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Life on the Ground Floor: Letters from the Edge of Emergency Medicine
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Life on the Ground Floor: Letters from the Edge of Emergency Medicine

4.02  ·  Rating details ·  309 Ratings  ·  45 Reviews
A celebrated humanitarian doctor's unique perspective on sickness, health and what it is to be alive. In this deeply personal book, humanitarian doctor and activist James Maskalyk, author of the highly acclaimed Six Months in Sudan, draws upon his experience treating patients in the world's emergency rooms. From Toronto to Addis Ababa, Cambodia to Bolivia, he discovers tha ...more
Hardcover, 272 pages
Published April 11th 2017 by Doubleday Canada
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Jan 06, 2018 rated it really liked it
Shelves: 2018, can-con, nonfiction
I sit behind the nursing station, stomach rumbling, humbled, watching white coats flash behind curtains. It's tough to say I'm proud of these people, as I have had nothing to do with making them. Still, daily, I feel something akin to that when I watch these doctors navigate a floor full of sick and worried people. Maybe it's awe. Maybe that's what pride was supposed to be in the first place: the awe one feels at participating in something beautiful.

Like author James Maskalyk does currently, m
Aug 28, 2017 rated it it was amazing
I knew I had to read this book when I heard Dr Maskalyk interviewed on CBC about this memoir. His passion balanced with skill and commitment came through then and throughout the book. The fact that he practices emergency medicine at St Michaels Hospital for part of his life drew me as well because I am a long ago graduate of that hospital's School of Nursing. The values I was trained in are evident in his medical practice whether in Toronto or Ethiopia or when he is assisting his aging and belov ...more
Adrian Sergiusz
Feb 01, 2018 rated it really liked it
Very humane, full of life and compassion. A well written first hand account of being a physician in the extremes, whether it is in Ethiopia or in a hospital in Toronto. Both worlds are continuously compared and contrasted through first person interactions, showing how the life of being a good doctor living on the extreme can be both immensely rewarding but taxing through all the different types of relationships formed. Sometimes it's hard to keep track of what's happening, the author does jump f ...more
Jun 21, 2018 rated it really liked it
This is a really inspiring book. The author describes life in the ER in two hugely disparate cities: Toronto and Addis Ababa. The miracles the medical teams perform in Addis are stunning, but he pulls no punches: the work is hugely impeded by the lack of even the most basic resources. At the same time, even with all the wonders of western medicine at hand, sometimes the miracles are elusive in Toronto as well.
My favourite chapters, however, are the ones with his beloved grandfather at his wilde
Nov 11, 2017 marked it as did-not-finish
Fascinating glimpses into the world of emergency medicine and some heartwarming moments with his grandfather, but the writing style just gets really confusing. I guess it makes sense given the frenetic pace and all the activity in his work, but he jumps from one topic to another and then another so quickly it feels like a flurry of glimpses of all the various pieces in his life (Toronto ER work, Addis Abba hospital and time with grandfather).

Possibly my brain is just tired or it's not quite the
Sam Newhook
Feb 04, 2018 rated it it was amazing  ·  review of another edition
Great book, heartwarming.

I debored this book in a single sitting and am excited to recommend it to everyone I know. Having worked at St Michael's hospital I have seen and met many people like the author and it is always inspiring to learn their stories. The book is fast paced, funny, heart wrenching and all together a worthwhile read.
Jan 28, 2018 rated it it was amazing
Recommended to Pankaj by: Matt Galloway on CBC
Wow! James has eloquently captured the frenetic activity that could result in life-death decisions, the frustration at not having resources at hand to save lives and the drive to push ahead and not allow anything adverse to impair a doctor's judgment. Brilliantly written.
Jan 20, 2018 rated it it was amazing
This book was not what it seems. Not only is it stories from the ER at St. Mike's in TO but it is also stories from ER in Ethiopia and a very poignant telling of his time with his ailing grandfather. For a physician Jim Maskalyk is a very good writer, heck not even for a physician. His writing, at time, almost reads like poetry. Thoroughly enjoyable reading. Hopefully this is a trend for 2018.
Jan Angus
Dec 06, 2017 rated it really liked it
Engrossing examination of the life of ER professionals by a physician who practices both in Toronto and Ethiopia. Extraordinarily candid and beautifully written, the book is arranged in alphabetical chapters (A is for airway, B is for breathing, C is for circulation . . . Z is for ze end). Maskalyk shifts back and forth between his experiences in a downtown Toronto ER department, his work in Ethiopia, and his visits to his ageing grandfather's remote home in rural Alberta. He manages to convey t ...more
Nancy Croth
May 17, 2017 rated it really liked it
In his latest book, James Maskalyk has provided a fascinating and discouraging account of life in emergency rooms in Toronto and Ethiopia. Mingled throughout are peeks at his relationship with his hunter/trapper grandfather who is in deteriorating health himself since the death of James's Grandmother.
He begins with the basics... the ABC's of medicine and moves throughout the alphabet of ER necessities. A for Airway, B for Breathing, C for Circulation.... if can't get those back in working order,
Mateo Farfan
Oct 02, 2017 rated it it was amazing
Excellently written memoir of a physician who toes the line between caretaker, educator, and a struggling being. Maskalyk's sharp, and subtle, yet direct prose has a way illuminating some of the bleakest moments anyone in the care professions can experience. Whether your work takes you through the work of a frantic, urban ER, or some other locale, the author's candor and humility, are sure to illuminate and shed light on the reader's own experiences.
Robert LeBlanc
Jun 24, 2017 rated it it was amazing
This book has heavily influenced the way I look at life and suffering
Amanda Munday
Mar 07, 2018 rated it really liked it
Shelves: memoir
A- A fascinating read about hospital life in Toronto
B - Breathtaking details about crisis management and especially trauma.
C - Could have used a bit more information about birthing. Aren't labour and delivery some of the most common reasons to be in hospital? Did this doctor never experience birthing emergencies (they all went up to the 15th floor?)
D - Direct experience with this hospital kept me reading through the night.
E - emergency medicine is its own field and I can't believe this author f
Ben Truong
Mar 26, 2018 rated it really liked it
Recommended to Ben by: RBC Taylor Prize
Before reading one word, I was pleasantly surprised by this medical memoir. At first I thought this memoir would be told in letters written – like an epistolary novel, but not a novel, because it's using real letters. I thought it would be a travelogue of sorts. However, I was quite surprised when I looked at the Table of Contents to see each chapter using a letter in the alphabet for the title. It was then I realized how cheeky Dr James Maskalyk might be.

Maskalyk who practices at St. Michael's
Pat Mills
This review has been hidden because it contains spoilers. To view it, click here.
Julie Callaghan
Mar 03, 2018 rated it really liked it
A raw, honest memoir, Dr. James Maskalyk takes you into his life as an emergency room doctor in Toronto and Ethiopia, and offers insight into the vague answers the doctors give when the news is really bad. He describes the conflicting priorities, the frustrations, the toll that his work takes on body and mind, the terrible choices thrust upon him, the mistakes he can never forget, and the outcomes of his efforts - from his particular, unique vantage point. He mixes in his personal life, his retu ...more
Lois Ann
Jan 01, 2018 rated it liked it
Several years ago I read Maskalyk' s book on Sudan as it was a country I have always been fascinated by and I found his treatment of that subject riveting.

This book, while interesting, was less so than the first. Perhaps because I was expecting more about life in Addis-- more stories about front line medicine in a developing country.

This book felt like reading a script for ER, House or Grey's; particularly the portions in Toronto.

I wasn't looking for a memoir so much as an introduction to a n
May 15, 2017 rated it liked it
The book is by turns uplifting, poignant, and discouraging, both in his family's life with his aging grandfather and reflections on his own history and life, as well as his working with dedicated people to establish Emergency Medicine as a specialty within Ethiopia, to improve the care of the population. We have little idea of how the public and private systems(or virtually non-systems) work in such countries. The success that starts to come with time, effort, and his commitment and that of the ...more
Mar 19, 2018 rated it really liked it
Shelves: memoir, non-fiction
He’s an excellent writer and has something to write about.

The chapters are organized by the alphabet —“a is for airway”, etc. That’s a simple framework that works quite well as a lattice for what he has to say.

Within that, his story slips easily from being an ER doctor in downtown Toronto, to teaching the first class of ER doctors in Addis Ababa, to describing various medical conditions, to tales of his grandfather in remote northern Alberta, to thoughts on how to live as a human being — a wide
Aug 18, 2017 rated it it was amazing
Really good. Well-written, beautiful & touching prose. I'm amazed by the scope of this. It's helpful to know some bio about human systems but not necessary at all--you'll probably just get more out of certain passages. Also makes excellent explorations of the importance and reality of self-care/burnout and principles of effective global development work (grassroots, etc). Impressive in making what I've studied theoretically very accessible. We move seamlessly between emergency medicine in To ...more
Maskalyk's second book seems as though it is mis-labelled and falsely advertised; the stories in the book bear little resemblance to the cover or summary. this is not a book about humanitarianism, it is wandering in tone, often with a more stream-of-consciousness style. This book would be better planned and pitched as a book about life in an ER, and it would have been much more interesting if the author had explored this topic more than he did (as the book stands, this is half explored).
Janet Coates
Aug 08, 2018 rated it it was amazing  ·  review of another edition
This was an incredibly moving book, filled with compassion and insight, all beautifully articulated. I learned much, glimpsed moments of pure kindness and shining love as well as those of sad futility. I recommend this book to anyone wanting/needing to be inspired by love - and to anyone in need of a forceful reminder that life's struggles and challenges take many forms and encompass many levels.
Feb 13, 2018 rated it liked it
A snapshot into the world of two emergency rooms; one in Canada and one in Ethiopia. What makes this book different from other ones I have read is how Maskalyk weaves the stories together, shares how his thinking changes over the years and adds the personal story of his own family. There is an underlying sense of a personal journey and struggle that he never names but it is hard not to feel as a reader.
Mar 09, 2018 rated it liked it
Three stories combined in one novel. Maskalyk switches between his job in the Emergency department in a major Toronto hospital, to his volunteer position teaching and working in a fledging emergency room in Ethiopia, contrasting the differences between the two. At the same time he weaves in the story of his grandfather in his old age.
Jun 22, 2018 rated it liked it
The first half of this book was better than the latter half. I enjoyed the parts about ER medicine but I struggled to understand how the relationship between James and his grandfather fit into the story.
Oct 07, 2017 rated it really liked it
Amazingly written. Going through an alphabetical order of what happens and what's important in life and in the hospital. Shows the differences between healthcare here and in developing countries. And where Medicine also falls short.
Mary Ann
Nov 28, 2017 rated it really liked it
Treating patients in emergency rooms in Toronto and (supply starved) Addis Ababa, Ethiopia. Amazing facts on how the body operates and tries to compensate for lost functions due to trauma. Recommended read.
Trudy Jaskela
Dec 03, 2017 rated it liked it
Interesting. I heard him at Vancouver Writers Fest 2017. I much preferred to listen to him describe his experiences in Addis Abba and Toronto and to compare the two than read his book. I found the book jumped around too much for me.
Apr 23, 2018 rated it it was ok  ·  review of another edition
Non è un saggio ma non è nemmeno un romanzo. Non è un romanzo ma non ha la completezza di un saggio. Vorrebbe essere ma non è. Ciao.
Nov 02, 2017 rated it really liked it
I think all emergency room doctors should write a book. They have a lot to teach. This was a more reflective narrative memoir than others I've read, but very engaging.
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James is a physician and author, both of the international bestseller “Six Months in Sudan” and more recently, “Life on the Ground Floor“. He practices emergency medicine and trauma at St. Michael’s, Toronto’s inner-city hospital and is an award winning teacher at the University of Toronto.

He directs a program that works with Ethiopian partners at Addis Ababa University to train East Africa’s firs
More about James Maskalyk

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