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Life on the Ground Floor
Cover of Life on the Ground Floor
Life on the Ground Floor
Letters from the Edge of Emergency Medicine
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*Canada Reads 2019 Longlist*Winner of the 2017 Hilary Weston Writers' Trust Prize for NonfictionDo no harm is our most important rule, but we break it all the time trying to do good. In this deeply...
*Canada Reads 2019 Longlist*Winner of the 2017 Hilary Weston Writers' Trust Prize for NonfictionDo no harm is our most important rule, but we break it all the time trying to do good. In this deeply...
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  • *Canada Reads 2019 Longlist
    *Winner of the 2017 Hilary Weston Writers' Trust Prize for Nonfiction
    Do no harm is our most important rule, but we break it all the time trying to do good.


    In this deeply personal book, winner of the 2017 Hilary Weston Writers' Trust Prize for Nonfiction, humanitarian doctor and activist James Maskalyk reflects upon his extensive experience in emergency medicine. Splitting his time between a trauma centre in Toronto's inner city and the largest teaching hospital in Addis Ababa, he discovers that though the cultures, resources and medical challenges of the hospitals may differ, they are linked indelibly by the ground floor: the location of their emergency rooms. Here, on the ground floor, is where Maskalyk confronts his fears and doubts about medicine, and witnesses our mourning and laughter, tragedies and hopes, the frailty of being and the resilience of the human spirit.
    Yet, he is swept most intimately into this story of "human aliveness" not as a physician, but as a grandson carrying for his grandfather, now in his nineties.
    Masterfully written and artfully structured, Life on the Ground Floor is more than just an emergency doctor's memoir—it's a meditation on health and sickness, on when to hang on tight, and when to let go.

Excerpts-

  • From the cover G is for ground.

    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 never-ending 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 poison-gas 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. Others step over him, as if he was downtown city furniture.
    Within a few blocks of my ER, there are a dozen shel­ters for abused women and the homeless. There are health clinics for indigenous people, gay men and women, refu­gees, detox centres, beds for kids who've run away from home. On my way to work I pass them, pierced, dyed, smoking. Sometimes I'll see them in the ER, shyly pulling away a bandage from the cuts they made on their arms.
    Seaton House, a men's shelter just up the street, holds more than...

About the Author-

  • Dr. James Maskalyk, bestselling author of the critically acclaimed Six Months in Sudan, is an emergency-room physician, award-winning teacher and member of Médecins Sans Frontières. He teaches meditation with the Consciousness Explorers Club and currently divides his time between Toronto and Addis Ababa.

Title Information+

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    Doubleday Canada
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    All copies of this title, including those transferred to portable devices and other media, must be deleted/destroyed at the end of the lending period.

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James Maskalyk
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