The Medicine of ER or, How we Almost Die, Harlan Gibbs, M.D. and Alan Duncan Ross

Basic Books, 1996, 232 pages, C$25.50 hc, ISBN 0-465-04473-5

One crucial test of the effectiveness of this new breed of media-derivate “The Science of Popular TV Show” books is to evaluate its impact on a non-viewer of said show. If Lawrence Krauss can teach science to non-fans with “The Physics of Star Trek”, then he must be doing something right. As a complete non-viewer of “ER”, that allowed me to judge the medical vulgarization of The Medicine of ER on its own value.

The book does get in a bit thickly into the show’s lingo and characters at times (for instance, it re-evaluates at least three episodes from a real-world perspective, giving good, bad and mixed marks to the show’s writing staff.) but seldom becomes confusing. At least the authors of the book know when to give leeway to dramatic needs, as they often note that real-world practices would remove a lot of tension from the show.

Overall, though, they give good grades to E.R.’s medical accuracy. Viewers tuning in each week can be assured that most of what they see can happen in the real world. Exceptions are made for dramatic needs (allowing relatives in treatment rooms, over-incidence of thoracotomies) or from the show’s original genesis in the seventies (when producer Michael Crichton wrote the pilot episode). As the writers wryly note at the end of chapter Nine (a thorough debunking of the shocker episode “Love’s Labour Lost”), bad medicine might not be good for your professional credibility, but it can get you an Emmy.

But, obviously, the book isn’t an episode guide, and its true value resides in the “Medicine for dummies” (or “medicine for couch potatoes”) details. Successive chapters look at the organisation of an hospital, heart diseases, trauma, illness, drugs…

Even though the book is written by one bona-fide M.D. and an ex-medical center administrator, the book is unusually readable, even laugh-aloud funny at times. Chapters title reflect the overall unpretentious sense of fun: “Lightning can strike twice”, “Things not normally found in your body” (including the requisite risqué anecdotes), etc… The writing is brisk, and -we hope- technically exact. The briskness extends to the relative shortness of the book (barely 230 pages in large type), so hunt for this in used bookstores rather than pay full price.

For a Canadian already used to the idea of a government-subsidized health care system, the strangest chapter of the book is “Fast as McDonald at Tiffany Prices”, an examination of hospital costs complete with several itemized costs breakdown of typical E.R. interventions. Had a traffic accident? That’ll be 6,500$, buddy. The chapter veers dangerously close to blatant editorial, but remains one of the strongest piece of the book.

Well, almost as strong as the epilogue, which reminds readers that during one prime-time hour of television, there are on average 10,000 admissions to real Emergency Rooms across the country.

In any case, The Medicine of E.R. accomplishes both of its goals with a certain amount of distinction: It examines the TV show and uncompromisingly find the flaws in its depiction of medicine, and uses the show as a springboard to give out a good overview of the current Emergency Medicine system as practised in the mid-nineties in the United States. Good show.