The Night Shift

night

The Night Shift: Real Life in the Heart of the E.R. by Dr. Brian Goldman. HarperCollins 2010.

If you’re lucky, your only knowledge of hospital emergency rooms is of a child with an earache in the middle of the night. Otherwise, you’re left with the T.V. version: plenty of blood and gore and urgent life-threatening situations, punctuated with doctors jumping into bed with each other in the few quiet moments. In The Night Shift, Dr. Goldman shines a light on what the emergency room experience is really like as seen from his side of the gurney.

Dr. Goldman is an emergency room physician with nearly 30 years of experience. I knew of Dr. Goldman from listening to his radio show, White Coat, Black Art, which can be heard on CBC Radio One. Follow the link for more details. I’ve always enjoyed the show, where Dr. Goldman and guests discuss topics as diverse as hospital parking and narcotic addiction. When I learned that he had written a book that was published last year, I looked it up.

The Night Shift follows Dr. Goldman as he works through the night at the Mount Sinai Hospital emergency room in downtown Toronto, Ontario. Mount Sinai doesn’t receive many trauma patients, who are routed to other nearby hospitals, so to round out his narrative, Dr. Goldman includes stories from other emergency room doctors here and there. As Dr. Goldman sees each new patient, he outlines the medical issue involved and uses it as a jumping off point to discuss related issues.

Meeting the patients and learning about their problems was my favorite part of the book. Some of the discussions didn’t interest me as much. For instance, Dr. Goldman talks about the pros and cons of calling in a specialist for a consult on a patient in the middle of the night. Really, I’d just as soon believe the doctor always does what is best for the patient and let it go at that. But of course, doctors are people too, and make mistakes, another of Dr. Goldman’s topics. Even staying awake and alert all night is an issue for a mere mortal as most doctors are.

Other topics I found very interesting. The discussion of addictive prescription drugs such as OxyContin is particularly timely as there was recently a case of a drug overdose death in our region related to the over-prescribing of OxyContin. Pain is a subjective thing that can’t be readily measured, so is difficult for a doctor to assess. And how is Big Pharma implicated in over-prescribing?

It’s fun to read some of the ‘insider’ terms used by doctors, such as Frequent Flyers and Moonlighters. I was fascinated to learn that the widespread use of hand sanitizers, with dispensers set up all round hospitals these days, has led to another problem: homeless alcoholics visiting the emergency room looking for a hit of alcohol from the dispensers, whose contents may be up to 75% alcohol.

Dr. Goldman is a gracious host as you tag along with him on his rounds. The Night Shift is an interesting read and recommended for anyone who would like to get a look at the real world of emergency room medicine.

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