Saturday, October 30, 2010

THE NIGHT SHIFT: REAL LIFE IN THE HEART OF THE E.R. by Dr. Brian Goldman (2010) HarperCollins Canada

Dr. Brian Goldman may be a familiar name to you if you're a CBC geek like me. He's the host of CBC Radio's "White Coat, Black Art," a show that aims to speak directly about issues facing doctors and patients. However, in addition to being a recognized medical journalist, Goldman also continues to work as an emergency room physician at Mount Sinai Hospital here in Toronto.

THE NIGHT SHIFT demystifies life in an Emergency Room and follows Goldman through a typical round from 10pm to 7am one evening, an evening where he deals with a dislocated shoulder, a dying cancer patient having a seizure, a stroke victim in denial, a paranoid woman, a pregnant woman who had no idea she was in labour, a victim of a date-rape drug, kidney failure presenting as a gastrointestinal bleed, a broken wrist, and a suicide risk, among several others.

Ever wondered about the triage rules? There are 5 levels ranging from 1-5 depending on the urgency of your required care and here are the wait times as well:
1: resuscitation (requires immediate, aggressive intervention) IMMEDIATE ATTENTION
2: emergent (almost same danger as level 1) WITHIN 15 MINUTES
3: urgent (vaginal bleeding, moderate head trauma, acute pain, suicidal thoughts) WITHIN 30 MINUTES
4: semi-urgent (back pain, headaches) 60 MINUTES
5: non-urgent (sore throat, minor abdominal pain) 2 HOURS

The book is rife with interesting anecdotes and statistics like, in Ontario, it may take anywhere from 24 hours - 3 years to have a suitable available liver for transplantation--that's quite an open window. If you have needed a push to SIGN YOUR Organ Donor Card, consider this statistic that reality check.

All of the chapters have engaging titles, but the most intriguing to me is "Moonlighters and Frequent Flyers" which explores the cases of patients who are prescription drug addicts and make their own rounds from hospital to hospital telling their embellished tales of lost-in-flight bottles of Oxycontin or accidentally flushed Demerol tablets. The frequent flyers of the title are alcohol dependents, some of whom have minor scrapes and bruises from a bar brawl, but who intend to be placed on a gurney in the hallway and wait for the opportunity to swipe bottles of hand sanitizer which they consume to become further intoxicated.

The range of patients requiring treatment on any given NIGHT SHIFT keeps E.R. physicians like Goldman engaged in the adrenaline-pumping, creative problem-solving essential to practicing their chosen medicine.

Dr. Brian Goldman may be followed on twitter @WCBADoctorBrian and you may meet him and have him sign a copy of NIGHT SHIFT at GET CAUGHT READING on Tuesday November 16th at 7pm at Ben McNally Books--RSGC's annual event that this year supports The Children's Book Bank here in Toronto. The event is open to the public. I hope to see you there.

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