The Current

From Toronto to Addis Ababa: Life lessons from an ER doctor

Emergency room doctor James Maskalyk looks at how societal and personal issues emerge in the ER — from a hospital in Toronto and another in Addis Ababa, Ethiopia.
Humanitarian doctor and activist James Maskalyk draws upon his experience treating patients in emergency rooms from Toronto to Addis Ababa in his book, Life on the Ground Floor. (Penguin Random House/Michael Banasiak)

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Doctor James Maskalyk has worked in emergency rooms from Canada to Ethiopia. He spends three-quarters of the year working at a state-of-the-art Toronto hospital and the other at a hospital in Addis Ababa, where the equipment is almost non-existent and the only medical staff on call are the ones Maskalyk is teaching.

He tells University of Toronto students in residency programs that "watching someone bleed to death sucks ... no matter how much blood you give them they're going to die. So it's a hard job."

But it's a misconception that you have to be tough to work in an emergency room.

"I think the rewards that I find are there when I'm softer when I don't put up the barrier that you know is possible to do, but when I let in the emotion it kind of guides me to be a better doctor," Maskalyk tells The Current's Anna Maria Tremonti.

Something that is important to Maskalyk who believes paying attention is at the core of an ER doctor's job.

He says it comes down to asking yourself: "How can I do the best for the person in front of me with as little bias as possible?"

"The more I pay attention to that intention,  the better the outcome is in terms of making decisions even ones that require haste," Maskalyk explains.

Emergency physician Biruk Girma, one of Dr. Maskalyk's former students, and one of Ethiopia's first four emergency specialists, working in the ER of Black Lion hospital in Addis Ababa. (Courtesy of Penguin Random House)

In his book, Life on the Ground Floor: Letters from the Edge of Emergency Medicine, Maskalyk shares the observations he has made working in ER rooms in Toronto and Ethiopia.

He tells Tremonti that in Ethiopia, some people come to the hospital alone with no one to advocate for them.

"They've taken buses because they've heard about Black Lion hospital, maybe they've come from a day away. And so they don't have that person at the front saying, 'Hey, my friend is sick.'"

Maskalyk says it's important to actively scan a waiting room to look for the people who need the most help because he says they often have the weakest voice.

He believes the lessons he's learned paying attention to patients in the ER also resonates in how to live life.

"Make sure that you're able to spend as much time around people you care about, and live your truth," he tells Tremonti.

That feeling that you're waiting for something to begin but you're not sure what it is, he answers, is life.

"And it's right here. And it's there to be lived."

Listen to the full segment at the top of this web post.

This segment was produced by The Current's Karin Marley.