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Letters from the Pit: Stories of a Physician's Odyssey in Emergency Medicine
In a culture of comic book heroes, it's gratifying to be reminded that there are real heroes out there. Every day the staff of emergency rooms throughout the world are saving lives - 24/7/365. Dr. Patrick Crocker provides us an intimate glimpse into the growing mind of an emergency physician, from residency to retirement.Told in a unique first-person stream of consciousness style, you are right in the middle of the action, looking over the doctor's shoulder while he works. In this compilation of notable, frightening, funny, sad, and poignant cases, you'll see Dr. Crocker's struggles to Do No Harm in the most challenging of situations. Through these stories, you'll see him find the delicate balance between help and harm, empathy and self-preservation.
244 pages, Paperback
First published January 1, 2019
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November 11, 2022*Update The author repeats 'primum non nocere. First do no harm,' endlessly. It's as if it is the theme of the book. As if being a doctor wasn't about doing their best to save a live, make someone better, but about starting from a low place instead - first of all, do no harm. I understand what the author means, and he's very genuine and forthright, but the constant repetition is wearing me down and making me want to throw something at him. This book maybe. Not enough to do him harm.
__________
find medical stories fascinating. The ER ones are all the same and completely different. I like the ones that concentrate on patient stories better than strictly autobiographical ones. I think the very best of the genre is This is Going to Hurt: Secret Diaries of a Junior Doctor which combined both elements really well. I hope this book does too.
__________
find medical stories fascinating. The ER ones are all the same and completely different. I like the ones that concentrate on patient stories better than strictly autobiographical ones. I think the very best of the genre is This is Going to Hurt: Secret Diaries of a Junior Doctor which combined both elements really well. I hope this book does too.
January 6, 2021
Imagine rookie Dr. Patrick Crocker is the new medical student and he decides to document the quasi hell via a round of letters to his college buddy Jack. So many problems arise, and the ER is definitely the place that many stories/lessons can be inspired from. Once such is the case of the nine-month-old baby choking to death.
When babies have obstructions (and the entire staff hears the baby gasping for air and as the nurse reaches for the Ambu bag) the tension is apparent with perspiration drops descending like hope. Quickly one runs to the OR to determine if an anesthesiologist can be commandeered. Emergency room physicians are just opposites of specialist doctors.
“God told him he needed to change his life. No more drugs, no more being an asshole. He was being granted a second chance. And there we were together. At the start of his new life, his second chance. He is clearly shaken and has been deeply moved by this experience.” His essence is like no other.
---Patrick Crocker, MD
Someone may try and pose an “argumentum ad ignorantiam” which does not phase Dr. Crocker. Stridor is heard as the crew is examining the baby. Breathing is critical and death is eminent for many with such an obstruction that cannot be identified. Fever is ruled out and an unlikely move would be to use drugs which could result in paralysis.
Dr. Patrick Crocker then intervenes with a treatment to reduce swelling in the airway. Though he feigns being calm on the outside, inside he is a mess. Then a second nebulizer treatment is ordered and then a sound is heard that brings an expression of surprise. Something is coming out! Letters from the Pit is a must read for any medical or health sciences student. Was the baby saved? Read.
When babies have obstructions (and the entire staff hears the baby gasping for air and as the nurse reaches for the Ambu bag) the tension is apparent with perspiration drops descending like hope. Quickly one runs to the OR to determine if an anesthesiologist can be commandeered. Emergency room physicians are just opposites of specialist doctors.
“God told him he needed to change his life. No more drugs, no more being an asshole. He was being granted a second chance. And there we were together. At the start of his new life, his second chance. He is clearly shaken and has been deeply moved by this experience.” His essence is like no other.
---Patrick Crocker, MD
Someone may try and pose an “argumentum ad ignorantiam” which does not phase Dr. Crocker. Stridor is heard as the crew is examining the baby. Breathing is critical and death is eminent for many with such an obstruction that cannot be identified. Fever is ruled out and an unlikely move would be to use drugs which could result in paralysis.
Dr. Patrick Crocker then intervenes with a treatment to reduce swelling in the airway. Though he feigns being calm on the outside, inside he is a mess. Then a second nebulizer treatment is ordered and then a sound is heard that brings an expression of surprise. Something is coming out! Letters from the Pit is a must read for any medical or health sciences student. Was the baby saved? Read.
August 18, 2019
Emergency Room cases
Casually written, in letter format, this book describes EM(emergency medicine) as it was decades ago. The cases were not all emergencies, but mist of them were. Now emergency departments see more non emergency cases because either the patient doesn't have a primary care doctor or that doctor is unavailable. Urgernt care centers have changed that somewhat.
Crocker often emphasizes the necessity of having a doctor who knows you well to plan end of life issues. Most people don't do that until it's too late.
Casually written, in letter format, this book describes EM(emergency medicine) as it was decades ago. The cases were not all emergencies, but mist of them were. Now emergency departments see more non emergency cases because either the patient doesn't have a primary care doctor or that doctor is unavailable. Urgernt care centers have changed that somewhat.
Crocker often emphasizes the necessity of having a doctor who knows you well to plan end of life issues. Most people don't do that until it's too late.
April 22, 2019
Great book. Would fully recommend to to others.
December 11, 2018
In a culture of comic book heroes, it’s gratifying to be reminded that there are real heroes out there. Everyday the staff of Emergency Departments throughout the world are there saving lives 24/7/365. Pat Crocker provides us an intimate glimpse into the growing mind of an Emergency Physician, from residency through a fascinating 37 year career. The stories are poignant, instructive and hard to put down. A great read. J. Bruce Moskow, M.D., FACEP.
Past President, Texas College of Emergency Physicians
Dr. Patrick Crocker uses his lifetime of stories from the most vulnerable place of all, the emergency department, and summarizes them in beautiful, chronological prose pulling the reader into this exciting world. Patrick lifts the curtain for the reader to see a different and unexpected side of life in the emergency department that portrays life-and-death medical situations with lyrical meditations on the world of medicine and the world at large. This little gem contains knowledge and lessons that can be applied not only in the medical field, but also in personal life. I found this book of personal vignettes to be a refreshing and exciting change in what I’m used to when reading medical emergency stories.
COL (ret) John McManus, M.D., SPEAKER, American College of Emergency Physicians
Dr. Crocker tells these stories so well the reader feels like he is looking over Pat’s shoulder as he unveils the mysteries and oddities of the emergency department. His recollections stir the memories of any emergency physician, some great, some terrible, all impossible to forget. Truman J. Milling Jr. M.D., News & Perspective Editor, Annals of Emergency Medicine
Letters from the Pit reveals a physician's journey to find balance between help and harm, empathy and self preservation. The "in-the-moment" writing style provides insight into the emotions and thought processes that occur in the midst of life-changing moments for patients, families and care givers. These stories reveal the appeal, rewards and costs of Emergency Medicine. We see evolution and growth seep through as a physician, a human being, is changed one case at a time by life events, as all of us are.
Sharon Long, M.D., Emergency Physician
A raw, unflinching look at one of the most bizarre and stressful occupations a person could choose. Dr. Crocker takes us through his career in emergency medicine, serving up one fascinating case after another. He writes with the vulnerability of someone keenly aware that they don’t get it right every single time. His honest, often humorous insight into medical education and practice is a refreshing departure from the norm. Travis Pipkin, RN, MSN, Emergency Nurse Practitioner
Letters from the Pit made me feel like I was right back in the middle of the ER action again. It brings what happens behind the scenes in the ER into focus from a new perspective inside the mind of the physician. A very enjoyable read. Terri Mantia, RN, Emergency Nurse
Letters From the Pit is a searing emotional account from the front lines of medicine. As Dr. Crocker relates his courageous stories, of the lives he saved or lost, we come away with a vivid portrait of an emergency physician, seeking to do the best for his patients, one shift at a time. I highly recommend this riveting story of loss and hope in the world of medicine. Will Clementson, D.O., Emergency Physician
Letters from the Pit is a wonderful example of elegant storytelling. Dr. Crocker explains through poignant prose the thoughts, emotions, and challenges of the emergency physician. Happy, sad, horrific and thought provoking moments from his career. Physicians are not often open about their failures along their path, but he shares it all. The book is an excellent selection for anyone interested in reading good stories, doctors, nurses, medical students and residents everywhere. A series of stories that is captivating and will keep you wanting more. Don Connell, M.D., retired Emergency Physician
In a very real way, Dr. Patrick Crocker combines powerful stories of life and death situations in the ER with common sense reflections on the over-medication of America and what should be done about it. You will be right there with him as he practices his unfailing devotion to “first, do no harm” in the day-to-day drama that is the emergency room. JoAnn S. Dawson, award-winning author of the Lucky Stable Series and Bed, Breakfast and Beyond
Past President, Texas College of Emergency Physicians
Dr. Patrick Crocker uses his lifetime of stories from the most vulnerable place of all, the emergency department, and summarizes them in beautiful, chronological prose pulling the reader into this exciting world. Patrick lifts the curtain for the reader to see a different and unexpected side of life in the emergency department that portrays life-and-death medical situations with lyrical meditations on the world of medicine and the world at large. This little gem contains knowledge and lessons that can be applied not only in the medical field, but also in personal life. I found this book of personal vignettes to be a refreshing and exciting change in what I’m used to when reading medical emergency stories.
COL (ret) John McManus, M.D., SPEAKER, American College of Emergency Physicians
Dr. Crocker tells these stories so well the reader feels like he is looking over Pat’s shoulder as he unveils the mysteries and oddities of the emergency department. His recollections stir the memories of any emergency physician, some great, some terrible, all impossible to forget. Truman J. Milling Jr. M.D., News & Perspective Editor, Annals of Emergency Medicine
Letters from the Pit reveals a physician's journey to find balance between help and harm, empathy and self preservation. The "in-the-moment" writing style provides insight into the emotions and thought processes that occur in the midst of life-changing moments for patients, families and care givers. These stories reveal the appeal, rewards and costs of Emergency Medicine. We see evolution and growth seep through as a physician, a human being, is changed one case at a time by life events, as all of us are.
Sharon Long, M.D., Emergency Physician
A raw, unflinching look at one of the most bizarre and stressful occupations a person could choose. Dr. Crocker takes us through his career in emergency medicine, serving up one fascinating case after another. He writes with the vulnerability of someone keenly aware that they don’t get it right every single time. His honest, often humorous insight into medical education and practice is a refreshing departure from the norm. Travis Pipkin, RN, MSN, Emergency Nurse Practitioner
Letters from the Pit made me feel like I was right back in the middle of the ER action again. It brings what happens behind the scenes in the ER into focus from a new perspective inside the mind of the physician. A very enjoyable read. Terri Mantia, RN, Emergency Nurse
Letters From the Pit is a searing emotional account from the front lines of medicine. As Dr. Crocker relates his courageous stories, of the lives he saved or lost, we come away with a vivid portrait of an emergency physician, seeking to do the best for his patients, one shift at a time. I highly recommend this riveting story of loss and hope in the world of medicine. Will Clementson, D.O., Emergency Physician
Letters from the Pit is a wonderful example of elegant storytelling. Dr. Crocker explains through poignant prose the thoughts, emotions, and challenges of the emergency physician. Happy, sad, horrific and thought provoking moments from his career. Physicians are not often open about their failures along their path, but he shares it all. The book is an excellent selection for anyone interested in reading good stories, doctors, nurses, medical students and residents everywhere. A series of stories that is captivating and will keep you wanting more. Don Connell, M.D., retired Emergency Physician
In a very real way, Dr. Patrick Crocker combines powerful stories of life and death situations in the ER with common sense reflections on the over-medication of America and what should be done about it. You will be right there with him as he practices his unfailing devotion to “first, do no harm” in the day-to-day drama that is the emergency room. JoAnn S. Dawson, award-winning author of the Lucky Stable Series and Bed, Breakfast and Beyond
June 3, 2019
In this book Dr. Patrick Crocker, an ER doctor for many years includes 40 writings that go from his time as a student to his actual work in the field. He recounts some of the patients that had a special value for him. After reading this book, we realize how difficult this area of medicine is as they must know about all different parts of the body and be so cold-blooded so as not to lose perspective and make the best decision when patients are dying. What they do can represent the difference between life and death. Additionally, he explains why doctors must not get attached to their patients and what worked for him is the dictum: First, never harm, which he upheld all throughout his career. His cases were interesting but his approach as a human being was much better. An interesting read for me.
January 29, 2019
As we find ourselves in the midst of what many people view as a healthcare crises, it is refreshing to read an honest, humanizing, first-hand account of the tribulations in the ER. Empathy, often lacking in healthcare, stands out in this series of personal vignettes shared by Dr. Crocker. An excellent book that definitely leaves the reader yearning for more. If only we could clone your brilliance, passion, empathy and understanding Dr. Crocker!
March 20, 2019
Truthful book
As a retired RN with some knowledge of hospitals and Emergency o rooms, I want to thank Patrick Crocker for writing an honest and truthful book.
He presents his life journey in such a way that it can be read and enjoyed by all. I recommend this book.
As a retired RN with some knowledge of hospitals and Emergency o rooms, I want to thank Patrick Crocker for writing an honest and truthful book.
He presents his life journey in such a way that it can be read and enjoyed by all. I recommend this book.
December 14, 2019
Great read!
The author draws you through many insightful and powerful vignettes of his career, and demonstrates well, the true meaning of “First, Do no harm”
The author draws you through many insightful and powerful vignettes of his career, and demonstrates well, the true meaning of “First, Do no harm”
July 2, 2024
I really do enjoy stories re medical cases like this!
September 1, 2020
As a nurse who spent most of my career in emergency care, I found Dr. Crocker's vignettes spot on. He vividly captures the chaos and roller coaster emotions inherent to this specialty. Anyone interested in the workings of a major trauma center will not be disappointed.
February 18, 2019
A wonderful book!
I wish I could have worked beside you! I have had 25 plus years spanning from labor and delivery to long term care. A few years in ER a lot of years in ICU. When you speak of listening to the patient, touching their hand my heart soared! My GP is in his seventies and you and he would be great friends. He always pays my hand, puts down the chart and listens to me. I can't say the same about my cardiologist. He is a very good doctor but he doesn't listen to me and has never shook my hand. Oh the things he could learn from you. This book should be mandatory reading for all medical students. Your wisdom on each page should be read and practiced. I was sad to finish this book. Please please write another book with more stories! You left me yearning for more. I also loved that you respected your whole team. I'm sure your lack of ego was surprising to most nurses. I just can't say enough about this book. I will be telling all my nursing friends to read this bookl
I wish I could have worked beside you! I have had 25 plus years spanning from labor and delivery to long term care. A few years in ER a lot of years in ICU. When you speak of listening to the patient, touching their hand my heart soared! My GP is in his seventies and you and he would be great friends. He always pays my hand, puts down the chart and listens to me. I can't say the same about my cardiologist. He is a very good doctor but he doesn't listen to me and has never shook my hand. Oh the things he could learn from you. This book should be mandatory reading for all medical students. Your wisdom on each page should be read and practiced. I was sad to finish this book. Please please write another book with more stories! You left me yearning for more. I also loved that you respected your whole team. I'm sure your lack of ego was surprising to most nurses. I just can't say enough about this book. I will be telling all my nursing friends to read this bookl
April 2, 2019
Very enjoyable memoir based on a series of letters that the author wrote (never ended up getting sent) to his brother relating experiences from 40 yrs of experiences as a ER doc. It takes a special sort of doctor to be up to the challenge of the ER to begin with, so with 40 yrs under his belt, he is that special.
Conversational style is easy to follow, even for a non medical audience like me.
His career started in the 80's when ER medicine was just coming of age, one of the few docs to be certified. Interesting to see how it evolved through the decades.
Hard to put down. got 5 stars from Amazon
Conversational style is easy to follow, even for a non medical audience like me.
His career started in the 80's when ER medicine was just coming of age, one of the few docs to be certified. Interesting to see how it evolved through the decades.
Hard to put down. got 5 stars from Amazon
May 15, 2022
Engaging and realistic
A very realistic portrayal of ER medicine throughout the author’s decades-long career. I enjoyed the “letter” format - I felt it was unique and made it more personal. Some very salient points were made about over-prescribing medications and the importance of proper psychiatric and social resources for people who are struggling. Great read!
A very realistic portrayal of ER medicine throughout the author’s decades-long career. I enjoyed the “letter” format - I felt it was unique and made it more personal. Some very salient points were made about over-prescribing medications and the importance of proper psychiatric and social resources for people who are struggling. Great read!
January 16, 2021
It doesn't take much for me to drop from five to four stars - and none of that applied here. The writing style is easy to read, the chapters (letters) are long enough to be complete but not long enough to be tedious. They're about real cases, too - so when you're reading it with actual medical knowledge in mind, you can (sometimes) figure out the case. Sometimes you can't - but neither could he.
Truly an awesome book - and one I highly recommend for anyone who works in EMS or Emergency medicine in any way, as well as anyone who does patient care at all.
Truly an awesome book - and one I highly recommend for anyone who works in EMS or Emergency medicine in any way, as well as anyone who does patient care at all.
August 15, 2025
If I read the words primum non nocere one more time I am throwing hands. The only reason I finished this book and the only reason it has 2 stars instead of 1 is my respect for him as a professional. I am sure he was an amazing doctor, but because he is also so so sure of it, the book was almost unbearable to read as someone who spends a lot of time in “the pit”. It would’ve felt A LOT more genuine if he had included at least ONE mistake he made ever (I cannot believe a doctor can have a decades long ER career and make NO mistakes at all). But no, this was 250 pages of this guys singing his praises in a very dramatic tone. He should’ve been a surgeon really.
June 7, 2022
Really interesting notes from an ER Doctor who chose to work in that environment for over 35 years. Well written, nicely introspective, and arranged in easy 'bites'.
January 16, 2019
Short and powerful stories about real like experiences in the ER. You just can't make this stuff up. I worked in IT at a major hospital years ago and we would hear snippets about what went on in the ER. But I never imagined or thought about how ER Doctors and staff dealt with the daily trauma week in and week out, year after year. This book captures not only how anything and everything must be dealt with in an ER, but the way Dr. Crocker examines each case and deals with each case from a professional and emotional standpoint. It makes you appreciate him and his line of work as never before. He is a patient, gifted physician and writer. Hats off to a great book and saving as many lives as you possibly could over your 37+ years of treating ER patients.
March 7, 2019
Really interesting read! Stories (chapters) are short enough to pick up and read 1 or 2 easily in a sitting, but they are also powerful and most will leave you with goosebumps at the end. This book also does a great job of putting the reader into the mindset of an ER doc by acknowledging and explaining things that you many don't realize these people have to think about while trying to make life and death decisions. Definitely recommend!
January 21, 2019
Such a great read and a true insight into what it is like to work in the ER. For those that know th ER, you will feel like you are there. You will be able to relate. If you are a lay person, you will be drawn into the stories and feel the emotion of all that comes with the job. Great job PC! It was so fun seeing those initials in every chapter, nice touch.
January 24, 2019
Dr. Pat Croker saved my life in 2010. His first book "Letters from the Pit" is an interesting, informative, enlightening, emotional, and exciting read. I believe it should be read by all of the people that are in the field of medicine that I've ever dealt with as well as those that are up and coming. I'm sure you'll agree. Enjoy!
February 9, 2019
An excellent portrait of the years-long journey from brilliant, hotshot ER resident to capable, experienced physician leader, who has appreciated and learned from every step of the process, and also maintained the ability to care for all his patients along the way. I have known Dr. Crocker since medical school days (and can thus attest to the brilliance), and remain proud to call him a friend.
February 15, 2019
This book is outstanding!! Upon receiving my copy, I could not put it down! Dr. Crocker brings us inside the emergency room, so that the reader can feel what a er doctor thinks and feels!The book is written by a true professional, who is compassionate and brillant in his treatment of his patients! Highly recommended!
April 25, 2019
Excellent perspective on the work of ER doctors. .
The amazing thought process that goes into diagnostic thinking and the importance of doing no harm. Dr. Patrick Crocker should be rewarded with satisfaction and awe over the course of treating 150,000 patients in his career. Thank you for writing this book.
The amazing thought process that goes into diagnostic thinking and the importance of doing no harm. Dr. Patrick Crocker should be rewarded with satisfaction and awe over the course of treating 150,000 patients in his career. Thank you for writing this book.
June 7, 2019
Excellent!
This book was a wonderful read. Dr. Driver's honest accounts of his years in emergency medicine really have me respect for this man, and a new found respect for the er. I recommend this book to anyone interested in medicine, or the medical field. Thank you Dr. Crocker for a career well spent, and for sharing!
This book was a wonderful read. Dr. Driver's honest accounts of his years in emergency medicine really have me respect for this man, and a new found respect for the er. I recommend this book to anyone interested in medicine, or the medical field. Thank you Dr. Crocker for a career well spent, and for sharing!
September 28, 2019
W
Reading this lets you walk in the shoes of another-you get the sense of someone having a conversation that you are not included in but listen to anyway
As a 40+ yr nurse, I can embrace the bare raw feelings of being in a place few understand yet expectations run high
Super job Doc- please keep writing
Reading this lets you walk in the shoes of another-you get the sense of someone having a conversation that you are not included in but listen to anyway
As a 40+ yr nurse, I can embrace the bare raw feelings of being in a place few understand yet expectations run high
Super job Doc- please keep writing
February 9, 2019
I think this is a must read for those working in the ER or for students thinking about going into The Pit! Wonderfully written. I’ve recommended it to several colleagues. Hopefully one day I will have a copy to pass around!
February 19, 2019
Enthralling description of Emergency Medicine
Five stars for this book! 40 tales of what it’s like in the ER, told with humor and compassion. For all those who wonder about the ER.
Five stars for this book! 40 tales of what it’s like in the ER, told with humor and compassion. For all those who wonder about the ER.
March 24, 2019
This is Good Stuff
I enjoy reading non-fiction books and truly enjoyed all of the stories shared by the author about his own personal “ER”, which my husband & I watched endlessly. Take a look, a glimpse really, into the doctor’s career and a small peek into his life.
I enjoy reading non-fiction books and truly enjoyed all of the stories shared by the author about his own personal “ER”, which my husband & I watched endlessly. Take a look, a glimpse really, into the doctor’s career and a small peek into his life.
May 5, 2019
TERRIFIC
This book was extremely well written. It gives the reader both the timeframe of the ER doctors busy life, but also the necessity of caring for each patient as an individual case. I thoroughly enjoyed it.
This book was extremely well written. It gives the reader both the timeframe of the ER doctors busy life, but also the necessity of caring for each patient as an individual case. I thoroughly enjoyed it.
Displaying 1 - 30 of 78 reviews