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Surprised by Nothing: Surviving the ER World of Worst-Case Scenarios
Kathryn Kyker used to faint at the sight of blood. But after three decades as an ER social worker, blood no longer phased her—and neither did anything else.
Kathryn took her job at a regional Georgia hospital because she was desperate for health insurance. Although she found the work meaningful and became the hospital’s first ER social work manager, the high-stakes environment left her unable to cry, hypervigilant about safety, and detached from family and friends.
With her inner emotional landscape sabotaged, Kathryn set out on a quest to regain her relationship with curiosity, joy, and the bonds that make us human. The result is a reflective interrogation of the US health care system, a meditation on social work, and a thoughtful inquiry into the emotional responsibilities we have to ourselves—and each other.
Full of compassion and humorous insight, Surprised by Nothing is a compelling reminder of how to live a creative and nurturing life, even in the face of the world’s random, devastating hardships.
Kathryn took her job at a regional Georgia hospital because she was desperate for health insurance. Although she found the work meaningful and became the hospital’s first ER social work manager, the high-stakes environment left her unable to cry, hypervigilant about safety, and detached from family and friends.
With her inner emotional landscape sabotaged, Kathryn set out on a quest to regain her relationship with curiosity, joy, and the bonds that make us human. The result is a reflective interrogation of the US health care system, a meditation on social work, and a thoughtful inquiry into the emotional responsibilities we have to ourselves—and each other.
Full of compassion and humorous insight, Surprised by Nothing is a compelling reminder of how to live a creative and nurturing life, even in the face of the world’s random, devastating hardships.
278 pages, Hardcover
Published August 19, 2025
6 people are currently reading
16 people want to read
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Displaying 1 - 8 of 8 reviews
September 19, 2025
SURPRISED BY NOTHING: SURVIVING THE ER WORLD OF WORST-CASE SCENARIOS by Kathryn Kyker is a philosophical and insightful glance behind the scenes of the medical institution. What is missing from the TV series, depicting the ER, is the team of nurses and social workers who carry the most weight in taking care of the patients. During her 28 years in the field, Kathryn Kyker witnessed the rise of social workers in the ER, who assisted patients and their families, as well as the transformation of information sharing from paper to digital screens.
If you are waiting for a quick succession of events as on the big screen, you may feel disappointed by the book. There are no “I came to the ER with a headache, and it turned out to be lupus” stories. Instead, each chapter is dedicated to one aspect of the ER or the author’s work. Slowly, she tells her life story, from her fear of blood to her unhealthy, in some respects, habit of compartmentalization: work is sharply separated from the personal matters. The book reflects her desire to sum up her working years and find new meaning in retirement. I don’t personally agree with some of her conclusions, but I still appreciate the author’s honesty and vulnerability as she fully opens up before the readers.
I received an advanced review copy from Netgalley, and I’m leaving my review voluntarily.
If you are waiting for a quick succession of events as on the big screen, you may feel disappointed by the book. There are no “I came to the ER with a headache, and it turned out to be lupus” stories. Instead, each chapter is dedicated to one aspect of the ER or the author’s work. Slowly, she tells her life story, from her fear of blood to her unhealthy, in some respects, habit of compartmentalization: work is sharply separated from the personal matters. The book reflects her desire to sum up her working years and find new meaning in retirement. I don’t personally agree with some of her conclusions, but I still appreciate the author’s honesty and vulnerability as she fully opens up before the readers.
I received an advanced review copy from Netgalley, and I’m leaving my review voluntarily.
July 23, 2025
3.58 stars ✨
Reading this made me think back to a social media post that criticized people for pressuring younger generations to only pursue high-paying jobs. Our society NEEDS social workers, librarians, teachers, etc. Their work is invaluable, and this book only scratches the surface of these efforts.
Kyker’s memoir is a vulnerable self-reflection on experiencing the ripple effect of someone else’s worst-case scenario—day in and day out. This book captures the toll that such a routine can take on a person whose job requires them to endure trauma while providing for strangers. It is honest storytelling.
That said, the writing itself fell short for me. The structure and timeline were a little wonky. There’s a lot of jumping back and forth between time periods, which makes it easier for repetition to slip into these moments. I tried telling myself to read it like a collection of short essays—not something I gravitate toward, but it would help me follow the story a little more easily; however, this still felt too choppy for that format.
Also, I like finding the title in books, but there was no reason to drop “worst-case scenario” twenty-three times!
The pacing was sort of exhausting, though that could also be because there were a lot of discussions surrounding philosophy and not enough seamless tie-ins to their relevance to the story. A lot of these philosophical parts had me asking, “ok, and?” It mostly came off as rambling. Sometimes it felt like I was reading a self-help book or something you read during an intro course to help you decide if you want to pursue a major in that field.
Overall, this was an insightful text on the healthcare and social work industries, and how we each come face to face with our humanity. Kyker’s story shines a light on the professionals learning about their own healing processes behind the scenes of everyday chaos.
Thank you very much NetGalley and Girl Friday Productions for the ARC of this book. This is my honest review. All opinions are my own.
Reading this made me think back to a social media post that criticized people for pressuring younger generations to only pursue high-paying jobs. Our society NEEDS social workers, librarians, teachers, etc. Their work is invaluable, and this book only scratches the surface of these efforts.
Kyker’s memoir is a vulnerable self-reflection on experiencing the ripple effect of someone else’s worst-case scenario—day in and day out. This book captures the toll that such a routine can take on a person whose job requires them to endure trauma while providing for strangers. It is honest storytelling.
That said, the writing itself fell short for me. The structure and timeline were a little wonky. There’s a lot of jumping back and forth between time periods, which makes it easier for repetition to slip into these moments. I tried telling myself to read it like a collection of short essays—not something I gravitate toward, but it would help me follow the story a little more easily; however, this still felt too choppy for that format.
Also, I like finding the title in books, but there was no reason to drop “worst-case scenario” twenty-three times!
The pacing was sort of exhausting, though that could also be because there were a lot of discussions surrounding philosophy and not enough seamless tie-ins to their relevance to the story. A lot of these philosophical parts had me asking, “ok, and?” It mostly came off as rambling. Sometimes it felt like I was reading a self-help book or something you read during an intro course to help you decide if you want to pursue a major in that field.
Overall, this was an insightful text on the healthcare and social work industries, and how we each come face to face with our humanity. Kyker’s story shines a light on the professionals learning about their own healing processes behind the scenes of everyday chaos.
Thank you very much NetGalley and Girl Friday Productions for the ARC of this book. This is my honest review. All opinions are my own.
June 29, 2025
Thank you to NetGalley and the publisher for providing this book in exchange for an honest review.
This is an interesting look at the more human side of ERs as opposed to the gritty medical side. Patient advocates are priceless and the ER is a perfect place to be able to give that assistance.
I did get a little bored with the philosophy parts but I did enjoy the psychology parts.
This is an interesting look at the more human side of ERs as opposed to the gritty medical side. Patient advocates are priceless and the ER is a perfect place to be able to give that assistance.
I did get a little bored with the philosophy parts but I did enjoy the psychology parts.
June 24, 2025
Thanks to the publisher and Netgalley for this eARC.
Kathryn Kyker’s Surprised by Nothing: Surviving the ER World of Worst-Case Scenarios is not your typical memoir—it’s a raw, clear-eyed meditation on what it means to bear witness to the worst days of other people’s lives, day after day, and still find a way back to your own humanity.
Kyker, a former ER social worker who once fainted at the sight of blood, chronicles her 30-year journey through the emotional minefield of emergency medicine. But this isn’t a book about heroism or adrenaline. It’s about the quiet, corrosive toll of hypervigilance, the numbing effect of repeated trauma, and the slow unraveling of one’s inner life in the name of professional duty.
What makes this memoir stand out is Kyker’s refusal to sensationalize. Her prose is unflinching but never gratuitous, laced with dry humor and a poet’s sensitivity to the absurd. She doesn’t just recount cases—she interrogates the emotional architecture of survival: how we compartmentalize, how we disconnect, and how we eventually must reckon with what we’ve buried.
The book’s title is a brilliant paradox. In a world where worst-case scenarios are the norm, Kyker finds herself “surprised by nothing”—and yet, in her quest to reclaim joy, curiosity, and connection, she becomes surprised by everything. The result is a memoir that’s as much about healing as it is about endurance.
Surprised by Nothing is a vital read for anyone who’s ever worked in crisis care, loved someone who has, or simply wondered how we keep going when the world keeps breaking. It’s not just a story of survival—it’s a quiet, powerful argument for reclaiming the parts of ourselves we lose in the process.
Kathryn Kyker’s Surprised by Nothing: Surviving the ER World of Worst-Case Scenarios is not your typical memoir—it’s a raw, clear-eyed meditation on what it means to bear witness to the worst days of other people’s lives, day after day, and still find a way back to your own humanity.
Kyker, a former ER social worker who once fainted at the sight of blood, chronicles her 30-year journey through the emotional minefield of emergency medicine. But this isn’t a book about heroism or adrenaline. It’s about the quiet, corrosive toll of hypervigilance, the numbing effect of repeated trauma, and the slow unraveling of one’s inner life in the name of professional duty.
What makes this memoir stand out is Kyker’s refusal to sensationalize. Her prose is unflinching but never gratuitous, laced with dry humor and a poet’s sensitivity to the absurd. She doesn’t just recount cases—she interrogates the emotional architecture of survival: how we compartmentalize, how we disconnect, and how we eventually must reckon with what we’ve buried.
The book’s title is a brilliant paradox. In a world where worst-case scenarios are the norm, Kyker finds herself “surprised by nothing”—and yet, in her quest to reclaim joy, curiosity, and connection, she becomes surprised by everything. The result is a memoir that’s as much about healing as it is about endurance.
Surprised by Nothing is a vital read for anyone who’s ever worked in crisis care, loved someone who has, or simply wondered how we keep going when the world keeps breaking. It’s not just a story of survival—it’s a quiet, powerful argument for reclaiming the parts of ourselves we lose in the process.
October 14, 2025
⭐⭐⭐
Surprised by Nothing
Author: Kathryn Kyker
Source: Purchased
Publication Date: August 19, 2025
Kathryn Kyker is a social worker (MSW) and has spent her life working the Emergency Room shift at an Atlanta hospital. Her insight is valid, and she makes good observations. She also provides some valuable points to consider if you ever need to visit the ER, which will help you receive the best service. The subtitle “surviving the ER world of worst-case scenarios,” and I would think that working in an emergency room, you do see many things you wish you could forget. She affirms that you don’t forget. I can’t imagine the suffering and grief she has experienced in her storied career, but then again, I would have liked more personal stories. Having said that, I think this book reads somewhat like a textbook and will likely be used in nursing schools for reference reading. The cover art is stunning. I appreciate Ms. Kyker sharing her hard-earned knowledge.
#SurprisedByNothing @kathrynthe8 #socialworker #hospitals #EmergencyRoom #ER #shiftwork #life #dedication #service #gfb
Surprised by Nothing
Author: Kathryn Kyker
Source: Purchased
Publication Date: August 19, 2025
Kathryn Kyker is a social worker (MSW) and has spent her life working the Emergency Room shift at an Atlanta hospital. Her insight is valid, and she makes good observations. She also provides some valuable points to consider if you ever need to visit the ER, which will help you receive the best service. The subtitle “surviving the ER world of worst-case scenarios,” and I would think that working in an emergency room, you do see many things you wish you could forget. She affirms that you don’t forget. I can’t imagine the suffering and grief she has experienced in her storied career, but then again, I would have liked more personal stories. Having said that, I think this book reads somewhat like a textbook and will likely be used in nursing schools for reference reading. The cover art is stunning. I appreciate Ms. Kyker sharing her hard-earned knowledge.
#SurprisedByNothing @kathrynthe8 #socialworker #hospitals #EmergencyRoom #ER #shiftwork #life #dedication #service #gfb
September 22, 2025
thanks to netgalley for providing me with an e-arc of this!
as someone who is a social worker in a hospital and would like to continue to be for some time, this was an interesting read to pick up. as someone what loves to learn how other mental health professionals manage the load, i am always fascinated to read that others do. so much of hospital social work is being there for people on what is often the worst day of their lives, and trying to find out how to do that over and over while managing your own mental health is something i'm still trying to figure out. this felt raw and honest, about the good things the author got from this work as well as the ways that it still can be damaging after retirement.
as someone who is a social worker in a hospital and would like to continue to be for some time, this was an interesting read to pick up. as someone what loves to learn how other mental health professionals manage the load, i am always fascinated to read that others do. so much of hospital social work is being there for people on what is often the worst day of their lives, and trying to find out how to do that over and over while managing your own mental health is something i'm still trying to figure out. this felt raw and honest, about the good things the author got from this work as well as the ways that it still can be damaging after retirement.
September 24, 2025
Thank you #Netgalley for the advanced copy! Who would have thought that Kathryn would end up working in an ER when the sight of blood used to take her out. But life happens and Kathryn needed a steady job and health insurance, little did she know this would end up changing the course of her life. She was the first ER social work manager, starting with minimal hours and developing a role and safe an environment to support patient and families.
August 5, 2025
I typically love these kind of memoirs, commentary on our modern systems and inequalities. But this felt disjointed and rambling. There were insightful moments, but they seemed to get lost in the random stories, many seemingly without endings.
**I received my copy from Netgalley.
**I received my copy from Netgalley.
Displaying 1 - 8 of 8 reviews