The ER and Toronto’s suffering souls
Five books have been nominated for the 2017 Toronto Book Awards.
This week, the Star is running excerpts from each to give readers a flavour for the writers and their stories.
This is the final excerpt. The winner will be announced at a ceremony — open to the public — tonight at the Toronto Reference Library’s Appel Salon. Today, a glimpse of Dr. James Maskalyk’s book Life on the Ground Floor, published by Penguin Random House Canada.
I’ve been cutting down my shifts in the last few years so I can spend more time on Ethiopia. I work about ten a month now. It’s just enough to keep my skills up. Fewer, and my fingers fumble.
When I graduated, I did twice as many. During those months, being in the ER was simpler than it has been since. My flow was natural, my hands steady, and my patients’ faces grew as indistinct as the date or time. It was the hours outside of work that started to hurt. It is easy to ignore your own worries when there is a neverending list of worse ones placed in front of you. My relationship failed. Friends fell away. Beauty too. I felt fine.
I wasn’t. Fatigue caught up with me and I slowed down for a minute, looked around, wondered where everyone was.
If we in ER gather in community, it is to talk about how to resuscitate a baby, to poke needles into fake plastic necks, or to practise for poisongas subway attacks. We don’t practise joy, how to stay well in the face of all the sickness. Doctor, Nurse, heal thyself. Or not. Those who work in the ER burn out faster than any other type of physician. I’m not sure if it’s the shifts or the long, steady glimpse of humans on their worst day.
I think most of us would say that it’s not the sickest that affect us, that it is the minutes in contact with them when we feel most well used. In a macabre way, we hope for the next person to have something really wrong with them, but it is more rare than you’d imagine to see a critical patient in Toronto, even in the trauma room, someone whose system needs the order the alphabet can bring.
Most of the work here is in minor. ERs are open all hours, and since the service is free, people often come in early, instead of an hour too late. Sometimes there is nothing wrong with their bodies at all. There are so many measures in place to keep people well, or to catch them before they get too sick, I can go weeks without intubating someone. Worried minds, though, latch onto subtle sensations that magnify with attention, and lacking context, they line up to be reassured. The two populations, the sick and the worried, mix together, and separating them keeps us up all night.
Suffering souls, though, there is no shortage of them. They circle this place.
Some sleep right outside, on sidewalk grates, wrapped in blankets, waiting. One is splayed in the clothes he lives in, face pressed against the metal grille in a deep, drunk sleep. Every few minutes, a subway passes below the grates, and a rush of warm air flutters his shirt like a flag.
Businesswomen spin in and out of an office tower’s revolving doors. They cross the street, eyes dancing between their phones and streetcar ruts, pretending not to notice the figure on the ground. Shoppers with bags from the Eaton Centre dangling from their arms lean into the road looking for taxis, jump out of the way of rushing cars.
A guy across the street notices the body. He glances at it, then at the hospital, makes a calculation that there must be no better street grate in the city, and moves on.