Life on the Ground Floor

Finished May 29
Life on the Ground Floor: Letters from the Edge of Emergency Medicine by James Maskalyk

This memoir is organized in a very interesting way. Maskalyk goes alphabetically through the letters of the alphabet, with each chapter on a topic starting with a letter. There are a couple of chapters where he combines two letters for his topic. So the subtitle doesn't mean what I thought it did, which was letters from one person to another.
Maskalyk works in emergency medicine at St. Mike's hospital in Toronto, and sometimes on the trauma team. He also teaches emergency medicine at the University of Toronto, and he works as an advisor, teacher, and consultant in emergency medicine in Addis Ababa, Ethiopia.
This memoir of his work in this field moves between his work at St. Mike's, his work in Ethiopia, and his offtime with his grandfather in northern Alberta, near where a lot of my family came from and some still live.
The interesting comparison of a rural area of Canada, with a very urban area of Canada, and an urban area of Africa is one that emphasizes both things in common and differences. The hospital he works at in Ethiopia struggles to get the staff, equipment, and drugs necessary to treat patients properly. The patients struggle to pay for what they need. The families are a big part of the caregiving due to staff shortages, and lack of experience. In Canada, St. Mike's is right downtown, with all the difficult situations that that environment brings: drugs, violence, homeless, and mental illness. But they have staff that are well-trained, the most up-to-date equipment, and easy access to the necessary medications.
With his grandfather in rural Alberta, medical care is available, but not necessarily coordinated. At one point, he reviews his grandfather's medications and eliminates ones that don't give enough benefit for the side effects, or aren't needed. At another he accompanies him to the loca doctor, and explains his grandfather's condition and the risks he faces, becoming an advocate for the right treatment at the right time. I loved the closeness between these two men, and the way they dealt with real life issues.
Maskalyk is a man who cares deeply, who wants to make a difference in the world for the good, and who lives a life that sometimes is a lonely one.
Highly recommended.