A License to Heal: Random Memories of an ER Doctor, by Dr. Steven Bentley, is a very interesting read for anyone interested in a career not just in medicine, but also in my favorite field: Emergency Medicine (EM). The author started his career as a board certified physician in EM in the late 1970’s in North Carolina. His “random memories” are just that...they are his reflections of the past laid out in a somewhat linear order from medical school, his internship, residency, and throughout his career as a doctor. Dr. Bentley went into medicine to “escape the poverty that I had known as a child” and to be one of the “good guys” in white coats. Bentley suffered from chronic bronchitis and sinus infections as a child because of a genetic condition known as Kartagener’s Syndrome. All his internal organs in his body are in reverse of a “normal” body. Which literally means that you would listen to the heart on the right side of his body. This condition occurs in 1 our of 32,000 live births, and is something most people only read about in textbooks. Thus throughout his life, Dr. Bentley had multiple opportunities to be helped by the “good guy” doctors.
He “deliberately” adds very little personal experiences, saying how privileged he felt to be an ER doctor, but decades later began wondering if he should have even chosen that career path. He wondered if he was suffering from “burn out” or if he “had missed all the signs and symptoms of severe depression” that he had missed in his brother who committed suicide. I believe his personal experiences would have made this good book into a great one.
Bentley's interpretation on the Veteran’s Administration’s job of providing medical care for our military and his understanding of malpractice insurance and law suits should be required reading for anyone serving in governmental healthcare. These chapters where he opens up about his experiences in the VA are the most valuable and thought provoking in his book. This was especially useful considering that I will be working at a VA hospital in the very near future during a 3rd year clerkship.
Dr. Bentley tells his most memorable patient stories and weaves some interesting quotes that make me, as a medical student take note. For example, he states “the residents were not really callous, they had just seen so much stuff. In two months, I was acting much the same way.” I have seen a few callous residents in my short time in the hospital, but I totally can understand how frustrating it would be to have to weed out those many patients that are just seeking narcotics.
He also opines that EM is a great field for those who have “little patience” to hear their patient’s life history when they only want to hear their medical history. “See them and street them” is the motto for the Emergency Department in his opinion. This is really good information for any medical student wondering if EM could be in their future.
Dr. Bentley decided to retire partly because medicine had become a business and patients were now “customers.” Health care has been taken over by huge corporations. Additionally, security was a “huge and growing problem.” He personally saw gun battles, hostages, and stabbings. Have to be willing to see and deal with anything in the ED!
In spite of coming across as a bit of a curmudgeon, Dr. Bentley manages to convey his pride in working in an emergency department long enough to see many, if not most of the ailments that can affect the human population. His “keystone cop” story, probably my favorite bit, shows his love of humanity. And his summary of what he learned in the ER that “with touch, understanding, and compassion, we all have the capacity to make this journey of life so much better for each other” shows he really is a good guy in a white coat. A License to Heal: Random Memories of an ER Doctor is worth a read, especially if EM could be your calling.