Patient Care: Death and Life in the Emergency Room

A boy is pulled from a river and brought back to life: Will he be the same child he was? A priest on the verge of a heart attack leaves the hospital to see old friends: Is an evening of reunion worth the risk of death?

Recalling remarkable cases—and people—from a career launched in the first days of the specialty of Emergency Medicine, Dr. Paul Seward leads us in his memoir through suspenseful diagnoses and explorations of anatomy. By his side, we learn to distinguish nursemaid's elbow from a true broken arm. We learn how our breathing and swallowing mechanisms resemble a practical joke.

But when a baby’s heart stops and a young doctor forgets what to do, the situation is far from funny. Within the conditions of great stress and rapid decision-making that are routine in the ER, Dr. Seward shows us that physicians must be more than technicians of the body; they must be restorers of the human. Whether it is comforting anxious family or subjecting a distressed patient to tough procedures—resulting, once, in a patient’s punching our doctor—on every shift, a physician learns the difficult work of caring for strangers.

Yet this is a physician who rejects doctor-as-god narratives. He highlights the essential role of nurses and other colleagues, including a pharmacist whose story is hard to forget. Throughout Patient Care, Dr. Seward reflects on how a life in medicine tests what it means to put ethics into practice.