More Letters From The Pit: Stories of a Physician’S Odyssey in Emergency Medicine

by Patrick J. Crocker

In More Letters From The Pit, a sequel to the popular Letters From The Pit, I share how, over the course of my career, I considered the roles that fate, destiny, and karma seem to play in our lives. Medical care is an imperfect science and it's delivery complicated. Why some patients we think will easily recover from an injury or illness die, and those we believe are already beyond our help somehow rally and recover is mystifying. Just what, if anything, controls these events? Are they preordained or are there true miracles.

The book is again structured in first-person, stream -of-consciousness narrative of my life as a doctor. What I saw and what I was thinking in real time as I treated patients. In addition this collection of fascinating and exciting cases, I explore some of the darker corners of life in the emergency Room. How we deal with those patients we can't help and the angst and feelings of personal loss that accompany those cases. Events so horrific and heart-rending they can never be forgotten. And of course the joy of triumph caring for those we pull from the jaws of death. The style of presentation will leave you with the feeling that you were there with me, looking over my shoulder, as I worked.

So find a comfortable spot, turn on your reading lamp, take a deep breath, and follow me into "the pit."
Review 5-star review!
Reviewed By Romuald Dzemo for Readers' Favorite
More Letters from the Stories of A Physician's Odyssey in Emergency Medicine by Dr. Patrick J. Crocker is a memoir that lifts the veil to show readers and non-medical professionals what the emergency room and experience as a doctor feels and looks like. Structured as letters to the author's college friend, Jack, it explores the author's experience in Emergency Medicine dealing with all kinds of patients facing life-or-death situations. Here the author shares in language that is crisp and emotions that are raw the thoughts harbored while working on patients, the frustrations, hopes and despair, and a lot more. The reader quickly understands that the experience of Emergency Medicine is fraught with unpredictable outcomes -- a patient with a mild injury can easily give up while someone who is thought to be already on the brink of death can pull through. The frenzy of activities, the emotional intensity of the experience, and relationships between patients and doctors as well as family are examined. In these letters, the author explores themes of fate, destiny, faith and miracles, healing and death, and in a way that resonates with readers.

Dr. Patrick J. Crocker might be trained as a doctor, but he is a terrific writer who brings his personal experience with human suffering alive, providing insights that are thought-provoking and sharing with readers how each unique experience spoke to his humanity in the course of his career. The descriptions of healing processes are clear and fascinating. The writing is bold and engaging and the author's ability to recreate the scenes from the cases he has handled with clarity and detail is captivating. It is poignant; it is so real that readers will feel as though they stood alongside the doctor and the frontline professionals of emergency medicine as they worked through each case. Each story is unique, each case unique, but there is a unifying factor that comes across the writing so brilliantly -- humanity. More Letters from the Pit is a book like no other, written in a mesmerizing voice and with compassion. You'll be informed, entertained, instructed, and inspired. You'll also experience the pathos as you read.

Genres: Medical, Nonfiction, Medicine, Science

294 pages, Kindle Edition

First published January 1, 2020

Reviews

[Dr. Bose · Rating 5 out of 5]

Dr. Crocker brings valuable insight starting from his early days during the birth of emergency medicine as a specialty. When he hired me at the Level I Brackenridge Academic Trauma Center in Austin, Texas he was a mentor to myself and many others. In addition to his keen medical acumen, this book adds an additional layer with a plethora of human stories weaved within the medical complexities. This is a must-read for anyone who wants a further understanding of the human condition. Even non-medical readers will enjoy, and I suspect if enough of them discover this book, it will instantly become a best-seller.

Sudip Bose, MD, FACEP, FAAEM
DocBose.com

[Barbara Godin · Rating 5 out of 5]

Loved it!!!

This was an excellent book filled with lots of knowledge, compassion, and strength! Couldn't put it down. Highly recommend this book!!

[Richard · Rating 4 out of 5]

Just as good as the first of the two books, but a little more of the unpleasant side of life in the ED or EMS. Also more of a thought-provoking book than the first one, with more questions about why we do the things we do and why things are the way they are - these questions have no easy answers.

So why only four stars? I've very sensitive to editing issues, and there are a few in this book. That's my pet-peeve; if it's not yours, consider this a five-star rating.

I highly recommend this book for anyone in emergency medicine, whether in the ED or pre-hospital setting. Also for anyone else in the medical field.

[Mary Wall · Rating 5 out of 5]

As a retired emergency physician of 29 years starting in 1974 in the dark ages before emergency medicine was a specialty, and we, the grandfathers of the EM, had the hospital status slightly higher than the janitors, I found MORE LETTERS..., a wonderful read not only from the emotional aspect of what it was like to be at the head of the patient's table where everyone turned to you to perform the miracle of saving lives from the brink of death, but, also, impressed by learning of so many advances in emergency medicine in the process. Amazing! At least, we had x-rays, lab, and a defibrillator that looked like a washing machine with paddles that could cause blunt trauma if swung around. Possibly, there could be more black humor to lighten the load as in my writing, ADVENTURES IN MEDICINE AND REDEMPTION IN HOSPICE, which, touches on my 15 year experience as a hospice physician. The comments at the end of the book about the end of life certainly rang with me. richardwallmd.com/storyteller is my web-site for anyone who wants to sample my work

[Deborah · Rating 5 out of 5]

Excellent.

[Patrick Crocker · Rating 5 out of 5]

This is the sequel to Letters from the Pit, which readers found very engaging. Take a look at these reviews and if you liked the first book, you will love this one. The same intriguing true ER stories but some deeper content.

Dr. Pat Crocker captures the stories of our lives as emergency physicians. At times tragic, at times humorous, More Letters from the Pit conveys a profound understanding of the gratitude we owe our patients and a sense of wonder at the mysteries of chance and providence that bring us together in the crucible that is the modern emergency department. Knox H. Todd, MD, MPH, Former Professor and Founding Chair, The University of Texas MD Anderson Cancer Center

More Letters from the Pit takes readers on a thrill ride they won’t soon forget. Crocker’s unflinching stories from his distinguished 37-year ER career take the reader behind-the-scenes on a journey through our flawed health care system. Crocker’s insights, ingenious sleuthing and determination to do right by his patients inspire. His stories range from delightful to wrenching. Some are haunting. Always, they are fascinating. Buckle your seatbelt. MA Roser, Founder and Chief of Roser Prose.

Patrick Crocker, DO, pulls you into his ER and makes you feel and understand what doctors in the ER go through. Throughout this adrenaline and emotion soaked book Dr. Crocker forces you to think and see the big issues of individuals experiencing a medical emergency and interfacing with an emergency department. From babies in dumpsters to man down at the 10k, this book is the bleeding edge on social issues encountered by health care providers. Tyler Cymet, DO, FACP, FACOFP, Chief of Clinical Education, American Association of Colleges of Osteopathic Medicine

Dr. Crocker's second edition of stories from the ER explores some of the darker corners of emergency medicine practice. Being there to save a life also means being there when you are powerless to do so. Those lifeless faces flash upon the inward eye long after their last breath. They are the things that can't be unseen. Truman J. Milling Jr, MD, Associate Professor, Dell Medical School at the University of Texas Austin

[kinperr5 · Rating 5 out of 5]

Stories from the ER can be so powerful and worthwhile when told well, and Crocker does an excellent job sharing his. ER doctors and nurses live in what can feel like an alternate universe — they witness emergencies that unfold across physical, mental, and emotional planes and resolve in a spectrum of ways (due not only to staff ability, but often to fate); they actively maintain a wealth of subject and skill knowledge that suits the vast variety of experiences they encounter; and their ability to figure through patient histories (sometimes just by asking the right question/s) can make a life or death difference. If I didn’t know most of these realities at the start of “More Letters,” I do now; Crocker conveys them all, flawlessly. I appreciate many of the broader life lessons this book taught, too, especially (1) “first, do no harm,” and (2) the value and ripple effect that remaining calm in a stressful situation can have. I skipped Crocker’s first “Pit” book to pick this one up, and I am so glad to have found it. Even as someone who works outside the field, I found it accessible, captivating, and educational.

[Marcia Lora · Rating 5 out of 5]

Superbly written firsthand medical stories

Phenomenal book. One of the best I’ve read. As an ER nurse, I find his stories spot on and insightful. Clear and concise. He writes pointedly and doesn’t waste time mulling over the what if’s but rather simply tells the accounts as they are leaving the reader time and space to digest and decipher the experience for themselves. Also, exceptional diagnostics are seen in this book. Few physicians and even fewer books posses such accounts of such accurate diagnosing and working through possible diagnosis including “zebras.” Highly highly highly recommend. In my top 5 all time best books ever read and that’s saying a lot as I read every night and have lost count of the number of medical books I’ve read. Hats off to this physician! We need more like him. And I’m seriously hoping he takes the time to write another book!! The world in general would generously benefit from such investment of his time!!

[Jack Coakley · Rating 5 out of 5]

I confess that as the friend Jack to whom these letters were written, I am somewhat biased here, but I find my friend Pat's second book of stories about his exploits in the ER to be just as moving as his first. Indeed, I appreciate the darker moments, introspection, and self-doubt that play a more prevalent role in this book. I'm sure all doctors share the horror of the best informed decisions and actions that do not work out, and Pat's stories detail the situations and thought-processes in a very human way. Each story's prologue-like ending is also a treat for the reader. The stories are short and poignant, delivering very satisfying food for thought. Enjoy this book. It's a terrific study of Pat's growth as a physician. Pat's writing is just like listening to him talk. Very genuine. Very heartfelt. Such an interesting journey. Thank you, Pat, for sharing it with me and the world!

[Lori Talbot Forsyth · Rating 5 out of 5]

After reading Dr. Crocker’s first book, “Letters from the Pit”, we eagerly anticipated this second ED installment. He continues in the stream of consciousness style as though is writing to a college friend, “Jack.” In each chapter, he brings to life the joys, stressors, and heartbreaks that occur in the life of an ED physician. He dwells on his decision-making algorithms as he faces each patient encounter.
This book presents a unique side of this extraordinary physician whom we worked with for many years, as an administrative assistant and registered nurse, respectively. This book provides a window into his thought processes as well as his emotional reactions to difficult situations.
Whether or not you are a medical professional, a patient, or a family member of someone who has needed emergency medical care, you will find this book to be a captivating read!

[Dan Stern · Rating 5 out of 5]

Dr. Pat Crocker was the long-time director of the Brack trauma center in Austin and opened up the Dell Children’s ER as its director. Dr. Crocker’s first book, “Letters from the Pit: Stories of a Physician's Odyssey in Emergency Medicine” is most assuredly not a print version of the TV show ER. It is a collection of his takes as a very, very wise man on what I call lifeitsownself. The chapters are wrapped around some of Pat’s experiences as a nationally respected ER doc. They are parables of life, from which all we call can learn. A lot. Dr. Crocker is retired now to ranch near Bandera, and has just published a second collection of his stories, “More Letters from the Pit” After reading the book many of you will immediately send them as gifts. Both books are great reads. Fast reads. And absolutely mesmerizing.
4 people found this helpful

[DS · Rating 5 out of 5]

Those who read the first volume, "Letters from the Pit" will recall that Dr. Patrick Crocker presented a series of well-told ER vignettes that were both elucidating and entertaining. This second book is more introspective, as befits a later stage in his career as a prominent ER doctor and director, and therefore compelling in a different way. The thought processes and emotions that lie behind both dramatic saves and tragic losses are clearly laid out, and the reader is given a deeper look into both the intelligence and compassion that are needed to create an outstanding physician.
Highly recommended!

[Jonathan D · Rating 5 out of 5]

Like Pat's first book, this one is a great read too! It strikes a great balance of the details of emergency medicine practice, the reality these doctors face and the psychological impacts on them, as well as the larger life lessons Pat learned through his career. Definitely recommend reading this one, as well as his first book Letters from the Pit. I also love that the chapters are short but meaningful-it's super easy to pick up the book and read 3-4 chapters at a time, even during a short break.

[Fallon · Rating 5 out of 5]

A peak at ER practice

We have all seen the glamorous portrayals of doctors on TV. This book is about the messy, gritty side of medicine from the treating physicians perspective. They deal with life and death. The cases they are involved in effect them at real and personal level. This book gives a view into that struggle.
Often throughout the chapters are pearls of wisdom. Many will stay with me long after the final words are read. Dr. Crocker does an excellent job of bringing all the stories together with an underlying theme. I highly recommend this book.

[Thomas Jagger · Rating 5 out of 5]

I enjoyed this book very much. It is an exciting series of accounts story after story. The insights from Dr. Crocker are quite impressively expressed. You'll come out with a greater appreciation of first responders, doctors, and nurses, and a better understanding of the camaraderie and respect developed in this web of essential workers. Dr. Crocker had an incredible career in Austin, not to mention saving my life, pg. 143. Thank You!

[Cynthia Wilson · Rating 5 out of 5]

Hard to put down

I enjoy nonfiction books written by doctors, and this one had my interest from the beginning. Dr Crocker gives honest real life portrayals of his experiences in the ER. The cases were often unusual and diagnoses difficult, but he left no stone unturned to figure out what needed to be done. The book is thoroughly absorbing, and I highly recommend it to readers who enjoy this genre.

[Stephen Harrigan · Rating 5 out of 5]

Patrick Crocker's previous volume about his far-ranging experiences as an emergency room physician was one of the best medical memoirs I've ever read, and this sequel only makes his contribution to the field more indelible. It's particularly relevant in the time of Covid-19, when we've learned so much about how our society depends on the courage and expertise of our frontline medical workers.

[Joanne Easley · Rating 5 out of 5]

Well-written deeply thoughtful sequel

I read both of Dr. Crocker’s books and highly recommend them. The stories are well told and give the reader a glimpse into the humanity and emotions of a man who literally held patients’ lives in his hands. I especially appreciated the pieces at the end. As a registered nurse with specialties other than the ER, I gained valuable insight into this world.

[William O. Robertson · Rating 5 out of 5]

This is one of those books that you know the book's ending will come, and as you approach the last chapters you are wanting more. This book is like a good documentary about the real-life encounters that an ER doctor had in telling of the many experiences that he witnessed in his career and saving multiple lives. This book did earn its five star rating!

[Nancy Portz · Rating 5 out of 5]

Interesting insiders view of an ER

This book provides many previously unknown insights of a working emergency department. We cannot let these heroes go unappreciated for all of the amazing things they do to save lives, especially when the case appears hopeless. Thank you, Dr. Crocker, for educating us as to the seemingly impossible job you and your colleagues perform daily.

[John Beaudin · Rating 5 out of 5]

Doctor Crockers second book, More letters from the Pit, is a wonderful read!! Doctor Crocker puts you in the emergency room and lets you be part of his thought process as he determines how to treat a patient! The book is very entertaining,and I could not put it down!! Great job Doctor Crocker!!

[Art Zeitz · Rating 5 out of 5]

Riveting accounts featuring bite-sized vignettes of emergency medical encounters. Introspective and thoughtful insights reflect a refreshing depth, more serious and probing than his first book. Great read.

[William Fowler · Rating 5 out of 5]

Dr. Pat Crocker is a great storyteller! He enlightens and challenges his readers to go beyond the closed doors into the heartbeat of a hospital. The stories bring to light the triumphs and tragedies of life in the ER. A thought provoking page turner! Easy to read and mesmerizing!

[Stephanie Turner · Rating 5 out of 5]

This really let's you witness and feel what an ER doctor experiences

This books gives a hopeful and compassionate look at what an ER doctor goes through in the day in and day out workings of a hospital.

[mary · Rating 5 out of 5]

Too true to ignore. Old woman assesses today.

Too much truth from the trenches. Too much uncertainty. That's reality. We are not in charge.
When I learned medicine we had a few drugs to treat a few conditions.
Dr Crocker is trying to find the sweet spot.

[Paul King · Rating 5 out of 5]

A Compassionate Man

Crocker is a compassionate man first and a doctor second. His stories about treating patients and his private thoughts while doing so are enlightening. It changed my treatment of my health.

[Ray Stokes · Rating 5 out of 5]

Excellent and thoughtful book. A side of medicine fee get to see.

Kept my attention! A learning experience to prepare one for this career. Not many people are suited to the confident decision making requirements.

[Hollie Kennedy · Rating 5 out of 5]

Great Read

Interesting read. An honest look at the inner workings of an ER! Everything you. Might imagine it to be and more. Told with compassion honesty and some humor. I would highly recommend it

[Cherie Federico · Rating 5 out of 5]

Who knew?

I am thankful that Dr Crocker shared these stories with me. I am definitely trying to let the important things in my life outweigh the negative things. His thought processes during an emergency and even after are amazing.

[Patsy Crawford · Rating 5 out of 5]

I enjoyed Dr Crocker''s second book as much as his first. Every chapter was his account of his patients and the memories included the weather, the people and sometimes the smells from that patient. Thank you for sharing PC, enjoy your retirement.