In The Emergency (One World, Mar. 2022), Fisher writes of his experiences working as an ER doctor on Chicago’s South Side in 2020. He spoke with PW about structural inequalities in healthcare and the importance of equal access.
How does your South Side Chicago ER represent larger healthcare issues?
Americans only see suffering when it’s in our family or when something’s splashed on the front page of the news. Over 700,000 Americans have died from Covid. When there are hundreds of Chicago men shot and killed in a year, it’s a statistic. But each one is a person, and each death means somebody is left behind to pick up the pieces. Sickness is not something that just gets packaged up and sent to a corner in the hospital to get managed. It happens every day, and it’s something that everybody should pay attention to.
What led you to write this book?
Everywhere I’ve been, I’ve found wonderful people who’ve often been trapped by systems that predated them. How do we as a society address the problem? How do we take care of each other? Are we truly willing to recognize our shared humanity? A main impetus for writing this was to reveal to folks who are trapped in the system how they’re trapped, because when you only see one small fraction of it, you don’t get it.
How do we begin to remedy the systemic injustices you write about?
A first step is to step back and recognize that we built it, so we can build something different. These are not inevitable decisions that have been bestowed upon us by God or nature. These are an accumulation of policy decisions. We can begin to accumulate different ones that center a shared humanity and dismantle the tiered healthcare system. Many developed nations have decided to figure out how to create a healthcare system that’s a reflection of their democratic policies and shared in common. We’ve gotten closer to that with Medicare and Medicaid in the ’60s and some of the Affordable Care Act regulations in the early 2010s. As an ER doctor, I know that in order to solve some of the violence in the South Side there are large systemic issues we need to address, but that doesn’t absolve me from today, from taking care of the person who’s bleeding. We don’t have to wait for government to come together and create a brand-new structure or for capitalism to become less pervasive. We can do most of that today. I would love to encourage that to happen.
Why did you intersperse epistolary sections to patients and colleagues in the narrative?
I credit [my editor] Chris Jackson. Early versions were much more wonky. He’d say, “You can’t tackle everything. You need to narrow this down.” And so one way is to address it to individuals. The opportunity to discuss American healthcare with patients is never. There are a ton of books out about how the payment systems work and how our healthcare system is structured but it’s not really what a patient needs. It made the book much more honest and personal. And I hope my colleagues see themselves, not just here in Chicago but around the country. I hope that they feel that I’ve captured their triumphs and struggles, because we’re all in this together.