Brian Goldman is one of those rare individuals who simultaneously pursues two careers. He has toiled for more than 20 years as an emergency physician at Mount Sinai Hospital in Toronto, Ontario while working as a medical journalist for the CBC, currently as host of CBC radio’s White Coat, Black Art. Without claiming the same far-reaching influence of American media darlings, Oprah’s Dr. Oz or CNN’s Dr. Sanjay Gupta, he is as close as we get in this country to a medical celebrity.
Goldman trades on his media personality with a book of his experiences in the emergency department and I am happy to report that it’s a satisfying read. The storyline proceeds as if over one night shift, but the author concedes in the introduction that the book is a composite of his most interesting cases over the many years of his career. In addition to being a medical memoir, it’s also a compilation of other physician’s stories.
The Night Shift rolls out along a timeline that begins at 9:15 pm one Friday evening as Goldman sets off to work. He arrives for a 10 pm start and is immediately thrust into the action. Cases are then laid out in chronological order, each one allowing the writer to riff onto other anecdotes. Along the way, the author weighs in on the many topics fundamental to emergency physicians including interactions with patients, police, consultants, residents and nurses, medical error and the schadenfreude that we sometimes feel (but shouldn’t) when talking about a colleague’s diagnostic blunder.
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HarperCollins Publishers Ltd.
Trauma care is central to the idea of what makes emergency medicine absorbing — at least in the public’s mind — and Mount Sinai is not a trauma hospital, but this obstacle is neatly hurdled when our doctor–journalist draws on his radio interviews to bring the stories of other Canadian emergency physicians to the page. Reading like a who’s who of Canadian emergency medicine, their narratives add considerable storytelling muscle to the book’s physique. I was particularly struck by former Vancouver General emergency specialist, Bruce Campana, who is quoted throughout the volume. He should consider writing his own book.
The pace is fast and the writing is engaging, but make no mistake, this is a book written for the nonmedical public. To that end, while the reader in me enjoyed the tour, my inner physician was sometimes nonplussed with the clinical explanations. For example, in describing the writhing discomfort of a 30-year-old woman, we learn that “It (the patient’s abdomen) was rigid, which now suggested peritonitis, an inflammation of the membrane that lines part of the abdominal cavity, often caused by infection and treatable with antibiotics.” While the patient, it quickly becomes apparent, is not suffering from this condition, the statement as presented is incomplete. Although I doubt it would detract from the flow of the paragraph for most readers, surely this gross simplification is likely to induce metaphorical scalp-scratching among MDs.
Goldman himself comes across as earnest, dedicated and diagnostically astute. And while he didn’t have to do so, he bravely discusses his own perceived weaknesses as an emergency physician, medical miscalculations, sleep disorder and use of a prescription drug modafinil to stay alert during night shifts.
Goldman admits to disliking criticism but these tablets serve as an example of the occasionally weak editing of the text. For example, at 9:15 pm on the way to his shift, “I popped a couple of modafinil pills.” At 2:44 am, “I took a modafinil and headed to my next patient.” At 5:18 am, “I resisted the urge to pop another modafinil. … I do worry that one day I’ll need three pills, then four, then five.” Dear Brian, either that day has arrived or your editor needs a little pharmacologic assistance in the awake and alert department.
But these comments seem like mere grousing. I finished the book surprisingly uplifted and proud to be part of the club which Goldman so ably describes.