The ER is a sacred space

Most of us have seen a fair number of emergency room scenes on the big screen. They generally feature haste, split-second decisions, interpersonal tension, expensive equipment, and high drama. Many of us have also spent time in actual ERs, mostly waiting, wondering what we’re being exposed to, wishing the person three uncomfortable chairs away would quit complaining quite so loudly. Some of us have spent that time crafting imaginary op-eds about the broken health-care system.

Neither TV nor actual ERs offer perspectives that would readily lead us to the generous notion that “the ground shared between doctors and patients is sacred ground.” Jay Baruch doesn’t begin there, either. He arrives at that summary statement near the end of his rich collection of stories from years of working as an ER doctor.

The focus of his stories is not public health as such, nor the state of health care. It’s not the pain, frustration, or needs of medical staff or patients. Instead, it’s the stories themselves. Doctors, he believes, are “stewards” of patients’ stories. Listening for whatever patients and distressed family members are able to tell them, they thread together patches of information, cues and clues, speculations, remembered material from medi­cal school, and the data flashing on monitors. Whether consciously or not, they come up with what is not simply a rational solution to a problem, but a story: this is what happened, and here’s why.