Amazon.com Review
In this outstanding collection of stories and "lessons," Pamela Grim, an emergency medicine physician, reveals the painful truths learned from the daily witnessing of the underside of life, where most who enter are addicts, idiots, drunks, and psychotics whose poor choices have led them to the end of the line. The ER is a more tragic, chaotic, and weird place than any TV show has ever portrayed. A man walks in with a butcher knife imbedded in his skull, a teenage girl asks incredulously, "I'm pregnant?" after delivery, and the best kind of cop dies on the table while his killer is saved in the next room. Grim brilliantly captures the adrenaline-fueled chaos of code calls in inner-city ERs, where the unrelenting pressure puts doctors and nurses alike in a perpetual state of shell shock. In this environment, doctors must make split-second decisions under the specter of malpractice suits and the knowledge that every moment weighs in on whether the patient will live or die. Fortunately, Grim is the sort of storyteller who can make a reader cry then laugh out loud in a matter of pages. She is a no-nonsense doctor--and author--whose compassion and wisdom are as unexpected and brightly illuminated as the resurrection of the 4-year-old with no pulse who was crushed by the family car.

Between the pressure and the bruises left by each death, burnout is inevitable. Grim's response is to head for Nigeria with Doctors Without Borders, and later to Bosnia and a Kosovar refugee camp, where once again she is "awestruck by the suffering God can inflict." The dearth of technology and supplies and the low survival rates make a shocking contrast to the miracles achieved in American hospitals. Grim considers some profound issues--the nature of grief, the humanitarian aid paradox in which helping out can indirectly enable corrupt governments, and the despair of trying to save lives when so many are dying. Ultimately, she realizes that the answer is in the particular; it is saving individual lives that makes her work--and life itself--meaningful. This is one powerful page-turner with the potential to change minds as well as lives. --Lesley Reed