The evening's book was Life on the Ground Floor: Letters from the Edge of Emergency Medicine by James Maskalyk. The 'presenter' led off a well-organized and articulate introduction, with background on Maskalyk, a summary of his previous book Six Months in Sudan, some excerpts from book reviews, and an audio clip of an interview with Maskalyk on CBC's The Current. Then the floor was opened to general discussion.
Masalyk divides his time between the emergency department of St. Mike's an inner-city hospital in Toronto and a program at Addis Ababa University to train emergency physicians in Ethiopia. The book interweaves vignettes from these two settings, interspersed with sketches of visits to his grandfather in Northern Alberta. The structure of the book follows the letters of the alphabet, with musings on a topic for each letter: A was for airways, B for Breathing, C is for Circulation, and so on. This might sound plodding, but Maskalyk writes with such verve and the ability to put you right in the situation he's describing that the artificiality of the structure soon melts away. Medical information is brought to life with anecdotes about the patients he's taken care of and some of his descriptions wander into the poetic.
The contrast between the conditions in Toronto and Addis Ababa is incisive and thought-provoking. Medicine in Toronto is dispensed without any concern about potential costs, whereas in Ethiopia everything is in short supply from the blood that must be rationed among patients who all need it and the payments that are 'pulled creased and tattered from some worried mother's pocket'. Equally clear are the similarities. Whether in Toronto or Addis Ababa, Maskalyk loves the the clarity of the ER - the sickest, most urgent first and the rest must wait. Emotions and biases must not distort those choices. Decisions must be completely independent of whether the patient is rich or poor, white or black, male or female.
For some in the book club, the sections where Maskalyk visits his grandfather showed the most humanity; they just didn't resonate as well with me and the opening section with his grandfather might have discouraged me from continuing if it hadn't been a book club selection. Once I got past that, I really loved the book and whizzed right along reading it. I definitely recommend this memoir.
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