Emergency Room Notebook, 1977

Berlin, Lucia

Primary Category: Literature / Fiction

Genre: Short Story

Annotated by:
Miksanek, Tony
  • Date of entry: Nov-14-2016
  • Last revised: Nov-28-2016


The narrator Lucia works in a California city emergency room. Her job title is not specified - possibly a registration clerk or triage nurse. She enjoys working in the ER and marvels at the human body: "I am fascinated by two fingers in a baggie, a glittering switchblade all the way out of a lean pimp's back" (p90). Death, however, is a regular visitor.

All day, ambulances back up to the emergency room, gurneys rumble by, and charts accumulate. The staff is too busy. Patients are restless, frightened, and angry. She notes how everything associated with the ER appears gray - patient's skin, blankets, emergency vehicles. And perhaps the prognosis of patients as well: "Everything is reparable, or not" (p90).

Lucia describes Code Blues, the deaths of gypsies, an encounter with a blind man whose wife was DOA, drunks, and suicide attempts. She wonders why the elderly fall down so frequently. She's frustrated by the large number of people who come to the ER without an actual emergency and longs for "a good cut-and-dried stabbing or a gunshot wound" (p93). But Lucia worries that she has become too desensitized working in the emergency room, maybe even inhuman. Yet the flow of patients doesn't slow down - those with true life-threatening conditions and those who probably don't need to be there.


The kinetics and chaos of an urban emergency room along with the sensory and emotional overload of a woman who works there are deftly captured in this narrative. The tension, pace, pressure, and cynicism of working in a busy ER are well-communicated. Less a short story than a gritty report from the trenches, there is little plot present.

Autobiographical elements are clearly embedded as the narrator unloads a bit of the burden she totes and confesses her peeves: inappropriate overutilization of the ER, misbehavior, cost, and bad deaths. She is annoyed by how medical, nursing, and ambulance staff cloak themselves in indifference as an act of self-preservation but frets that her own empathy for patients is steadily dripping away. Maybe it is an inescapable consequence of working in such a place for too long. But she remains able to discern that "Fear, poverty, alcoholism, loneliness are terminal illnesses. Emergencies, in fact" (p93).


See also Mijito

Primary Source

A Manual for Cleaning Women: Selected Stories (pp 88-97)


Farrar, Straus and Giroux

Place Published

New York




Stephen Emerson

Page Count