“Patient Care: Death and Life in the Emergency Room,” by Paul Seward, MD

  • Catapult.  240 pp.  Hardcover $25.00.

This insider account of the ER provides high drama, fascinating detail, and unexpected humor.

Paul Seward’s half-century in the emergency room has yielded a bounty of stories illustrating the joys and frustrations of his trade. The 21 friendly, well-carved vignettes he shares in Patient Care penetrate the mysteries of emergency medicine while underscoring the compassion, skill, and dedication of the modest practitioner/author.

One of the recurrent concerns expressed by Seward is his inability, when sharing his reminiscences here, to remember everything relevant to a particular patient’s case and to his own behavior during the crisis. He fills in these blanks by explaining what his customary action would likely have been.

Why does he take the time to worry about these memory lapses? Perhaps it is one way of admitting the human fallibility to which physicians, like all people, are prone. And while he often puts his colleagues on a pedestal, he keeps himself on the ground.

Paul Seward.. credit Carl Burkard

Seward reveals that he has always taken great personal interest in the people and situations he has encountered. While emergency medicine is characterized by its dependence on tried-and-true routines, it’s important to recognize when a situation is going off the rails — and to be able to improvise or ask for help.

It’s a highly pressurized workplace in which minutes, even seconds, can mean the difference between life and death. Seward emphasizes this reality over and over. And he makes the stakes feel real for readers.

One of his patients in the ER was a middle-aged man sitting stiffly in a wheelchair, a pair of shears sticking out of his back. The man looked like “some kind of grisly windup toy with a key in the back of his neck shaped like the handle of a pair of shears.”

The man was a professional gardener attacked by a co-worker; the shears’ blades had entered “exactly in the midpoint of his neck, halfway from his shoulders to the back of his neck.” They stopped just short of the spinal cord.

The description of the neurosurgeon removing the weapon, with exquisite care, is charged with suspense, but the real miracle was the amazingly lucky placement of the shears. The man just needed to have the wound flushed and closed. . . .

To read the entire review, as it appears in the Washington Independent Review of Books, click here: Patient Care

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