Emergency Doctor is a riveting, informative account of the workings of the Emergency Department at Bellevue Hospital in New York City, the oldest public hospital in the country.  On any given day, tourists, residents, the wealthy and those who live in shelters come to the Emergency Department, some with life threatening injuries and others who need little more than a hot meal and a shower.  No one is turned away.  

Published in 1987, the book was written by a former editor at Reader’s Digest in cooperation with Dr. Lewis Goldfrank, the former Director of Emergency Services and a leading toxicologist.  Goldfrank’s personal story of his path to emergency medicine and his experience in creating the Emergency Department out of what was once known as the Emergency Room frame the narrative, but the main focus is on the day to day activities of the patients and staff in the Emergency Department.  Because Bellevue is NYC’s main trauma center, the book is rich with stories of trauma including construction accidents, cardiac arrests, fires and suicide attempts among others.  Even the title chapters-- "A Question of Poison," "An Alkaloid Plague," "The Case of the Crazed Executives," for example—convey the urgency and medical detective work needed for each person who comes through the triage area. 
“We don’t know if a patient is alive or dead when we first see him,” Dr. Goldfrank says.  “And we’re never sure what we’re going to find, or what kind of emergency medicine we may be called upon to practice—surgery, neurology, pediatrics, psychiatry, cardiology, obstetrics. (p118)   Accident victims are stabilized in the trauma area and rushed to the operating room. People with cancer, or TB, children who have been abused, broken bones, suicide attempts, accidental or intentional poisoning and overdoses—all must be evaluated and decisions made whether they should be admitted to a medical floor, the operating room or perhaps kept for observation.

Beyond medical expertise, however, working in the Emergency Department requires a large dose of compassion to cope with the needs of patients who rely on the Emergency Department for basic care for their chronic conditions such as asthma,  and social services because they lack a place to live or have no means of support.   Perhaps they need to detox from alcohol or have mental health issues.  “Emergency medicine demands the most intense involvement personally and intellectually,” observes Dr. Stephen Waxman. “Every area of clinical medicine is practiced, every emotion is taxed.”  (p 119)      


The book reads, at times, like a thriller: Will the woman who was crushed by a crane survive?  We follow the hour by hour rescue effort, fearful that she will die or lose her legs should she survive.  And while it artfully builds the narrative of the patient stories, the book also describes what is going on inside the bodies of these patients.  What happens, for example, in the body of a fireman who is brought in suffering from smoke inhalation?  What happens to the blood of alcoholics?  These sections never overpower the narrative; rather they help the reader understand the thought processes that go into the critical decisions that might make the difference between life and death. 

When the book was first published in 1987, the Department had about sixty rooms and forty attending physicians with many, many more support staff.  By 2004 when the afterword was added, and the threat of terrorism was on the minds of  every New Yorker, the Bellevue Emergency Department  was seeing approximately 95,000 patients annually in a new space designed to handle multiple crises- mass casualties, microbiologic agents, and unknown toxins.  

In an era when many public hospitals have closed their doors, Bellevue preserves the safety net that allows all people, regardless of their life circumstances, to receive medical care and to be treated with dignity and respect. There is no better example of this than the Bellevue Emergency Department.  



Place Published

New York



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