A health-care system emergency

Emergency room physician Thomas Fisher captures two common feelings in The Emergency. The first is the sense of panic and anxiety that began in March 2020 as many people in the United States waited for COVID-19 to reach us. The second is annoyance and frustration with our country’s health-care system, which many have experienced in ER lobbies while waiting for hours to be seen by a doctor.

Fisher chronicles his experiences working at the University of Chicago Medical Center during the COVID-19 pandemic against the backdrop of the racism that shapes not just his city but also the ER where he spends his days. A native South Sider, Fisher is impassioned about communicating clearly with his patients. This passion takes the form of letters to some of his patients, which are interspersed throughout the memoir. By examining segregation, capitalism, and social determinants of health, Fisher attempts to show his patients that they are not the ones who have failed. The problem is systemic: due to the very structure of our society, low-income people of color face worse health outcomes than others.

Fisher sets the stage by portraying just how rapidly a shift in the ER unfolds for medical personnel, in stark contrast to the extended wait times patients often experience. “Sometimes the patients flow,” he writes. “Individuals turn into a blur of symptoms that need diagnosing, urgent problems that need fixing, impossible circumstances that need unraveling, and impediments to getting to the next patient.” Time usually permits ER doctors to spend only three minutes with each patient. In that time period, Fisher explains, he must evaluate the patient and determine a course of treatment. Those three minutes don’t allow him the time to truly see his patients, to unpack their experiences and answer their questions fully. Questions like, he writes, “How did this happen to me? Why am I suffering like this? How can I make it stop? And who, exactly, are you, this stranger standing so close, touching me, seeing me, this stranger I suddenly need?”