains what they mean
The main reason that I read this is because I don’t intend to stay in the US for that much longer.
I want to get a glimpse into other nation’s healthcare systems, because I know that when I do leave, the easiest option will be getting a work visa as a healthcare worker.
Dr. Goldman did a great job of explaining a typical shift at an ER in Toronto.
The stress level is high and despite saving someone’s life, they often get little appreciation.
Canada and The United States have different healthcare systems, and sadly both have many flaws.
In the US we have an affordability crisis.
It already had flaws, but as a result of the “Big Disgusting Bill”, we have people who are now trying their best to get by without health insurance, because the premiums have gone up so much that they can’t afford it.
I believe that basic routine healthcare should be a RIGHT, and not just a privilege for those who can handle the costs.
At the beginning of every year, my dad has to spend $300 per month for ONE medication.
The good news is that because of the cost he quickly meets his deductible, but for a senior on a fixed income, that is a big monthly expense.
He has two heart conditions, so the medication isn’t optional.
(I will be so happy when their patent expires and people will be able to get generic Eliquis).
In Canada, depending on where one lives, they can have trouble finding a primary care physician (and sometimes getting appointments can take a few months).
Without that access, they can’t preventively notice medical issues that are often manageable when noticed early enough.
They end up in the ER, which puts a lot of pressure on the staff, as it’s designed for unpredictable conditions like car crashes or cuts and scrapes that require sutures.
In this book, I felt like I got to follow Dr. Brian Goldman (an ER physician who works the overnight shift) around.
If I were working with him I’d call him Dr. Goldman, but I appreciated the fact that he said that as he’s approaching retirement he’d rather just be called Brian.
In some ways it reminded me of The Pitt, because on that show each episode is one hour working in the ER and in this book each chapter is roughly the same.
I don’t think that you need to work in healthcare to enjoy this book.
Even when using medical terms, he explains what they mean
The main reason that I read this is because I don’t intend to stay in the US for that much longer.
I want to get a glimpse into other nation’s healthcare systems, because I know that when I do leave, the easiest option will be getting a work visa as a healthcare worker.
Dr. Goldman did a great job of explaining a typical shift at an ER in Toronto.
March 1, 2026
3.5 rounded up.
Interesting but not gripping. Factual without being overly dramatic. I do think readers geographically linked would find this more pertinent. It did, however, make really grateful that Australia’s health system is (currently) in better shape than the depiction of Canada’s system.
Important warnings for all health care!
Interesting but not gripping. Factual without being overly dramatic. I do think readers geographically linked would find this more pertinent. It did, however, make really grateful that Australia’s health system is (currently) in better shape than the depiction of Canada’s system.
Important warnings for all health care!
October 21, 2025
**I received a free copy from Edelweiss so I could review this**
I've been really into medicine videos/podcasts lately (obsessed with The Pitt too). This is Dr. Goldman's story of his ER and the cases that come in every day, entwined with other stories of the state of medicine in Canada. Obviously not being from Canada, I was fascinated by their medical system. It's so overwhelmed, and there are nowhere near enough doctors, especially since so many Canadians don't have primary care doctors and use ERs for basic treatments. One story about a doctor who flies all over Canada to bring care to rural areas was fascinating.
I've been really into medicine videos/podcasts lately (obsessed with The Pitt too). This is Dr. Goldman's story of his ER and the cases that come in every day, entwined with other stories of the state of medicine in Canada. Obviously not being from Canada, I was fascinated by their medical system. It's so overwhelmed, and there are nowhere near enough doctors, especially since so many Canadians don't have primary care doctors and use ERs for basic treatments. One story about a doctor who flies all over Canada to bring care to rural areas was fascinating.
March 1, 2026
Very eye opening
March 2, 2026
4⭐️
A shocking but realistic view of the Emergency medicine system in Canada. From a lack of primary care physicians, to a nursing shortage, to closures and more complex medical complaints Emergency rooms are becoming the catchall for those seeking medical attention. And they are reaching a boiling point. However, there are places across the country that are trying innovative new approaches to support a crumbling system. As someone who works for a hospital that has the busiest ER’s in the country, I see firsthand what is happening. And it’s terrifying. But Goldman does an amazing job highlighting the failures without placing the blame on anything. He explores the reasons why we got to where we are and showcases solutions that are working for others. But make no mistake, he doesn’t paint a rosy picture, and without everyone making big swaths of change, things are only going to get worse. The highlight for me was how compassionately he focuses on both the patient and the staff he works with. They are the collateral damage to a failing system, and he makes sure that their stories show how they continue to do miraculous things in the face of the impossible
A shocking but realistic view of the Emergency medicine system in Canada. From a lack of primary care physicians, to a nursing shortage, to closures and more complex medical complaints Emergency rooms are becoming the catchall for those seeking medical attention. And they are reaching a boiling point. However, there are places across the country that are trying innovative new approaches to support a crumbling system. As someone who works for a hospital that has the busiest ER’s in the country, I see firsthand what is happening. And it’s terrifying. But Goldman does an amazing job highlighting the failures without placing the blame on anything. He explores the reasons why we got to where we are and showcases solutions that are working for others. But make no mistake, he doesn’t paint a rosy picture, and without everyone making big swaths of change, things are only going to get worse. The highlight for me was how compassionately he focuses on both the patient and the staff he works with. They are the collateral damage to a failing system, and he makes sure that their stories show how they continue to do miraculous things in the face of the impossible
Read
May 5, 2026Excellent book on the state of health care in Canada. Written from the perspective of an ER doctor who practices out of Ontario but with examples from across the country. This book explains how nearly all provinces are in crisis, trying to accommodate the aging population, increased unhorsed population and complex chronic diseases as humans are living longer. I read this physicians other book and it was just as compelling of a read. Highly recommend.
February 24, 2026
This book dives into the total collapse of Canada’s medical system — the shortages of nurses, ER doctors, and family doctors — and it’s honestly one of the most engaging nonfiction reads I’ve picked up in a while.
You can tell how much research and how many interviews went into it. The stories aren’t just from the author, but from his colleagues across the country, and each chapter focuses on a different crack in the system. The stories are raw and sometimes frustrating, but also incredibly informative and eye-opening. It never feels dry or overloaded with data — somehow it manages to pack in so much information while still being completely readable.
The best way I can describe it: it felt like being in a class taught by that one teacher everyone loves. You learn a ton, you’re fully engaged, and you don’t want the lecture to end. That’s how I felt about Dr. Brian Goldman’s writing. I’m genuinely excited to go read his first book because I loved his voice so much.
He also ends the book by offering practical solutions to the mess that is Canada’s healthcare system, which I appreciated. It’s not just doom and gloom — there’s thoughtfulness and hope there too.
Highly recommend, especially if you live in Canada and have ever sat in an ER waiting room wondering how things got this bad.
Thank you to NetGalley and Harper Collins Audio for the advanced audiobook in exchange for my honest review.
You can tell how much research and how many interviews went into it. The stories aren’t just from the author, but from his colleagues across the country, and each chapter focuses on a different crack in the system. The stories are raw and sometimes frustrating, but also incredibly informative and eye-opening. It never feels dry or overloaded with data — somehow it manages to pack in so much information while still being completely readable.
The best way I can describe it: it felt like being in a class taught by that one teacher everyone loves. You learn a ton, you’re fully engaged, and you don’t want the lecture to end. That’s how I felt about Dr. Brian Goldman’s writing. I’m genuinely excited to go read his first book because I loved his voice so much.
He also ends the book by offering practical solutions to the mess that is Canada’s healthcare system, which I appreciated. It’s not just doom and gloom — there’s thoughtfulness and hope there too.
Highly recommend, especially if you live in Canada and have ever sat in an ER waiting room wondering how things got this bad.
Thank you to NetGalley and Harper Collins Audio for the advanced audiobook in exchange for my honest review.
March 12, 2026
Such a necessary book. Eye opening and insightful. If you care about your emergency room access, this is a must-read.
I kind of wish that the author went more into how provincial governments (Doug Ford) have changed health care for the worse, but maybe that’s another book for the future lol.
I kind of wish that the author went more into how provincial governments (Doug Ford) have changed health care for the worse, but maybe that’s another book for the future lol.
March 24, 2026
A fascinating insight on Canadian emergency rooms. Satisfied my urge to rewatch The Pitt for the umpteenth time
February 19, 2026
It was refreshing to read a book written by a Canadian doctor and see a Canadian perspective throughout. The issues discussed felt very current and relevant—things like GLP-1s and South American plastic surgery made the stories feel grounded in the present. The accounts were raw and emotional, and I really appreciated the author’s willingness to openly acknowledge failures within the universal healthcare system.
March 10, 2026
Goldman, host of CBC's 'White Coat, Black Art,' has written an update to his 2010 memoir The Night Shift, about working in a Toronto Emergency Room. In this new book, he looks at the changes brought on by the diminished number of Family Physicians in Canada, the surge in opioid addictions and overdoses, Covid, and the effects of new technologies. It's a bleak picture and parts of the book are a bit of a rant. But if the last decade and a half have shown us anything, it's that nothing stays the same. Goldman points to models utilized in other countries, changes being implemented here in Canada, and ways of thinking about emergency medicine that might move us in the right direction. Change is clearly needed, and this title is a great place to start the conversations that will move the needle (as it were).
April 8, 2026
A tremendous book profiling a ‘night’ in the ER. Lots of it a fairly depressing account of systems issues, very sick patients and insufficient staff at all levels of the hospital to serve all who come. Nonetheless, there are stories of success, particularly in rural communities who have virtual care and locum physician services. In larger hospitals, there is much better equipment at the bedside. A must read for those in leadership roles, those contemplating careers in medicine and those interested in the human body, human frailty and illness. Dr Goldman’s compassion and role modelling are inspirational.
April 16, 2026
This is Dr. Brian Goldman's follow up to "The Nightshift". I was captivated by the ER stories. I was duly impressed by the abilities of these docs/nurses/healthcare workers to do their jobs with so little sleep. Obviously not sustainable. And dangerous.
The astronomical healthcare costs (dollars and damage to personnel) of the ER care is scary.
The stats he has referenced are disturbing. As Canadians we need to encourage change. We have all been an in ER with a loved one or for ourselves.
Other countries can deliver publicly funded healthcare better. We need to keep working at this. The future of the system is at risk.
The astronomical healthcare costs (dollars and damage to personnel) of the ER care is scary.
The stats he has referenced are disturbing. As Canadians we need to encourage change. We have all been an in ER with a loved one or for ourselves.
Other countries can deliver publicly funded healthcare better. We need to keep working at this. The future of the system is at risk.
May 1, 2026
A fairly interesting read which highlights many of the issues and concerns facing emergency departments across Canada. I appreciated that Goldman offered suggestions periodically but readily acknowledged the complexity and politicization of the issues that have no easy solution. He does have a folksy tone that occasionally grates on the nerves and tends to elevate most emergency staff to sainthood, but there can be no doubt that most staff in ERs across the nation face numerous challenges and put in hard shifts. I think my main takeaway was that there is no one magic solution and we have to be open to many possible options and adapt solutions to fit the various challenges faced in both urban and rural settings.
February 15, 2026
Thank you HarperCollins Canada Audio, HarperCollins Publishers, and NetGalley for the advanced electronic audio review copy of this book. This is a medical memoir providing a realistic behind-the-scenes look into one of the Canadian ERs but delving into the realities of the ERs across the country. I really enjoyed this fast paced, edge of your seat read. Loved figuring out diagnoses alongside the doctors and am definitely recommending it to anyone who enjoys medical memoirs with a front row seat at the look at the front lines.
March 4, 2026
Very thought provoking book about medical services in Canada, focusing mostly on the ER. Anecdotes about various patients mingled with statistics and analysis of the state of medical care.
If you're familiar with Goldman's first book, The Night Shift: Real Life in the Heart of the E.R., you'll know that he's an excellent writer. Things have changed a lot in the sixteen years since that book came out--technology, the aging population, the proliferation of drugs and mental illness, just to name a few. In this book, Goldman sets the narrative within the scope of a Casino shift, a shorter overnight shift in the ER.
He talks about various patients he sees and how he comes to a diagnosis for them. If you're a fan of the show The Pitt, this part will really resonate with you. I found the case studies to be fascinating anchors for the rest of the tale.
There are a lot of statistics here, he explores the pros and cons of Canada's medical system, the doctor and nurse shortages, the challenges and triumphs that have taken place. Overall I found the entire book to be very fascinating and a good mix of analysis and medical care.
I voluntarily reviewed a complimentary copy of this book, all opinions are my own.
If you're familiar with Goldman's first book, The Night Shift: Real Life in the Heart of the E.R., you'll know that he's an excellent writer. Things have changed a lot in the sixteen years since that book came out--technology, the aging population, the proliferation of drugs and mental illness, just to name a few. In this book, Goldman sets the narrative within the scope of a Casino shift, a shorter overnight shift in the ER.
He talks about various patients he sees and how he comes to a diagnosis for them. If you're a fan of the show The Pitt, this part will really resonate with you. I found the case studies to be fascinating anchors for the rest of the tale.
There are a lot of statistics here, he explores the pros and cons of Canada's medical system, the doctor and nurse shortages, the challenges and triumphs that have taken place. Overall I found the entire book to be very fascinating and a good mix of analysis and medical care.
I voluntarily reviewed a complimentary copy of this book, all opinions are my own.
March 14, 2026
I love Dr Goldmans podcasts on CBC and his first book. He does such a good job of explaining what’s happening in Canadian healthcare in terms the general population can understand. It’s alarming to read so many experts calling our healthcare system broken. It’s also frustrating that so many times nothing happens to patients unless them or their family advocate for them, when you shouldn’t have to kick and scream to get quality, timely care.
Big shoutout to ER docs, nurses and all healthcare personnel who show up everyday and do their best in a broken system.
Big shoutout to ER docs, nurses and all healthcare personnel who show up everyday and do their best in a broken system.
March 20, 2026
The Casino Shift is the sequel to The Night Shift that Dr Brian Goldman wrote 10 years ago. The Casino Shift was an eye opening book that showed not much has changed in the ERs in Toronto over the past 10 years. They are still over crowded with exhausted front line workers. In the book Dr. Goldman shares some innovative ideas about how ER medicine can be adopted into the field to increase patient survival rates and he also explains the push back that some of these ideas have received.
I read this book in preparation for an author event that Dr. Goldman will be one of the authors featured and I am looking forward to hearing his discussion.
I read this book in preparation for an author event that Dr. Goldman will be one of the authors featured and I am looking forward to hearing his discussion.
May 1, 2026
This emergency doctor takes you behind the scenes of one night shift at a Toronto Hospital. The casino shift takes its name from casinos that use 2 shifts, 10 pm to 4 am, then 4-10 in order to give night workers part of a night to sleep. He interweaves stories of this shift with stories of similar hospital night shifts across Canada. He discusses such issues as hospital closures, a travelling ER doctor in B.C. and the troubles plaguing the Canadian health system. He is also the host of a CBC radio broadcast, White Coat, Black Art.
February 23, 2026
This shed some light on the internal emotions of healthcare providers throughout Canada. Although written from a MD perspective, you can understand easily what message the author is trying to get you to understand! Such good stories to read, being a nurse myself, 4 stars only because the book references many stories outside of the “one shift” it would read better if it was all from one night, taking you along with them!
March 16, 2026
3.5 rounded up! An interesting look into Canada's healthcare system and what could eventually be total system collapse if we don't get our act together lol. I took half a star off for the narration, very staccato and kind of lifeless and it wasn't even the author (which I would have given the pass to)
Grateful for all the health care workers who continue to show up to work every day <3
Grateful for all the health care workers who continue to show up to work every day <3
April 23, 2026
A glimpse into the emergency rooms of some of Canada’s hospitals. It’s somewhat reassuring to know that knowledgeable, dedicated people like Dr. Goldman and the others he works with are out there providing emergency care: doctors, nurses, EMTs, radiologists, etc. It’s somewhat disturbing to see how overworked, overwhelmed, and understaffed they are.
May 8, 2026
As a Canadian and a fan of The Pitt, this was a FASCINATING listen. It was so great to get a deep dive on issues that are impacting ER employees and services across Canada, and some of the amazing out-of-the-box ideas that are helping mitigate some of those challenges. Definitely would recommend as a read for people interested in Canadian healthcare that is not at all dry, but also inspiring.
February 17, 2026
Excellent summary of the current state of Emergency Medicine in Canada.
Must read for anyone interested in the topic - medical and non-medical alike.
Must read for anyone interested in the topic - medical and non-medical alike.
February 25, 2026
Absolutely excellent!!
March 8, 2026
Read this and then tell me again how you think healthcare workers are overpaid.
March 16, 2026
A lot of statistical information. It was interesting where the future of emergency médecine could go.
March 22, 2026
Meh. lots of statistics. Definitely not The Pitt comparable.
March 27, 2026
If I could give this book 10 stars I would. Very well written, terrifying, captivating, enraging, and oh so insightful!
March 31, 2026
Round up to 3,5 stars - such an interesting look into the ER and where it needs to go
Displaying 1 - 30 of 37 reviews