Hey there. A few months ago I read a book called The Emergency by Thomas Fisher. He's an ER doc

and this is his chronicle of the COVID pandemics first year. And among other things it is full of

piercing descriptions of what he and others call moral injury. That's when there's deep conflict

between what you feel you should do and what your job tells you you have to do. Even when that's

something as simple as helping a patient get a pillow or allow them a visitor or not. He writes that

when he failed to help patients this way, he would avoid their rooms out of shame. Here he is

narrating the audiobook. I close the door and try to forget. No matter what I said, they

interpreted my inability to deliver as mistreatment. And while my avoidance protected me from feeling

like a failure, it added to their perception of institutional neglect. They're right. They're

anger and sadness are justified. And their assessment of my role is accurate. I am a perpetrator

of the system's mistreatment. And I am also a casualty, trying to do the best I can with what I have.

This phenomenon, moral injury, lots of healthcare workers describe it, but not in this kind of

detail. He describes a shift where he's got three minutes with each patient which fulfills

a mandate that patients get seen by a doctor as soon as possible, even if those three minutes

aren't enough to actually help them. Often, they're just a prelude to a long wait for actual treatment.

He describes waking up the morning after a shift, haunted.

Now I remember the time I couldn't remove a bullet or relieve cancer pain, but my patients implored

me to. I knew they required more, but I did only what I could. Was it enough?

I quit asking to suffer and wound something deep inside me. I know it. I just don't know what I can do

about it. I read the emergency this spring and I was like, I want to meet this guy. And he's right

here in Chicago where I live, writing about places I know. I meet up with Thomas Fisher at a noisy

intersection in the middle of the University of Chicago Medical Center's complex where he practices

...