I am frequently asked about the origins of my book. It all began in the following manner: I was a resident in medicine and I had just admitted a man named Solomon Darby to my service. He had a large lung mass that we assumed was lung cancer, but we needed to evaluate him for the extent of the disease and the specific type of cancer. These were critical factors needed to determine the type and length of his treatment. During his hospitalization, we became good friends. I knew he did not feel well, but as part of my duties, I would check on him each day and ask him how he felt. Each day he would give the same answer – “I’m just fine, doctor”. Then he would smile that big smile of his and light up the room with his mouth full of gold teeth.
I knew of course that he was, in fact, dying. One morning, as I went in, I could sense that something was different. Solomon was awake; his arms were stretched out in front of him suspended in mid-air. He was staring far beyond his immediate surroundings and speaking to people that were not in the room. When I asked him how he felt, he just kept staring ahead and replied “I’m just fine doctor, just fine. I don’t need no doctors now, everything is going to be alright. They are all here and everything will be just fine”. I knew that he was seeing and speaking to people that he had known in his life and that we doctors were simply irrelevant at this point. My hair stood up on the back of my neck and I turned and spoke to my interns and students. “This man will be dead in a few hours” and of course he soon expired. I promised him then, that one day, if I lived, I would try to tell his story and the events of that day.
As the years went by, and the patient encounters multiplied, I became aware of the special window on human experiences that an ER doctor has. It occurred to me that it would be a huge challenge, but that an account of these accumulated experiences would perhaps make for interesting reading.