The Emergency: A Year of Healing and Heartbreak in a Chicago ER

by Thomas Fisher

The riveting, pulse-pounding story of a year in the life of an emergency room doctor trying to steer his patients and colleagues through a crushing pandemic and a violent summer, amidst a healthcare system that seems determined to leave them behind

“Gripping . . . eloquent . . . This book reminds us how permanently interesting our bodies are, especially when they go wrong.”—The New York Times

ONE OF THE BEST BOOKS OF THE YEAR: Time

As an emergency room doctor working on the rapid evaluation unit, Dr. Thomas Fisher has about three minutes to spend with the patients who come into the South Side of Chicago ward where he works before directing them to the next stage of their care. Bleeding: three minutes. Untreated wound that becomes life-threatening: three minutes. Kidney failure: three minutes. He examines his patients inside and out, touches their bodies, comforts and consoles them, and holds their hands on what is often the worst day of their lives. Like them, he grew up on the South Side; this is his community and he grinds day in and day out to heal them.

Through twenty years of clinical practice, time as a White House fellow, and work as a healthcare entrepreneur, Dr. Fisher has seen firsthand how our country’s healthcare system can reflect the worst of society: treating the poor as expendable in order to provide top-notch care to a few. In The Emergency, Fisher brings us through his shift, as he works with limited time and resources to treat incoming patients. And when he goes home, he remains haunted by what he sees throughout his day. The brutal wait times, the disconnect between hospital executives and policymakers and the people they’re supposed to serve, and the inaccessible solutions that could help his patients. To cope with the relentless onslaught exacerbated by the pandemic, Fisher begins writing letters to patients and colleagues—letters he will never send—explaining it all to them as best he can.

As fast-paced as an ER shift, The Emergency has all the elements that make doctors’ stories so compelling—the high stakes, the fascinating science and practice of medicine, the deep and fraught interactions between patients and doctors, the persistent contemplation of mortality. And, with the rare dual perspective of somebody who also has his hands deep in policy work, Fisher connects these human stories to the sometimes-cruel machinery of care. Beautifully written, vulnerable and deeply empathetic, The Emergency is a call for reform that offers a fresh vision of health care as a foundation of social justice.

Genres: Nonfiction, Memoir, Medicine, Medical, Health, Audiobook, Biography

288 pages, Paperback

First published March 22, 2022

Reviews

[Petra X]

Instead of white privilege-black victims blame and shame, this is a book of how money and policies in medicine prioritise the health care of 'patients of distinction' - people with health insurance, overwhelming white, over blacks who are 8 times more likely to be on Medicare, Medicare or uninsured. These are not racial policies by any means and hurt poor whites just as much, but although the malign intention isn't there, the application of it is racist, as are the results.

Very interesting to read, it proves yet again, yet again, that medicine as a business is just wrong. Socialised medicine, not 'free' as people who don't like it are wont to point out, but free at the point of need, is the only humanitarian way to go.

[Christine · Rating 4 out of 5]

As a retired infectious diseases physician, I was immediately drawn to this nonfiction book penned during the initial year of the COVID pandemic. Read the blurb. I almost always like to go into a book cold, but this beautifully written, powerful synopsis is inspiring and will hopefully make you want to read the book. As an aside, the book is not specifically about COVID, which is a peripheral issue here.

Thomas Fisher is a Black man from the South Side of Chicago. He went to medical school in order to come back to his home community and take care his people. He did indeed secure a job with the University of Chicago as an emergency room physician on the South Side. Dr. Fisher works as hard as he can, making the most out of the 3 minutes per patient he is allotted in the rapid evaluation unit where people are seen for triage. He spends his evenings reflecting on the patients he saw and regretting not having more time to bond with and take better care of them.

The book is laid out in a unique way. The chapters alternate between a day in the ER and a personal (yet never sent) letter written by Dr. Fisher to a patient or colleague or family member that he saw that day. The letters explain why many Black and other disadvantaged people are not offered the same opportunities for care as those (mainly white people) with private insurance. He puts forth a thoughtful and convincing argument that it is not race and/or genetics that cut life expectancy for Blacks and others who are disadvantaged; it is the medical system of our society. I read these letters with great interest; they gave me lots of food for thought.

Dr. Thomas Fisher is a jewel of a man. He cares deeply for his patients and has done everything in his power to try to jumpstart changes in our country’s health care system. Unfortunately, the system we have seems to be deeply entrenched, and I’m not sure we will be seeing any significant improvements any time soon or even ever. That makes me sad. This is a book for everyone. It is well written, full of empathy, and very compelling.

I would like to thank Net Galley, Random House/One World, and Dr. Fisher for the opportunity to read an advanced review copy. Opinions are mine alone and are not biased in any way.

[Elyse Walters · Rating 5 out of 5]

Audiobook….read by Ta-Nehisi Coates, and Thomas Fisher
….7 hours and 50 minutes

Long days….L O N G intense days for the life of an ER doctor….
Add….
….social issues….bullying….chronic needs…inequality….injuries…..limited supplies….limited time….poor people….poor Black people….severe sick people….immediate treatment needs: which patients need care first and which patients can wait depending on the severity…..diagnosis and intervention can take hours….. patients who are often psychotic, exhausted, and at their wits end.
Etc… etc….etc….etc…….
“The entire healthcare system grows fat if nothing changes”
Etc. etc. etc. etc. etc. etc. > it’s maddening!!!

“The Emergency”…..the audiobook….a memoir…. in a hospital on the South Side of Chicago…..is VERY HARD TO PULL AWAY FROM LISTENING …..
The mesmerizing intimacy writing is deeply felt ….
…..it’s beyond devastating from every which way one examines the circumstances.

Emergency doctors like Thomas Fisher learned to make quick choices with incomplete information —patients lives are on the line.
The ER doctor must treat the most dangerous disorders, first, but angry waiting patients can get violent.
It was shocking to learn about the amounts of violence in an emergency room….
doctors ‘physically-assaulted’ by patients.

ER doctors have loan debts, administration work, pressure and hopes for emotional freedom that can’t be reconciled.
Moral dilemmas is a reality that ER doctors are faced with every day.

There is a high rate of burnout among ER doctors….
Depression is real. They just can’t do it all.
With Covid-19, burnout elevated at insurmountable rates.

Critically ill emergency patients waited the longest —because there were not enough ICU beds….

This book was terribly frightening— and terribly sad ….
Anything I write here only scratches the surface.

It was heartbreaking to me to listen to the stories that Fisher tells…
….no matter how hard he worked, committed to healing ….
at the end of the day ….he went home feeling awful about himself ….he just could not do more - or even do better….
He started writing letters to his patients apologizing.

This entire healthcare story couldn’t possibly be told in just one book (although it’s POWERFULLY written and paints to the HORRORS)…..
……the problem is sooooo much bigger —- than the doctors, patients, and even the hospitals themselves.

By Thomas Fisher sharing as honest as he has —
his frustration- his loneliness- his empathy for the upset patients (who are right)…a doctor who sees the problems….but doesn’t know what he can do to fix anything….
broke my little heart FOR THE ENTIRE HUMAN RACE……

I don’t say this often….(suspicious when people say this to me)…..
But I really ‘do’ feel that everybody should read or listen to Thomas Fisher’s story….…..
……it’s written for mainstream regular folks (no textbook medical language)….
It’s NOT BORING….it educates …(and yes, it is a call to action book)…..but more than that ….it’s worthy to read > PERIOD!!!!
EVEN IF THE READER THINKS THEY ALREADY KNOW ALL of STUFF…..
…….(I doubt ‘everything’), it goes in differently….
maybe it’s the tone by which it’s written or read….VERY DIRECT…(even kinda entertaining for lack of a better word)…..
GROUNDED in TRUTH….
HUMBLENESS…..FORGIVENESS…..RESPONSIVENESS…….
SOLICITOUSNESS….
It’s a phenomenal ‘BETTER-THAN-WELL-WRITTEN’ healthcare book during Covid!

Thomas said he wanted to weep for all the loss …..but what good would it do? I wanted to weep too….
What good ‘would’ it do??? (I admit to tearing anyway)

If this is a buzz book —I agree. The buzzer-folks got it right.
This blurb got it right too:
“The riveting, pulse-pounding story of the year in the life of an emergency room doctor trying to steer his patients and colleagues through a crashing pandemic and a violent summer, amidst a healthcare system that seems determined to leave them behind”

Read it!! Listen to it!!!! Absorb it!!!

Thank you Thomas Fisher. I’d be proud to have you as my doctor!

[Lisa Vegan · Rating 4 out of 5]

I’d forgotten exactly what this book was about between the time I shelved it and put it on hold and by the time I’d borrowed it without rereading the description. I hadn’t remembered that so much of this account is about race and about the state of health care in the United States and about covid. When I was reminded of the book’s focus I wasn’t sure how much I’d like it but I liked it very much.

I was amused when he said he was a nonpracticing agnostic. The quote: “I PREPARE FOR MY shift with gospel music. I’m a nonpracticing agnostic, but today the gospel themes of hope, sacrifice, and community give me comfort.”

I admired this doctor’s honesty and appreciated his taking social and cultural factors into account when looking at the health status of individuals. He writes about the connection between money and health care and about the inequities in health care. I acknowledge his medical and social activism credentials. He’s also a good writer.

I loved how he wrote and structured this book. I especially enjoyed his “letter to” various patients and an intern, a medical trainer, his mother. I’d like to think that all doctors are this thoughtful about their work and about society’s ills. I appreciated him spelling out exactly why doctors, ERs, hospitals aren’t always able to do their best by patients, even when their hearts are in the right place.

This is a sobering account and I can’t say it made me feel optimistic about things but the author’s intentions and work kept me from feeling too, too depressed. We have a lot of work to do with societal racism, providing good health care to all, and a lot of discussions should be had. Whether or not it’s “enough” we can definitely do more and need to do better.

The author is good at humanizing his patents and I ended up caring about everyone he wrote about, including himself. The patients, colleagues, family members, and people in the news, and everyone else.

4-1/2 stars

[Lynn · Rating 3 out of 5]

3.5 stars rounded down.

Full disclosure: I bought this book after having read a review in the Chicago Tribune. Apparently I did not read the review correctly. I thought it was going to be about the ED at Northwestern Medical Center during the pandemic, and I was interested because my husband was being treated for cancer at NWM at the start of the pandemic. This book was nothing like I expected. Apparently my reading comprehension could use some work. My bad.

This is a tough to read and an even tougher book to review. It ostensibly takes place in the Emergency Department of The University of Chicago Medical Center during the Covid-19 pandemic. Dr. Thomas Fisher is an ED doctor and he relates his experiences during this time. His tales of the ED are less about dealing with Covid than they are about the systemic inequality of health care on the south side of Chicago. How the ED is used by local residents for less than emergency illnesses; about the preponderance of gunshot wounds that they have to deal with; how the wait times can be hours and people fall through the cracks of this country’s health care system.

Every other chapter is a “letter” to a patient that he encountered in the ED, whose care he felt was lacking. These “letters” turned into treatises about different aspects of the health care system and its failings, especially in the Black community. He brings up the Northside’s Lincoln Park neighborhood a lot and the medical care those residents receive, as a contrast to the medical care received on the South side. He resents that some patients at UCMedical Center get VIP care and others don’t, yet when his own mother became ill, he tried (and failed) to get her VIP care. She eventually received the proper care at a different hospital.

The chapters about the cases seen in the ED are harrowing, and not for the faint of heart. I cringed a lot while reading these…this is why I am not in the medical field. Although well written and raising valid points, the chapters with the “letters” felt like lectures. I am the first to admit that that as an older white woman, I have worn a cloak of white privilege all my life, as well as always having access to good to excellent medical care. I live in the western suburbs of Chicago, with a Level 1 trauma center 5 minutes from my home. My experiences in an ED have not been the same as described in this book, and for that I am aware that I am truly lucky as well as grateful.

This book is truly eye opening in good and bad ways. As noted before, this book is a tough read and you probably have to be in the right frame of mind to read it. I probably wasn’t. Some chapters had me in tears, as I recalled what my life was like during those time periods. (Yes, it’s all about me.) Some chapters made me angry at the injustice of it all and my powerlessness to do anything about it.

Some good quotes:

”The Emergency is not just a year in the life of an ER during Covid but a powerful examination of the entire complex of healthcare and the inequalities that bend it. It is worth remembering the early days of Covid‘s arrival, when it was said to be “colorblind.” Maybe we wanted to believe that in a true crisis we would find ourselves together, on even footing, if only in our common human frailty. But now here we are, two years later, with Blacks and Latinos having lost some three years of life expectancy over the course of the pandemic– triple that of whites. We should’ve known better. We should now know better. The Emergency explains why, be at the plague of gun violence or the plague of Covid, the burden is never born equally.” Foreword by Ta-Nehisi Coates

“When America catches a cold, Black America gets pneumonia.”

“Meanwhile, hospitals that are financially flush because they serve wealthier populations are more likely to have ERs that flow swiftly. While you will always wait behind more seriously ill people, have you gone to an ER in the north suburbs, even one that has just as many daily patient visits, it’s possible you would’ve been seen immediately.”

This was almost a DNF for me and I was so glad when I finally finished it. It’s very informative and enlightening, but I can’t say that I would recommend it. There was just something about it that put me off.

[Valleri · Rating 4 out of 5]

My thanks to@One World, as well as to @NetGalley, for the opportunity to read and review an early copy of The Emergency.

The Emergency was written during the first year of Covid but it delves into so much more! As an emergency room doctor working on the rapid evaluation unit, Dr. Thomas Fisher has about three minutes to spend with the patients who come into the South Side of Chicago ward where he works, before directing them to the next stage of their care. Bleeding: three minutes. An untreated wound that becomes life-threatening: three minutes. Kidney failure: three minutes.

This was quite an eye-opening book! Does our healthcare system work? Not by a long shot. Dr. Fisher considers it his mission to heal wounds and relieve suffering - but how can he do that in three minutes?

As if that weren't bad enough, in February 2009, the hospital administration announced they would shutter ten ICU beds and save them for Patients of Distinction. You know the ones. The white patients. That's the way to segregate the Emergency Department or any department for that matter! (That plan was eventually rescinded.)

The book is written in an interesting manner in that some of it is in letters to Dr. Fisher's patients, his colleagues, and even his mom. (I believe none of the letters are actually mailed.) In that fashion, he is able to write about events like the Great Migration when 500,000 Black people fled to Chicago, fleeing white terrorism in the South ... or of his love for the Southside of Chicago.

I think everyone needs to read The Emergency!

[Jen Dussold · Rating 5 out of 5]

I saw this book browsing in the bookstore, read the blurb on the inside cover and knew this was a book I needed to read. As someone living in Chicago during the pandemic, it was fascinating to get an inside look at a year in the life of a Chicago ER doctor during 2020. Beyond the stories from the ER, the book provides powerful explorations of the segregation present in Chicago and how this impacts people’s daily lives. It forced me to think deeply about the many facets of inequity present in our society. While this was a heavy read, it was hard to put down and I am so glad I stumbled upon it.

[Lisa O · Rating 3 out of 5]

As you would expect, this was not an uplifting read. Thomas Fisher, an ER doctor at the University of Chicago, shares the experiences, frustrations, and challenges he encountered while providing patient care during 2020. While the book is set during the beginning of the COVID-19 pandemic, and naturally there are some COVID-related situations, this is not a book about the pandemic. It is a broader exploration of the racial injustices and faulty policies of the US healthcare system that create insurmountable barriers for the poor and uninsured. Fisher also questions how urban academic medical centers (like University of Chicago) choose to prioritize their patients and reinforces their responsibility for also serving the people in their local community, regardless of level of medical care required and economic status.

Early on in the book, Fisher admits that sometimes he imagines taking the names and addresses of his patients and "writing them letters with all of the answers I didn’t have time to give them in the rush of the emergency room." Fisher cleverly used this urge to inspire the format of his book. The chapters alternate between one chapter detailing Fisher's activities or interactions during a specific day or emergency room shift, and the next chapter is a letter from Fisher to someone he encountered along the way. The letters dig into the reasons why he wasn't able to provide the level of care he wanted to and/or his frustrations about the limitations and racial bias of US healthcare.

While I thought the format was creative, it ended up making this a good, not great, read for me. During the chapters detailing Fisher's ER shifts, he cycles through a number of patients with various ailments and temperaments. The level of detail was really intriguing the first couple times, but then some of it starts to blend together after awhile, and there starts to be some repetition in the issues that Fisher is highlighting. By the end, it felt like the book and the messaging was dragging a bit in the repetitiveness.

Overall though, I still thought this was a well-written, worthwhile read, and I walked away from it with a lot to think about. I recommend this one if you're interested in the politics and social injustices of healthcare.

[Rachel · Rating 4 out of 5]

The emergency is the state of the USA's health care system, where the rich and employed people get excellent care, and the poor people (black people are far overrepresented in this group) don't. The emergency room is where Dr. Thomas Fisher works, at a Chicago hospital serving people who are mostly poor and almost all black. Fisher is black, and grew up middle class in an almost-all-black neighborhood.

The book has stories about ER patients, which I always like. At the beginning, it seemed like it would be a lot about Covid, but though most of the stories are set during the pandemic, it's not about that. It's more about the inequities in the system, illustrated by the way the author and his coworkers are unable to spend enough time with patients and often unable to get them the care they need.

The chapters alternate between stories of the ER and "letters" to people featured in the previous chapters. I didn't like the letter structure of those chapters. They were actually infodumps about the state of medical care in this country, focusing on racism and economic inequality. For me, acting like each one was directed to a specific person made them seem, I don't know how to say it, but weaker? Or too cute? But they are still absolutely right on. I agree with everything the author says, and it needs to be said and repeated until we get some changes.

The author talks about the time he spent in the nonprofit and private health-care sectors, trying to effect change from there, since there wasn't much he could do about that as an ER doctor. He learned a lot as he tried to make improvements in specific local programs. It didn't work; the current system is too entrenched, and the money needed to work within it is not available.

The last patient story in the book is how he sent his own mother to his ER, while he wasn't working. He alerted the staff and asked them to expedite her care, but she got up and left after several hours with no diagnosis and inadequate pain management (she did get the perk of being put into a room quickly). She had to go to a different hospital the next day, where she was diagnosed with pulmonary emboli; she was lucky that her condition didn't get precipitously worse due to the wasted day.

Here are some quotes from the last chapter, styled as a letter to his mother regarding her disastrous day at his ER:

Addressing the torments that send people to me weary and sick requires that America rearrange its allegiance to systems that subvert our inherent human value and absorb our bodies as inputs to a production function. If we accept that health is a human right, then we have a duty to ensure everyone has similar opportunity to flourish and can obtain necessary prevention, maintenance, and cure.

Each in its own way, our peer countries are committed to health-care systems that provide essential services to the entire population ... We too need a new arrangement, one that ceases the resource transfer from those at the bottom of society to those at the top, one that dismantles the separate tiers of our health-care system, one that invests in public health alongside innovation and treats everyone with the humanity we deserve.

And from the author's concluding paragraph:

...Fixing it and building a healthy population requires a revolution in the way we view humanity, clarity in the trade-offs we're making, and honesty in the costs embedded in seemingly neutral decisions. In the process we must face the damage we've accepted in the name of profit, elevate moral leadership, reconcile conflicting truths with honorable new systems--and protect the lives of my worthy and beautiful patients who seem doomed from the start. Only then can we follow steps toward better health and a better health-care system for America, one that is just and true.

[Jennifer · Rating 1 out of 5]

Thank you to Netgalley for an advanced copy:

As one of Newsweek's Most Anticipated Books of 2022, I had high expectations for this book. Sadly, I was disappointed. While this book had potential, the author chose to use it as a means to lament all that is wrong with American society. Instead of an inside look at how one inner-city hospital coped with COVID, it was a platform to spotlight the overought issues that are burdening American today: racism, poverty, lack of education, lack of insurance, etc... instead of hailing the medical workers of the ED as the heroes they are.
The author seems to have written two different books within the context of one. The first is an insight into a hospital in the grips of a pandemic, but every other chapter the author devotes to what he calls "a letter to a patient." It is within these "letters" that the author rails against racism, poverty and the litany of other societal ills continues. He is outraged at the VIPs who receive what he considers the gold standard of care at the expense of the minorities that come to his ED. However, it's a much different story when the author's own mother comes for care and he demands VIP care for her and is upset when after receiving VIP level of care, she is treated like just another black woman during a change of shift, until he calls in to speak to the new ED doctor. Such hypocrisy that it is stomach-turning!
I would do yourself a favor and save yourself both time and money by finding another book to read.

[Marika · Rating 5 out of 5]

Dr Thomas Fisher is a man of color who writes passionately about his life as an emergency medicine physician in Chicago. He goes home each night after his shift and writes letters (that he never mails) to his many patients about the care that they received by him. He apologizes for what he sees as the lack of health equality for all. He apologizes for the poverty that his patients live in. He apologizes because he recognizes that just because a person is living in poverty does not mean that they should receive less than optimal healthcare. One might go into this book thinking that the emergency that he writes about takes place in the E.R only. But readers will come away asking themselves what is the real emergency. The right to education, employment, community safety affects how well and how long we live. So what is the real emergency?
Award winning author Ta-Nehisi Coates writes the forward for this moving book which will bring much attention.
* I read an advance copy and was not compensated.

[Susanne · Rating 4 out of 5]

I liked this one a whole lot. A Black emergency room physician alternates chapters describing the patients he sees with chapters examining the state of health care in the U.S. He is a hard working and compassionate doctor but can't even guarantee his own mother the sort of quality care he feels she deserves at his South-side Chicago hospital.. He concludes "I know that there cannot be justice in health or healthcare until there is justice in society." A very sobering look at a serious problem.

[Diana · Rating 3 out of 5]

Mixed feelings about this one. It was more about the difficulties of managing a hospital in a poor neighborhood than about Covid. I enjoyed the autobiographical aspects the best but the hospital parts seemed all over the place. Glad I read it.

[Madeline S · Rating 3 out of 5]

This book was a real page-turner. I mean, I blew through the whole thing in less than 24 hours. I read more than 50% during my normal daily routine (during commute time and lunch break), and the book was light and engaging enough for me to decide to push through and finish it after I got home from work. A very easy, fast read.

Look, I've been living in Chicago for 5+ years now. I lived here through the pandemic. I volunteered in an ER for a few months before the COVID-19 pandemic came in swinging and the hospitals forced all the unpaid volunteers to go home. I worked in a pharmacy for a little while and have dealt with processing insurance claims and facing the people that can't afford the medications they need on a daily basis. I read The Emergency and am writing this review during a major upswing in gun violence across the city. I've even walked past the UChicago ER Dr. Fisher works at many, many times! Everything about this book hits a little close to home, and, by proxy, I already knew a lot of the information he was presenting in this book. The American health care system is fucked and hates poor and/or black people, plain and simple.

Ultimately, I think this book works better as a snapshot of what Chicago was like during the early pandemic. The uncertainty about spread and contamination, the limited visiting hours, the self-quarantining, the dependency on Zoom, it's all here. I liked the inclusions of the letters to former patients as a way to explain why the medical industry is so messed up, but none of the information was particularly surprising to me. At the very end, he tries to make the thesis of the book to be an argument for universal health care, but, to me, it felt kinda shoe-horned in (like, 'Oh shit, this book probably needs to have a point'). I think thematically The Emergency would have worked better if it just showcased how hard COVID-19 hit the Chicago South Side community in order to garner sympathy for everybody that lives and works there. The most compelling part of the book was the mother who had to say her goodbyes to her dying son through a FaceTime call.

My one big gripe with this book is that I feel like Dr. Fisher was trying to present himself in the best possible light at all times, which I found to be a tad disingenuous. I've had a handful of pre-med friends and have read a lot of med school application essay drafts over the years, ones where you're supposed to show how you've faced and overcome adversity or how you've learned from your failures and become a better person in the end. The prose in had the exact same tone as a "pls let me into med school" essay. He acknowledges his failures sure, but he doesn't really tell us the consequences of those shortcomings. I would have loved to have a scene where he absolutely lost his shit and just started crying or yelling at people, but I realize how unprofessional that would have made him look. Maybe instead, he could have written about recurring patients, or what happened to his mom, or what happened to some of the former employees or customers of Next Level Health, or the long-term consequences of lengthy ER wait times and overly priced health care, or what his letter at the end accomplished.

[Darragh Howard · Rating 4 out of 5]

Erik got me this book and I'm really grateful he did. This book comes in a string of books that I've read recently addressing different aspects of healthcare/medicine, spanning topics like mortality, aging, & (and now) injustice. Fisher is clearly an incredible provider and person and I think he recounted his experience within healthcare beautifully and shone light on the healthcare disparities that exist and how it is inseparable from the context of America and our history. I think this book was more impactful given its backdrop of the pandemic and how this event affect physicians and exacerbated so many existing problems with our system.

4 stars as there were certain parts that I found more vague or confusing or minor qualms I had with certain descriptions or parts of the book (but also I may just need a change in genre/topic for a little lol) but overall I really enjoyed it and would recommend.

[Emma · Rating 4 out of 5]

It was truly moving to read something so specific to the ER I live right by and have interacted with through EMTing… the same patient populations, the same ambulances, etc. (shoutout CFD #38 fr)
Fishers’s stories were heartbreaking and his reflections—specifically about his family and their place in the web of health racism—were beautiful.
Overall I think this is such a heartbreaking portrait of emergency medicine that left me feeling worse than when I started it— and thats exactly what we all should be feeling.

[Infosifter · Rating 4 out of 5]

I got three main takeaways from this book.
1. The author is burnt out, and desperately trying not to be and to prevent his frustration from negatively affecting his patients.
2. The American healthcare system is a complete disaster for anyone who isn't well off and possessed of expensive comprehensive insurance, which most people can't afford; even middle class people can usually only afford minimal insurance that only covers catastrophic situations.
3. The author is experiencing moral hazard because the system prevents him from doing what he believes is right in behalf of the patients he cares for. This is a terrible position for highly skilled health workers to be caught in.

[Sapna Ramappa · Rating 4 out of 5]

I see why this was our required reading before starting medical school. There's a lot of good material and reflection here about moral injury, social/systemic determinants in healthcare, race-based medicine, and the corporatization of American healthcare.

Wasn't a huge fan of the structure of the book, and it did feel a bit repetitive, but I'm giving it four stars for the strong reflections.

[Courtney Smith Atkins · Rating 5 out of 5]

An insightful look into healthcare in Chicago’s south side ER. The author is a seasoned doctor that weaves in our biased nation-healthcare, poverty, access, education, violence-during COVID.

The book reads like a journal with his patient interactions and then a letter he writes to someone from that shift.

All of us in a helping profession leave each interaction wanting to do more.

[Lynn · Rating 4 out of 5]

A Chicago ER during COVID-19. Interesting story but also harrowing to read how uninsured get little help in ER even for bad conditions.

[Mary · Rating 4 out of 5]

I would describe this as primarily memoir with a lot of health justice information mixed in. It is powerful and engaging.

[Meghan Keenan · Rating 4 out of 5]

A very real and at times heartbreaking look at the American health care system with regard to race and inequity that is built into our societal structures.

[Brennan · Rating 4 out of 5]

Dr.Fisher’s book is part physician memoir and part a call to health policy reform. If you are looking for a great place to gain foundational knowledge of health policy and to understand the injustices in our health care system this is your book.

[Lynda Coker · Rating 4 out of 5]

It only took reading a few pages before I knew I needed to get comfortable because I was going to be in this story for a while. Two hours later, I had to put the book down because I was so exhausted. Following Dr. Thomas Fisher as he navigates the impossible hurdles of an ER physician working under America’s flawed healthcare system was an exercise in frustration. But it was also an opportunity to appreciate the many medical staff members that do all they can under a system that limits, curtails, puts off, and abandons many of those who come to it for help. I finished the book the next day. It was a compelling read.

There are so many facts and an abundance of personal perspectives about what works and what doesn’t work in America's healthcare and hospital policies. And some perplexing views on injustice and partiality showed prospective patients/clients.

The author puts you in his shoes as he strives to make the best medical evaluations he can in about 3 minutes, the average time he has to spend with each patient in the ER’s rapid evaluation unit as he makes triage type decisions on their options for further care.

Dr. Fisher writes letters that may, or may not, be sent to these individuals explaining the conditions and policies that hinder so many from getting the best healthcare available, reasons, and conclusions which left me with a lot to ponder.

Between the actual ER cases, the people, and the letters, this book kept me completely immersed in this account.
#Goodreadsgiveaway

[BookStarRaven · Rating 4 out of 5]

Quick Take: Chicago is a segregated city. Seen through the eyes of an ER doctor at University of Chicago Hospital on Chicago’s south side, medical care is not easy.

The Emergency: A Year of Healing and Heartbreak in a Chicago ER by Thomas Fisher is a look into one of Chicago’s premier hospitals on the south side. Chicago is a segregated city, you can look at a map and see where different groups of people live: if you’re black you probably live on the south side, if you’re white you probably live in the north, if you’re Hispanic you might live around the northwest. While none of these are official boundaries, Chicago IS one of the most segregated cities in America.

Fisher shares his days in a south side ER. Through his lens as a doctor, you get a look into the life of someone from the south side of Chicago. He discusses the fear of being in the ER during covid, exhaustion and burnout, and how depressing it is to only be able to spend 3 minutes with a patient when they deserve more. He also writes letters to his patients to explain what’s gone wrong with our medical system and why he can’t serve them better.


I really appreciated this look at what the healthcare system is like on the south side of Chicago. I would recommend this book to anyone but especially anyone interested in public health.

Rating: 4/5
Genre: Non-Fiction

[Sara · Rating 5 out of 5]

If you're under some sort of illusion that our healthcare system works, read this book and find out who it works for and who it most definitely does not work for.
Dr. Fisher describes his year in a Chicago ER. Does it read like Grey's Anatomy or (more likely) Chicago Med? In some ways, it does. It's riveting reading and the stories of his patients' realities are very sobering. I can't even imagine how Dr. Fisher doesn't want to drink himself to sleep every night because it is so obvious that he cares, that he's trying and that the system is beating him down; even the good ones are powerless with the healthcare system we have that is motivated far more by $$$ than health or care.

I wish that people who don't believe in systemic racism would read this book and see exactly how pervasive racism is when seeking out medical care--which should not be determined by race or economic status. But it is and Dr. Fisher has painted a compelling picture for us.

Thank you to NetGalley for an advance copy of this book.

[Kade Gulluscio · Rating 5 out of 5]

Wow. This book was great. This doctor shows SO MUCH empathy to his patients, which is not something you see everyday, that's for sure.

This book is a memoir of his time as a doctor in a busy ER before and during Covid. His stories about his experience are heartbreaking at times. I love that he even wrote letters to some of his patients that had an effect on him and featured them in this book.

I'd definitely read more by this author.

[Molly · Rating 5 out of 5]

This was excellent. I listened on audible, narrated by the author, which I recommend. More expansive than just looking at covid - there is so much in this book. Recommended for those interested in medicine, health care inequities, and humanity in general

[Kathy · Rating 3 out of 5]

When I heard that an ED physician at the University of Chicago Hospital- just miles from where I live- had written a book about his experiences in an urban emergency room during Covid, I was immediately interested.

The stories about the ER were interesting - the author really does a fine job of highlighting the double pandemics of Covid and gun violence that he dealt with on a daily basis. His description of Covid precautions, risks to health care workers and related stress is relatively understated in contrast to other things I have read. Dr. Fisher also highlights the discrepancies in health care for the poor vs. rich, black vs. white. His efforts to recognize the humanity in all his patients and hear their stories despite the twin constraints of time and resources are commendable and heartwarming. He writes about the times he fails with honesty and humility. He is a truly admirable physician and person.

Each chapter is followed by a "letter" composed to one of the patients (or in one case a colleague) about the events of the day. In these letters, Dr. Fisher speaks of failures of insurance, hospital administrators too interested in the bottom line, and the crippling effects of racism and poverty on health care. Although these are all important topics, my preference would have been to focus more on the "stories" of the emergency room and then maybe wrap up with a chapter on policies and their impact. The letters pulled me away from the humanity of the story and were not anything I hadn't heard before. Since these are long-standing issues, I understand the need to say them again, but I think a "show, don't tell" focus would have improved the book.

[Stacie · Rating 3 out of 5]

This is billed as a personal perspective of a doctor’s time in the ER during COVID. I would say it is less about COVID and more about the systemic issues related to health care in an inner-city hospital. Thomas Fisher works in the University of Chicago ER and shares stories of patients that left him frustrated due to the lack of care he was able to give them. He writes certain patients a letter and other chapters are more of a diary of his days during that month in the ER.

I don’t doubt that our healthcare system is a joke and there are major issues when it comes to equal care and equal costs. His insights were similar to my reading of THE HOSPITAL which shared the struggles of small-town hospitals competing with larger conglomerates.

While I understood his frustrations and sympathized with the sad health cases he shared, it wasn’t exactly the book I was expecting and definitely not a happy story. This might have been a timing thing for me, but it wasn’t a great read for me. The author narrates it himself.