A Passerby

September 6, 2016

 He’s overdressed in killing heat, the sun                                        a screw that’s turned too tight, the air on fire,                                concrete a punishment. Some thing is done                                     for him, extinguished, turned to ash. Desire                                     looks gone from his worn face, his eyes like holes                         that sink in sand. Perhaps a junkie, dressed                                   like that. Perhaps another crazy soul,                                     whose home can never square with his address.                               Perhaps he’s twenty-three or four, an age                                 when life should whistle through his bones.                                 Across the bridge he hurries on, the cage                                         surrounding him belongs to him, alone.                                       And gone, an apparition passing by,                                             the shape a man’s, who has, in some way, died.



Ed Hack was a teacher. Now he’s a poet. He’s been writing for years, published here and there, and, most recently, exploring the precision, passion, and forms of the sonnet. He is the father of the emergency medicine physician and toxicologist, Jason Hack, MD. When Jason asked his father why he would write a poem applicable to the experience of emergency medicine, he said, “I’ve lived it through your eyes and in the stories you have told me for the past twenty years.”

Story seduction and the opioid crisis

May 11, 2016

It was Saturday evening and Audrey G lay awkwardly on an emergency department stretcher in search of a comfortable position. She suffered from chronic hip pain, the unfortunate and unexpected effect of pelvic surgery. But her real chief complaint involved her drug-abusing husband, who that morning stole her recently filled bottle of oxycodone, an opioid pain medicine. Her story included the surgeon who doubted her pain and a year of failed therapies. Now only oxycodone touched the pain, or so she said, fighting back tears. The on-call physician didn’t know her and said to go to the ER.

Any decision that involves prescribing an opioid asks that I pivot in a space mined with judgment and peril. Studies show that four of five new heroin abusers began their habit by abusing painkillers, and opioid painkillers and heroin have a heavy hand in the 47,000 lives lost prematurely in a single year from drug overdoses.

To be an emergency physician requires, first and foremost, being a skilled story listener. Before I can fashion a response or formulate a plan, I must first understand the patient’s story. This isn’t earth-shattering news. Humans, a group that includes both physicians and patients, have been using stories for thousands of years to communicate, connect and forge relationships. Read the rest of this entry »