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Tornado of Life: A Doctor's Journey through Constraints and Creativity in the ER
Stories from the ER: a doctor shows how empathy, creativity, and imagination are the cornerstones of clinical care.
To be an emergency room doctor is to be a professional listener to stories. Each patient presents a story; finding the heart of that story is the doctor's most critical task. More technology, more tests, and more data won't work if doctors get the story wrong. Empathy, creativity, and imagination are the cornerstones of clinical care. In Tornado of Life, ER physician Jay Baruch offers a series of short, powerful, and affecting essays that capture the stories of ER patients in all their complexity and messiness.
Patients come to the ER with lives troubled by scales of misfortune that have little to do with disease or injury. ER doctors must be problem-finders before they are problem-solvers. Cheryl, for example, whose story is a chaos narrative of "and this happened, and then that happened, and then, and then and then and then," tells Baruch she is stuck in a tornado of life." What will help her, and and what will help Mr. K., who seems like a textbook case of post-combat PTSD but turns out not to be? Baruch describes, among other things, the emergency of loneliness (invoking Chekhov, another doctor-writer); his own (frightening) experience as a patient; the patient who demanded a hug; and emergency medicine during COVID-19. These stories often end without closure or solutions. The patients are discharged into the world. But if they're lucky, the doctor has listened to their stories as well as treated them.
To be an emergency room doctor is to be a professional listener to stories. Each patient presents a story; finding the heart of that story is the doctor's most critical task. More technology, more tests, and more data won't work if doctors get the story wrong. Empathy, creativity, and imagination are the cornerstones of clinical care. In Tornado of Life, ER physician Jay Baruch offers a series of short, powerful, and affecting essays that capture the stories of ER patients in all their complexity and messiness.
Patients come to the ER with lives troubled by scales of misfortune that have little to do with disease or injury. ER doctors must be problem-finders before they are problem-solvers. Cheryl, for example, whose story is a chaos narrative of "and this happened, and then that happened, and then, and then and then and then," tells Baruch she is stuck in a tornado of life." What will help her, and and what will help Mr. K., who seems like a textbook case of post-combat PTSD but turns out not to be? Baruch describes, among other things, the emergency of loneliness (invoking Chekhov, another doctor-writer); his own (frightening) experience as a patient; the patient who demanded a hug; and emergency medicine during COVID-19. These stories often end without closure or solutions. The patients are discharged into the world. But if they're lucky, the doctor has listened to their stories as well as treated them.
318 pages, Kindle Edition
Published August 30, 2022
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June 11, 2022
My experiences in hospital emergency rooms have led me to believe that a fair number of physicians who work in them are adrenaline junkies: quick thinkers who crave stimulation and variety, don’t have long attention spans, and are there in part because ER work does not involve following up on patients as internists or primary care physicians are obligated to do. They’re fix-it-fast or pass-them-on clinicians. Jay Baruch himself writes:
Early in my career, I was aware of a knock against emergency medicine— a lack of closure. We rarely follow a disease through to the end. We don’t see pneumonia improve with antibiotics. We’re not tracking the wrist fracture through healing and rehabilitation. Dr. G, a dean at my medical school, a prominent internist and infectious disease researcher, when learning of my intention to enter emergency medicine, said, “Emergency medicine is to internal medicine as the short story is to the novel. And there are no great short story writers.”
Evidently well acquainted with literary fiction, Baruch not surprisingly disagrees with the last statement, and in his book he disproves, or is at least an exception to, my characterization of ER doctors. Maybe it’s because he, like fellow emergency medicine physician Frank Huyler, is a writer as well as a doctor. Baruch is philosophical, introspective, self-critical, and sensitive to the nuances of complex situations. He’s interested in stories, those that patients tell, as well as literary ones from such writers as Anton Chekhov and Lorrie Moore. Stories, Baruch writes, structure experience, try to make meaning of it, but physicians can miss key elements based on cognitive shortcuts they’ve learned. Doctors’ brains are as hardwired for stories as the next person’s, but if physicians aren’t careful, the story they create “may be very different from the one the patient is telling.”
To illustrate this point, Baruch tells of a suicidal veteran with PTSD, Mr. K, whose girlfriend called 911 after he phoned her at work, panicked, saying he had fallen. The paramedics who found the man at home sensed “a disturbing violent intensity” emanating from him and called on police to escort him to hospital. Mr. K’s face was bruised, but he wouldn’t allow anyone to touch him, never mind perform scans to determine if he had a head injury. Restraints would likely be needed to treat him. Only when the patient’s girlfriend and sister arrived at the hospital and Baruch spoke to them did he learn that Mr. K’s PTSD long predated his military service: he had been raped as a child. Looking at the muscular men surrounding the man’s stretcher, ready to tie him down, Baruch was appalled by how he’d approached Mr. K’s case. After asking those men to step aside, the physician apologized to the patient, who had calmed somewhat and now permitted his neck and head to be examined. But that was where it ended. The trust had been broken; the patient would not allow a full medical workup. Baruch reflects that Mr. K’s “emotional state was treated as pathology that demanded a response, rather than evidence in a narrative that needed further investigation. Despite all the harms that take place in hospitals, the ones less frequently addressed are narrative errors.” Such misinterpretations are all too common in the ER where “a pressured listener tries to understand a pressured storyteller.”
Baruch’s essay collection consists mostly of stories similar to the one related above, describing doctor-patient interactions that left him feeling “lost, inadequate, confused or ashamed, unsettled, or just plain silly.” However, some essays focus on his own experience as a person with a serious heart condition, which required him to undergo major surgery at age 41.
“The practice of emergency medicine is a dance with the unexpected,” he says. At other times, it “seems like an emotional and moral contact sport.” Among the many challenging patients at the centre of these stories are gun trauma and motor vehicle accident victims, people in the throes of heart attacks, cancer patients in crisis, exhausted caregivers accompanying parents with dementia, and aggressive or frightening patients, some of whom have blood alcohol levels two to three times the legal limit or through whose blood some other substance is coursing. Abusive people like these are routinely kicked out of bars for their behaviour, but they cannot legally be denied emergency medical care. Limited time and resources can force a doctor to send a homeless person, who has been drying out in an ER bed needed by someone else, back to the streets before he’s ready. Sometimes the same individual will be back in hospital a few hours later with precisely the same problem.
Baruch mentions the ideas of Arthur Frank, a sociologist known for his work on illness experience, narrative, and the ethics of care. Frank has identified three kinds of medical narrative: restitution (the type you see in drug commercials: “take this pill and the sun will shine again”); quest (the once-well patient journeys into the land of the ill and is transformed by his trials); and chaos (in which “the troubles run so deep that putting language to these experiences can be difficult, if not impossible.”) Chaos narratives are commonly heard in the ER. Baruch’s book is in fact named for a comment made by a patient who tells one of these stories. Cheryl, brought into the ER for the ruckus she caused at a homeless shelter, had overdosed on heroin the previous night and was angry about being alive. “I’m stuck in a tornado of life,” she told him. Hers was an existence consisting of a myriad of problems woven into a multitude more. A story like Cheryl’s is threatening to clinicians, Baruch says; it stirs up their own anxieties and challenges their illusions of control. A doctor’s task is to hear the chaos narrative, not interrupting the patient but allowing her to tell the story. In this way, enough trust can be gained to enable the physician to provide care and a sense that change is possible.
I found almost all of Baruch’s forty essays fascinating, illuminating, and insightful. They present and interpret compelling stories and are accessibly and beautifully written in clear prose. Many are enriched by literary references or succinctly supported by the highlights of research studies. Overall, the impression the essays leave is of Baruch’s humanity and commitment to gleaning the truth of difficult interactions with people who are stressed and in pain. Most of the pieces are serious and searching in tone, but there are a few welcome humorous anecdotes. One very short chapter about a wheelchair in a hospital parking lot reads like a prose poem; it put me in mind of “The Red Wheelbarrow” by William Carlos Williams. In fact, what Williams observed about how his work as a doctor informed his writing applies equally to Baruch: “My ‘medicine’ was the thing that gained me entrance to these secret gardens of the self. It lay there, another world, in the self. I was permitted by my medical badge to follow the poor, defeated body into these gulfs and grottos.”
A few of the essays, most notably the last, concern the coronavirus pandemic. While Baruch’s views on Covid-19 are more moderate than those of many in the medical community, I admit to being disappointed that he isn’t more open to or informed about differing perspectives. He cautions against demonizing those who have chosen not to take the vaccine, pointing out that their reasons are often more thoughtful and nuanced than the media would have us believe. He nevertheless assigns too much blame for the dire outcomes and loss of life to irresponsible members of the public, failing to acknowledge the role of the mainstream media and medical spokespeople in silencing the voices of knowledgeable physicians and scientists with differing views on how to respond to such an emergency. Many well versed in epidemiology, public health, virology, vaccinology, and infectious disease who had valuable contributions to make to the discussion were unjustly vilified and deplatformed over the last two years. Accomplished, ethical physicians—who recognized the importance of early treatment, successfully used repurposed drugs with excellent safety records, and kept people out of hospital and off ventilators—have received no recognition or have been falsely depicted as dangerously unscientific mavericks. Furthermore, vaccines that were rushed through inadequate clinical trials have caused significant and well documented injury. Their maker, Pfizer, evidently aware of its own shoddy practices, attempted to block public access to its data for 75 years. A judge decided otherwise. Finally, one really should be concerned about the American drug regulatory body’s actual commitment to public safety when it gets around half its funding from the very pharmaceutical industry whose products it’s supposed to be stringently evaluating and vetting. None of these facts is even passingly mentioned in Baruch’s discussion of the pandemic response. Either he was unaware of them or worried about the professional consequences of straying too far from the unnuanced “narrative” that has dominated all our lives for the past couple of years. For a physician interested in narratives and ethics, Baruch is surprisingly uninterested in questions of informed consent and bodily autonomy, particularly when it comes to people’s being injected with a novel experimental vaccine, inadequately trialled, without long-term safety data, and made available only under emergency-use authorization. I state all the above as a person who did receive the vaccine, though my consent was hardly informed.
My reservations about Baruch’s views on Covid-19 aside, I greatly enjoyed and highly recommend his book. As he himself observes, all of us, at some point or another, find ourselves being tossed about by the tornado of life.
Rating: 4.5
Thank you to the MIT Press and Net Galley for an an advance reading copy of this book.
Early in my career, I was aware of a knock against emergency medicine— a lack of closure. We rarely follow a disease through to the end. We don’t see pneumonia improve with antibiotics. We’re not tracking the wrist fracture through healing and rehabilitation. Dr. G, a dean at my medical school, a prominent internist and infectious disease researcher, when learning of my intention to enter emergency medicine, said, “Emergency medicine is to internal medicine as the short story is to the novel. And there are no great short story writers.”
Evidently well acquainted with literary fiction, Baruch not surprisingly disagrees with the last statement, and in his book he disproves, or is at least an exception to, my characterization of ER doctors. Maybe it’s because he, like fellow emergency medicine physician Frank Huyler, is a writer as well as a doctor. Baruch is philosophical, introspective, self-critical, and sensitive to the nuances of complex situations. He’s interested in stories, those that patients tell, as well as literary ones from such writers as Anton Chekhov and Lorrie Moore. Stories, Baruch writes, structure experience, try to make meaning of it, but physicians can miss key elements based on cognitive shortcuts they’ve learned. Doctors’ brains are as hardwired for stories as the next person’s, but if physicians aren’t careful, the story they create “may be very different from the one the patient is telling.”
To illustrate this point, Baruch tells of a suicidal veteran with PTSD, Mr. K, whose girlfriend called 911 after he phoned her at work, panicked, saying he had fallen. The paramedics who found the man at home sensed “a disturbing violent intensity” emanating from him and called on police to escort him to hospital. Mr. K’s face was bruised, but he wouldn’t allow anyone to touch him, never mind perform scans to determine if he had a head injury. Restraints would likely be needed to treat him. Only when the patient’s girlfriend and sister arrived at the hospital and Baruch spoke to them did he learn that Mr. K’s PTSD long predated his military service: he had been raped as a child. Looking at the muscular men surrounding the man’s stretcher, ready to tie him down, Baruch was appalled by how he’d approached Mr. K’s case. After asking those men to step aside, the physician apologized to the patient, who had calmed somewhat and now permitted his neck and head to be examined. But that was where it ended. The trust had been broken; the patient would not allow a full medical workup. Baruch reflects that Mr. K’s “emotional state was treated as pathology that demanded a response, rather than evidence in a narrative that needed further investigation. Despite all the harms that take place in hospitals, the ones less frequently addressed are narrative errors.” Such misinterpretations are all too common in the ER where “a pressured listener tries to understand a pressured storyteller.”
Baruch’s essay collection consists mostly of stories similar to the one related above, describing doctor-patient interactions that left him feeling “lost, inadequate, confused or ashamed, unsettled, or just plain silly.” However, some essays focus on his own experience as a person with a serious heart condition, which required him to undergo major surgery at age 41.
“The practice of emergency medicine is a dance with the unexpected,” he says. At other times, it “seems like an emotional and moral contact sport.” Among the many challenging patients at the centre of these stories are gun trauma and motor vehicle accident victims, people in the throes of heart attacks, cancer patients in crisis, exhausted caregivers accompanying parents with dementia, and aggressive or frightening patients, some of whom have blood alcohol levels two to three times the legal limit or through whose blood some other substance is coursing. Abusive people like these are routinely kicked out of bars for their behaviour, but they cannot legally be denied emergency medical care. Limited time and resources can force a doctor to send a homeless person, who has been drying out in an ER bed needed by someone else, back to the streets before he’s ready. Sometimes the same individual will be back in hospital a few hours later with precisely the same problem.
Baruch mentions the ideas of Arthur Frank, a sociologist known for his work on illness experience, narrative, and the ethics of care. Frank has identified three kinds of medical narrative: restitution (the type you see in drug commercials: “take this pill and the sun will shine again”); quest (the once-well patient journeys into the land of the ill and is transformed by his trials); and chaos (in which “the troubles run so deep that putting language to these experiences can be difficult, if not impossible.”) Chaos narratives are commonly heard in the ER. Baruch’s book is in fact named for a comment made by a patient who tells one of these stories. Cheryl, brought into the ER for the ruckus she caused at a homeless shelter, had overdosed on heroin the previous night and was angry about being alive. “I’m stuck in a tornado of life,” she told him. Hers was an existence consisting of a myriad of problems woven into a multitude more. A story like Cheryl’s is threatening to clinicians, Baruch says; it stirs up their own anxieties and challenges their illusions of control. A doctor’s task is to hear the chaos narrative, not interrupting the patient but allowing her to tell the story. In this way, enough trust can be gained to enable the physician to provide care and a sense that change is possible.
I found almost all of Baruch’s forty essays fascinating, illuminating, and insightful. They present and interpret compelling stories and are accessibly and beautifully written in clear prose. Many are enriched by literary references or succinctly supported by the highlights of research studies. Overall, the impression the essays leave is of Baruch’s humanity and commitment to gleaning the truth of difficult interactions with people who are stressed and in pain. Most of the pieces are serious and searching in tone, but there are a few welcome humorous anecdotes. One very short chapter about a wheelchair in a hospital parking lot reads like a prose poem; it put me in mind of “The Red Wheelbarrow” by William Carlos Williams. In fact, what Williams observed about how his work as a doctor informed his writing applies equally to Baruch: “My ‘medicine’ was the thing that gained me entrance to these secret gardens of the self. It lay there, another world, in the self. I was permitted by my medical badge to follow the poor, defeated body into these gulfs and grottos.”
A few of the essays, most notably the last, concern the coronavirus pandemic. While Baruch’s views on Covid-19 are more moderate than those of many in the medical community, I admit to being disappointed that he isn’t more open to or informed about differing perspectives. He cautions against demonizing those who have chosen not to take the vaccine, pointing out that their reasons are often more thoughtful and nuanced than the media would have us believe. He nevertheless assigns too much blame for the dire outcomes and loss of life to irresponsible members of the public, failing to acknowledge the role of the mainstream media and medical spokespeople in silencing the voices of knowledgeable physicians and scientists with differing views on how to respond to such an emergency. Many well versed in epidemiology, public health, virology, vaccinology, and infectious disease who had valuable contributions to make to the discussion were unjustly vilified and deplatformed over the last two years. Accomplished, ethical physicians—who recognized the importance of early treatment, successfully used repurposed drugs with excellent safety records, and kept people out of hospital and off ventilators—have received no recognition or have been falsely depicted as dangerously unscientific mavericks. Furthermore, vaccines that were rushed through inadequate clinical trials have caused significant and well documented injury. Their maker, Pfizer, evidently aware of its own shoddy practices, attempted to block public access to its data for 75 years. A judge decided otherwise. Finally, one really should be concerned about the American drug regulatory body’s actual commitment to public safety when it gets around half its funding from the very pharmaceutical industry whose products it’s supposed to be stringently evaluating and vetting. None of these facts is even passingly mentioned in Baruch’s discussion of the pandemic response. Either he was unaware of them or worried about the professional consequences of straying too far from the unnuanced “narrative” that has dominated all our lives for the past couple of years. For a physician interested in narratives and ethics, Baruch is surprisingly uninterested in questions of informed consent and bodily autonomy, particularly when it comes to people’s being injected with a novel experimental vaccine, inadequately trialled, without long-term safety data, and made available only under emergency-use authorization. I state all the above as a person who did receive the vaccine, though my consent was hardly informed.
My reservations about Baruch’s views on Covid-19 aside, I greatly enjoyed and highly recommend his book. As he himself observes, all of us, at some point or another, find ourselves being tossed about by the tornado of life.
Rating: 4.5
Thank you to the MIT Press and Net Galley for an an advance reading copy of this book.
September 3, 2022
Combining an essay form with his experience as a physician, Jay Baruch in Tornado of Life: A Doctor's Journey through Constraints and Creativity in the ER created an unusual yet very compelling medical nonfiction book.
The author's approach to storytelling requires adaptation. You'll be disappointed if you expected a sequence of intriguing and/or challenging medical cases like the 'Code Black' or 'ER' series. Instead, the author bases his book on the premise that {S}tories reveal how people face, cope, succumb, and surmount the obstacles in their lives and make their way in a world we all share. They serve as portals of social interaction that pipe us emotionally into the experience of another. (The quote may differ in the published version.)
Fictionalizing actual patients, partly because of privacy matters, partly due to showcase his points, Jay Baruch treats each ailment as a story, each person as a storyteller. The storyteller tries to tell his/her story that is more than just a headache or cancer to a doctor, under tremendous pressure, in a limited time frame. The doctor must unravel what is said and, more importantly, what the patient fears or cannot describe.
I strongly recommend Tornado of Life not to medical nonfiction appreciators but more to short story/novel writers. The author's rich, tight language (I didn't notice any repetitions of words, phrases, or thoughts) and analysis of Anton Chekhov make the book a handy tool for those seeking inspiration.
Minus one star from my ratings corresponds to the incomplete, in my opinion, chapters that describe one medical encounter in the ER without further analysis. The reader may find himself/herself unaware of the reasons behind the author's decision to include this or that episode.
I received an advance review copy through Netgalley, and I am leaving this review voluntarily.
The author's approach to storytelling requires adaptation. You'll be disappointed if you expected a sequence of intriguing and/or challenging medical cases like the 'Code Black' or 'ER' series. Instead, the author bases his book on the premise that {S}tories reveal how people face, cope, succumb, and surmount the obstacles in their lives and make their way in a world we all share. They serve as portals of social interaction that pipe us emotionally into the experience of another. (The quote may differ in the published version.)
Fictionalizing actual patients, partly because of privacy matters, partly due to showcase his points, Jay Baruch treats each ailment as a story, each person as a storyteller. The storyteller tries to tell his/her story that is more than just a headache or cancer to a doctor, under tremendous pressure, in a limited time frame. The doctor must unravel what is said and, more importantly, what the patient fears or cannot describe.
I strongly recommend Tornado of Life not to medical nonfiction appreciators but more to short story/novel writers. The author's rich, tight language (I didn't notice any repetitions of words, phrases, or thoughts) and analysis of Anton Chekhov make the book a handy tool for those seeking inspiration.
Minus one star from my ratings corresponds to the incomplete, in my opinion, chapters that describe one medical encounter in the ER without further analysis. The reader may find himself/herself unaware of the reasons behind the author's decision to include this or that episode.
I received an advance review copy through Netgalley, and I am leaving this review voluntarily.
July 18, 2022
Thank you to Netgalley and MIT press for the ARC.
Tornado of life is a beautiful product of decades of experience in emergency medicine. Baruch's humanity seeps into every word, and I often found myself writing down excerpts to think on and remember.
Tornado of life explores the emergency room and those who enter. We see the everything from the relatively benign to the heartbreaking. In Tornado of Life, Baruch takes us through the lessons learned and the patients and family members who taught them.
I appreciated the care taken with writing on the patient, as well as the fact that Baruch takes us into his confidence and admits to shortcomings and how some things had to be learnt the hard way.
This book is reminiscent of Critical Care by Theresa Brown in how well it navigates letting the reader in to the narrative while not commoditising the patient's experience.
All in all, this is really one of the better medical 'memoirs', and I'd recommend it without second thought
Tornado of life is a beautiful product of decades of experience in emergency medicine. Baruch's humanity seeps into every word, and I often found myself writing down excerpts to think on and remember.
Tornado of life explores the emergency room and those who enter. We see the everything from the relatively benign to the heartbreaking. In Tornado of Life, Baruch takes us through the lessons learned and the patients and family members who taught them.
I appreciated the care taken with writing on the patient, as well as the fact that Baruch takes us into his confidence and admits to shortcomings and how some things had to be learnt the hard way.
This book is reminiscent of Critical Care by Theresa Brown in how well it navigates letting the reader in to the narrative while not commoditising the patient's experience.
All in all, this is really one of the better medical 'memoirs', and I'd recommend it without second thought
March 12, 2024
I appreciated this book! Good anecdotal stories about patient care. Wouldn’t necessarily recommend but I enjoyed it!
July 14, 2025
Medicine is described by some as part science and part art.
Author Jay Baruch believes that to be a successful Emergency Room doctor (and, perhaps, a doctor in any specialty), the doctor should stop and really listen to what the patient is saying or not saying. Don’t just rely on the science but learn to lean on the less tangible.
This isn’t the typical doctor’s discussion of what they treated during a patient’s emergency room visit, instead, while each vignette is patient centric, Dr Baruch discusses how he approaches the patient and his philosophy on the disease, his treatment, or what the patient’s actual problem was or could have been.
Tornado of Life would appeal to the reader of books on doctor’s perspectives on medicine but is looking for a bit more of the doctor’s philosophy concerning the art of medicine.
(Ironically, I had read a previous book by Dr Baruch, Fourteen Stories: Doctors, Patients, and Other Strangers, a collection of short stories that I had reviewed and didn’t really enjoy. At least I am enjoyed this book.)
4/5 stars
[Thank you to NetGalley and the author for the advanced ebook copy in exchange for my honest and objective opinion which I have given here.]
Author Jay Baruch believes that to be a successful Emergency Room doctor (and, perhaps, a doctor in any specialty), the doctor should stop and really listen to what the patient is saying or not saying. Don’t just rely on the science but learn to lean on the less tangible.
This isn’t the typical doctor’s discussion of what they treated during a patient’s emergency room visit, instead, while each vignette is patient centric, Dr Baruch discusses how he approaches the patient and his philosophy on the disease, his treatment, or what the patient’s actual problem was or could have been.
Tornado of Life would appeal to the reader of books on doctor’s perspectives on medicine but is looking for a bit more of the doctor’s philosophy concerning the art of medicine.
(Ironically, I had read a previous book by Dr Baruch, Fourteen Stories: Doctors, Patients, and Other Strangers, a collection of short stories that I had reviewed and didn’t really enjoy. At least I am enjoyed this book.)
4/5 stars
[Thank you to NetGalley and the author for the advanced ebook copy in exchange for my honest and objective opinion which I have given here.]
November 17, 2022
Damn, it's not easy to make a book about being an ER doctor boring, but this author succeeded. Dry as toast for the layman reader, but a lovely light textbook for med students. I quit on page 53 after skimming the previous 20 pages.
February 12, 2023
This is a very personal and deeply human look at what it’s like to be an ER doctor. As the book’s press release says: “It is poised to change the way we view doctors, illness, and the ‘emotional and moral contact sport’ that is emergency medicine.” Dr. Baruch writes: “Practice of ER medicine is a dance with the unexpected.” He says the book “represents his effort to dig into experiences that left me feeling lost or inadequate, confused or ashamed, unsettled or just plain silly.”
His humanity comes through on every page and in every story. A major theme of the book is to understand the story of the patient, not just their symptoms. The ER can be a narrative disaster zone—communication is hard in crowded spaces, with little time for stories and no closure. He argues the stakes are high:
“The ability to work with stories is, and will continue to be, the most cost-effective and critical navigation instrument in medical care. The best technology is of little use if we get the story wrong.”
Yet, sometimes the patient has no language to express what they are going through. This is expressed well in the book’s epigraph: “We can learn a lot about a person in the very moment that language fails them.” ––Anna Deavere Smith, Talk to Me. The patient’s story isn’t the vehicle toward a diagnosis, it’s the destination. He also tells the story of his heart trouble, the surgery he went through, how he selected the surgeon. It reminded me of the movie, The Doctor, starring Will Hurt. That movie was based on the book, A Taste of My Own Medicine: When the Doctor is the Patient, by Dr. Edward Rosenbaum (excellent read). He also talks about the social justice roots of ERs, which have to take patients and accept as normal behavior that would get people tossed from bars.
This is an incredibly human and fascinating look at an area of medicine that most of encounter as some point in our life, but we don’t give much thought about after being discharged. The professionals who work in this chaotic, unpredictable, and complex environment deserve our respect and gratitude. What an honor it was to be able to interview Dr. Jay Baruch on our show, The Soul of Enterprise: Business in the Knowledge Economy, on January 27, 2023. You can listen here:
https://www.thesoulofenterprise.com/t...
His humanity comes through on every page and in every story. A major theme of the book is to understand the story of the patient, not just their symptoms. The ER can be a narrative disaster zone—communication is hard in crowded spaces, with little time for stories and no closure. He argues the stakes are high:
“The ability to work with stories is, and will continue to be, the most cost-effective and critical navigation instrument in medical care. The best technology is of little use if we get the story wrong.”
Yet, sometimes the patient has no language to express what they are going through. This is expressed well in the book’s epigraph: “We can learn a lot about a person in the very moment that language fails them.” ––Anna Deavere Smith, Talk to Me. The patient’s story isn’t the vehicle toward a diagnosis, it’s the destination. He also tells the story of his heart trouble, the surgery he went through, how he selected the surgeon. It reminded me of the movie, The Doctor, starring Will Hurt. That movie was based on the book, A Taste of My Own Medicine: When the Doctor is the Patient, by Dr. Edward Rosenbaum (excellent read). He also talks about the social justice roots of ERs, which have to take patients and accept as normal behavior that would get people tossed from bars.
This is an incredibly human and fascinating look at an area of medicine that most of encounter as some point in our life, but we don’t give much thought about after being discharged. The professionals who work in this chaotic, unpredictable, and complex environment deserve our respect and gratitude. What an honor it was to be able to interview Dr. Jay Baruch on our show, The Soul of Enterprise: Business in the Knowledge Economy, on January 27, 2023. You can listen here:
https://www.thesoulofenterprise.com/t...
February 20, 2023
This book is a series of vignettes of incidents in the life of an Emergency Room doctor and staff. I have the pleasure of working alongside Dr. Baruch as a unit secretary, and this book truly hits home and verbalizes all that we go through during a shift. Each chapter is a snapshot of a patient's time with us. And that is what emergency medicine is about. We don't get to write full chapters in people's lives; we enter in the middle, take up a paragraph or two and move them onto the next section of their care. Dr. Baruch gives voices to those in emergency medicine as staff and patients with this book. Ours is a world of chaos, and all we can do is stablize it long enough to help and heal as we can. Thank you for giving us a voice.
February 8, 2025
I am about 2/3 of the way through this book and finding it very intense. I fear any trips to the ER that may be in our future. I have to remind myself that we have had a few such trips and they went well. We were treated with compassion and skill each time. But this book is a reminder that doctors are people who make mistakes, who get stressed, and who have to deal with a situation that is complex. Sometimes there just are not enough beds or staff to care for the many folks in the waiting room and that needs have to be prioritized.
-----------finished and worth reading to begin to understand how difficult it must be to be an ER doctor--or for that matter, any person in medicine who has to deal with complicated people with complicated problems.
-----------finished and worth reading to begin to understand how difficult it must be to be an ER doctor--or for that matter, any person in medicine who has to deal with complicated people with complicated problems.
April 8, 2025
This is not a book I would typically read, but the title intrigued me, and I’m happy I spent the time on it. With the world we live in right now, the frustrations I and others experience in our health care system, this ER physician’s short stories about the people he encounters and the lives he touches and those that touch him provided a whole different perspective for me. It confirmed what I know to be true: there is good in most people. We just have to be willing to open ourselves up, make a connection, and listen. And I know one other thing for sure after reading this book. Being an ER doctor takes a special type of person, and I’m thankful they exist, especially Dr. Jay Baruch!
April 27, 2024
This is not a collection of stories about people the author encountered in the ER. Well, it is, but it is more about the author's philosophical takes on these stories, each making a point about some aspect of medical care or the human condition. It's well-written, as one would hope from someone who considers himself a physician/writer. He takes the kind of literary approach that uses a lot of words and convoluted thinking to make points that, imo, could be stated quite simply. The literati eat this kind of thing up. I don't care for it.
December 2, 2022
Baruch, an emergency room physician, has written a series of brief tales spanning the three decades between medical school and the second wave of the ongoing pandemic. His voice is curious, open, compassionate, self-critical, humble, and moving. The writing is strong, at times lyrical, but maintains an emergency room physician’s focus on the matter at hand, which is humanity in extremis. Highly recommended.
February 4, 2023
I’d give it 3.5 stars if Goodreads would let me. It’s a well written book with compelling stories that explore the tensions and contradictions in our modern health care system. Reading a doctor talk honestly about is moral and ethical struggles was inspiring and dispiriting at the same time.
I did not love the “story-tellers” framework and found the literary overlay he tried to include cumbersome rather than enlightening. I’m curious what health care professionals think of this memoir.
I did not love the “story-tellers” framework and found the literary overlay he tried to include cumbersome rather than enlightening. I’m curious what health care professionals think of this memoir.
December 31, 2025
Provides keen insight into the life of an ER doctor. Not easy to find the answer in stressful environment. Good reminder that those who work in the ER are there to help you. The ER is a frustrating environment, with the waiting and unknown, while you are there on a day that isn’t your best. Staff are doing all they can, but they are in a constant crisis environment, which is tough to navigate. I thought the essays were well written, but a few of them went on a bit long.
October 16, 2023
I felt this was a very honest book that will resonate with many who work in the medical field and struggle with making challenging decisions and with self-doubt. It helps humanize physicians but not in a super preachy or inauthentic way. It’s written as a series of short vignettes which makes it easily digestible and has both funny and sad moments but is quite satisfying to read overall.
March 6, 2025
This book was written by an ER doctor who speaks about his experiences and patients in this very stressful environment. He has learned that speaking to patients and finding out something about their lives can make a difference in their diagnosis and treatment, offering them a better chance to recover and to return in the best condition possible to their daily lives.
August 15, 2025
A Dr with good bedside manner
Wish my encounter with all ER doctors had the compassion and care of the author. My small city has contract Drs in the ER who, seem to care more about landing a job in the location of their choice. Know this is not true of all hospitals and Drs but it leaves patients longing for a Dr like Baruch.
Wish my encounter with all ER doctors had the compassion and care of the author. My small city has contract Drs in the ER who, seem to care more about landing a job in the location of their choice. Know this is not true of all hospitals and Drs but it leaves patients longing for a Dr like Baruch.
September 11, 2022
Those not intimately familiar with how physicians make decisions in the many situations they encounter will learn much. Having facilitated courses in patient-physician communication and difficult conversations myself, Baruch is right on.
Want to read
November 30, 2023Written by Jay Baruch,
https://www.youtube.com/watch?v=TKjRB...
who taught the mooc "Beyond Medical Histories: Gaining Insight from Patient Stories" on using creativity in medicine. I know I said I wasn't going to read any more "doctor books" but he has an interesting approach.
https://www.youtube.com/watch?v=TKjRB...
who taught the mooc "Beyond Medical Histories: Gaining Insight from Patient Stories" on using creativity in medicine. I know I said I wasn't going to read any more "doctor books" but he has an interesting approach.
April 27, 2024
While reading it in one burst, you can feel the essays blur together, like a proper shift in the ED. Dr. Baruch has a unique voice that is a joy to read. The tiny chapters are my favorite, little sketches of life that reverberate.
February 1, 2025
Wonderful Book!
I thoroughly enjoyed reading this book. It is an honest story by a caring physician. I appreciate his willingness to be open minded and willing to grow from his experiences.
I thoroughly enjoyed reading this book. It is an honest story by a caring physician. I appreciate his willingness to be open minded and willing to grow from his experiences.
August 31, 2022
Must must read for life
September 27, 2022
Interesting short essays about ER encounters and the monetization of medical care.
January 27, 2023
Good insights into the life of an ER doctor. He writes with honesty and compassion about the cases he must deal with.
Read
January 5, 2024Tornado
Read
May 3, 2024Well found the perspective kinda wonky but unique!
Read
February 8, 2025DNF. Dr. is definitely a fan of his insight. That's okay. But it's boring.
February 9, 2025
The focus of this book is too broad. If Baruch wants to write about writing, he should do that alone. Take another book to write about his ER experiences.
August 30, 2022
This review originally appeared on my blog at www.gimmethatbook.com.
Thanks to NetGalley and MIT Press for this review copy!
TORNADO OF LIFE is a quick read, filled with short stories about patients presenting to the emergency room and how they provoke the doctor’s thoughts and actions. For example, one of the first patients the author sees (as a brand-new doctor) is a woman, presenting with vague symptoms, but appearing well. It turns out that she may have been abused by her husband, and just needed someone to talk to, and perhaps have someone suggest a course of action for her. Baruch regrets not seeing the patient’s true needs and says that case stayed in his mind for a while. He attributes his lack of communication to his inexperience and explains to the reader why it is important to consider the whole patient, not just what they are telling you. He also says an ER doctor should not judge a patient on how they look when they show up to the ER. Sometimes the most disheveled need the least care, and vice versa.
He tells the story of a patient asking for pain meds; and is unsure if he should prescribe them. He discusses the dilemma of drug-seeking patients and how pain is unmeasurable, unlike a temperature or a heart rate. Baruch says that “do no harm” is a doctor’s first tenet, but when it comes to pain, you may be damned if you do or damned if you don’t. If someone is in real pain, he is obligated to help them. But if a patient is looking for drugs to feed his habit, then prescribing them could harm them as Baruch encourages them to continue their addiction.
Each chapter holds a new patient’s story and the lesson the ER doctor learned from the case. Communication and empathy are a recurring theme, which makes sense. An ER visit is fraught with anxiety, and it can be comforting if a caring physician examines you. Often the doctor has only a few minutes to connect with the patient, which makes getting through the layers of each person’s needs exceedingly difficult. The chapters are stand-alone stories, making the book easy to read in small bites.
Baruch touches on each of those layers in depth, ruminating on how he could have helped some patients better, how some patients helped him learn more about himself, and detailing the psychic struggle that doctors experience daily. Baruch comes across as an extremely caring and empathetic person; I would appreciate his care should I ever need to visit his ER.
The only thing that frustrated me about TORNADO OF LIFE was that I never got closure on any of the patient’s ailments. The author states that in the beginning of the book – there will only be a few details about the ER visit and then the rest of the chapter will be introspection. I found myself wanting to know more about each patient, what their diagnosis was and how they were addressed before they were discharged. I learned to put my dismay aside as I got through each chapter, understanding that the point of each story was Baruch’s rumination and a lesson learned.
This is an unusual book, as the doctor’s thoughts are shared front and center. Most books written by those in the medical field will give a great deal of detail on their patients with a bit of introspection added. TORNADO OF LIFE is the opposite, and the reader needs to take time to digest the deep thoughts Baruch shares. Reading this will give you new respect for ER doctors and all that they handle on a daily basis.
Thanks to NetGalley and MIT Press for this review copy!
TORNADO OF LIFE is a quick read, filled with short stories about patients presenting to the emergency room and how they provoke the doctor’s thoughts and actions. For example, one of the first patients the author sees (as a brand-new doctor) is a woman, presenting with vague symptoms, but appearing well. It turns out that she may have been abused by her husband, and just needed someone to talk to, and perhaps have someone suggest a course of action for her. Baruch regrets not seeing the patient’s true needs and says that case stayed in his mind for a while. He attributes his lack of communication to his inexperience and explains to the reader why it is important to consider the whole patient, not just what they are telling you. He also says an ER doctor should not judge a patient on how they look when they show up to the ER. Sometimes the most disheveled need the least care, and vice versa.
He tells the story of a patient asking for pain meds; and is unsure if he should prescribe them. He discusses the dilemma of drug-seeking patients and how pain is unmeasurable, unlike a temperature or a heart rate. Baruch says that “do no harm” is a doctor’s first tenet, but when it comes to pain, you may be damned if you do or damned if you don’t. If someone is in real pain, he is obligated to help them. But if a patient is looking for drugs to feed his habit, then prescribing them could harm them as Baruch encourages them to continue their addiction.
Each chapter holds a new patient’s story and the lesson the ER doctor learned from the case. Communication and empathy are a recurring theme, which makes sense. An ER visit is fraught with anxiety, and it can be comforting if a caring physician examines you. Often the doctor has only a few minutes to connect with the patient, which makes getting through the layers of each person’s needs exceedingly difficult. The chapters are stand-alone stories, making the book easy to read in small bites.
Baruch touches on each of those layers in depth, ruminating on how he could have helped some patients better, how some patients helped him learn more about himself, and detailing the psychic struggle that doctors experience daily. Baruch comes across as an extremely caring and empathetic person; I would appreciate his care should I ever need to visit his ER.
The only thing that frustrated me about TORNADO OF LIFE was that I never got closure on any of the patient’s ailments. The author states that in the beginning of the book – there will only be a few details about the ER visit and then the rest of the chapter will be introspection. I found myself wanting to know more about each patient, what their diagnosis was and how they were addressed before they were discharged. I learned to put my dismay aside as I got through each chapter, understanding that the point of each story was Baruch’s rumination and a lesson learned.
This is an unusual book, as the doctor’s thoughts are shared front and center. Most books written by those in the medical field will give a great deal of detail on their patients with a bit of introspection added. TORNADO OF LIFE is the opposite, and the reader needs to take time to digest the deep thoughts Baruch shares. Reading this will give you new respect for ER doctors and all that they handle on a daily basis.
June 9, 2023
One the beauties of this book is the short chapters; makes you tell yourself, "Just read one more."
An accomplished doc-turned-writer on display here: Polished and professional in his new craft.
One personal irritation: Having no children, we long ago determined that it would be wise for us to obtain and properly fund a long term care (LTC) insurance policy for the both of us. LTC policies provide coverage for custodial assistance when we're both older and not able to conduct the routine activities of daily life like, dressing, eating, transferring to a chair, etc. Dr. Baruch wrote achingly in his chapter 28 of the arduous struggles a daughter endures every daily in caring for her mother who is solidly in the grip of dementia.
When the ignorance of the substantial financial protections that LTC insurance affords to policyholders later in life extends to a practicing physician, one wonders how much of a numbskull he may be since, as a doctor in the ER, he witnesses the sorrow of dementia almost everyday?
Read this book but after you read chapter 28, sit down with a licensed and certified LTC insurance professional and get your family protected!
An accomplished doc-turned-writer on display here: Polished and professional in his new craft.
One personal irritation: Having no children, we long ago determined that it would be wise for us to obtain and properly fund a long term care (LTC) insurance policy for the both of us. LTC policies provide coverage for custodial assistance when we're both older and not able to conduct the routine activities of daily life like, dressing, eating, transferring to a chair, etc. Dr. Baruch wrote achingly in his chapter 28 of the arduous struggles a daughter endures every daily in caring for her mother who is solidly in the grip of dementia.
When the ignorance of the substantial financial protections that LTC insurance affords to policyholders later in life extends to a practicing physician, one wonders how much of a numbskull he may be since, as a doctor in the ER, he witnesses the sorrow of dementia almost everyday?
Read this book but after you read chapter 28, sit down with a licensed and certified LTC insurance professional and get your family protected!
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