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A Thousand Naked Strangers

2017; Elsevier BV; Volume: 69; Issue: 2 Linguagem: Inglês

10.1016/j.annemergmed.2016.09.040

1097-6760

Nikita Joshi, Melody Glenn, Tanner Gronowski, Audrey Sanford,

The emergency department (ED) is an amalgamation of persons from all walks of life who range from the patients, physicians, nurses, social workers, janitors, and medics who are constantly in and out of the department. All of these persons bring their quirks, personalities, and reasons for being in the ED that are as varied as the scents that permeate throughout. As unique as the ED can be, out-of-hospital experiences are a whole different level of fascinating and bizarre. Kevin Hazzard's A Thousand Naked Strangers breaks down the basic components and emotions of out-of-hospital medicine. He then chews them up and vividly spits them back out in a creative nonfiction smorgasbord of stories illuminated with bodily fluids, sounds, and smells. Fear, happiness, excitement, despair, and hope all make appearances, and the reader finds it hard to stop, with each successive story surpassing the excitement of the previous one. Poignant throughout, the patient encounters on the rough streets of Atlanta are Hazzard's evolution into a hardened and experienced paramedic. Hazzard breaks up his memoir into books that serve as turning points in his career as he goes through his rise and fall as a paramedic. Book 1 is about the author's own accidental entry into the field of emergency medical services (EMS) after a combination of random events that culminate with enrollment in a community college emergency medical technician course. He introduces us to the “ecosystem” that is Grady Memorial Hospital and its affiliated EMS system. In book 2, Hazzard transforms from fresh meat to passionate confidant to the reader. He recounts incredible tales that only those familiar with the emergency system can begin to fathom, contrasting fear with humor and the somewhat dark desire to happen on sickness and trauma with each EMS call. Hubris rings large in book 3 as Hazzard grows both in his medical and street knowledge, which at times leads him slightly astray. Tones of friendship and teamwork ooze throughout these chapters. Ultimately, summits are followed by descent, and the loss of his partner and friend leads Hazzard in a free fall that is captured in book 4. He begins to experience burnout and questions his motivation to continue his work as a paramedic. Overall, Hazzard provides a witty, full-frontal account of the wild side of out-of-hospital emergency medicine. His tongue-in-cheek patient stories bring to life various aspects of humanity while paralleling the growth and metamorphosis of a medic. However, these stories do not hold back and often provide raw reflections about patients that would shock and perhaps offend the nonmedical reader. As emergency physicians, we can relate; these clinical vignettes stick in our psyche and shape who we become as professionals, and can often spill into our personal lives. Similarly, the way we reflect on our clinical experiences and the words we choose to describe what we go through are much rougher when shared with colleagues who are also indoctrinated in the ED. Hazzard also somehow manages to bring comedy and levity to the complex themes of provider burnout, relationships, spirituality, bearing witness to death, provider safety, workplace politics, hubris, urban poverty, and the search for meaning. As fellow emergency providers, we realize that our individual experiences with these heavy themes are perhaps not unique; burnout may also loom on the horizon for us. We should learn from the telling of these narratives and apply the lessons learned in healthy ways that can prevent burnout and the dehumanization of our patients.