Welcome to Group Text, a monthly column for readers and book clubs about the novels, memoirs and short-story collections that make you want to talk, ask questions, and dwell in another world for a little bit longer.
On Tuesday, July 21 at 7 p.m., we’ll be talking live with Michele Harper on our Instagram. If you have a question for her, please leave it in the comments and she may respond then.
In her memoir of surviving abuse, divorce, racism and sexism, an emergency room physician tells the story of her life through encounters with patients she’s treated along the way.
Usually I read to escape. This summer, I’m reading to learn. Harper’s crash course on the state of American health care should be a prerequisite for anyone awaiting a coronavirus vaccine.
Michele Harper was a teenager with a learner’s permit when she volunteered to drive her older brother, John, to an emergency room in Silver Spring, Md., so he could be treated for a bite wound on his left thumb. The gash came from Harper’s father’s teeth.
It wasn’t the first time he was violent, and it wouldn’t be the last. But that night was the first time Harper caught a glimpse of a future outside her parents’ house. While she waited for John, she took in the scene in the emergency room: an old man napping, a young man waiting for a ride home, a father rushing through sliding doors with his little girl in his arms. As Harper remembers it, “The whole gamut of life seemed to be converging in this space.”
She decided she wanted to become an emergency room doctor — because “unlike in the war zone that was my childhood, I would be in control of that space, providing relief or at least a reprieve to those who called out for help.”
THE BEAUTY IN BREAKING (Riverhead, 280 pp., $27) is the riveting, heartbreaking, sometimes difficult, always inspiring story of how she made this happen. It wasn’t easy. Each milestone came with challenges: Harper’s father tried to pass himself off as the wind beneath her wings at her medical school graduation, and her marriage to her college sweetheart fell apart at the end of her residency in the South Bronx.
Still reeling, Harper moved to Philadelphia to work at a hospital where she was eventually passed over for a promotion by an apologetic (white, male, liberal) department chair who said: “I just can’t ever seem to get a Black person or a woman promoted here. That’s why they always leave!”
From there, Harper went to an emergency room in North Philadelphia (which had a volume of more than 95,000 patients a year) and then across town to yet another facility, where she had fewer bureaucratic obligations and more time for her true calling: seeing patients.
Harper tells her story through the lives of people she encounters on stretchers and gurneys — patients who are scared, vulnerable, confused and sometimes impatient to the point of rage. Each chapter introduces us to a different case, although Harper never boils people down to their afflictions. We learn names and meet families. There’s a newborn who isn’t breathing; a repeat visitor whose chart includes a violent behavior alert; a veteran who opens up about what she’s survived; an older man who receives a grim diagnosis with grace and humor. Harper looks each one in the eye. She listens.
In this summer of protest and pain, perhaps most telling is Harper’s encounter with a handcuffed Black man brought into the emergency room by four white police officers (“like rolling in military tanks to secure a small-town demonstration”). He refuses an examination; after a brief conversation in which it seems as if they are the only two people in the crowded triage area, she agrees (against the wishes of the officers and a colleague) to discharge him. She writes about the incident “so we always remember that beneath the most superficial layer of our skin, we are all the same. In that sameness is our common entitlement to respect, our human entitlement to love.”
“The Beauty in Breaking” is a journey of a thousand judgment calls, including some lighter moments. Each one leads the author to a deeper understanding of herself and the reader to a clearer view of the inequities in our country. (An emergency room is a great equalizer, but only to an extent.) Just as Harper would never show up to examine a patient without her stethoscope, the reader should not open this book without a pen in hand. There are so many powerful beats you’ll want to underline.
[Read an excerpt from “The Beauty in Breaking.” ]
True or false: “We ignore the inconvenient problem because it doesn’t have a rapidly accessible answer.” How does this apply to the world outside an emergency room?
We’ve all seen the signs that say “Thank You Health Care Heroes.” How does Harper’s memoir change how you think of those words?
“When Breath Becomes Air,” by Paul Kalanithi. In this gutting, philosophical memoir, a 37- year-old neurosurgeon chronicled what it is like to have terminal cancer. Not only did he read his own CT scans, he stared unflinchingly at his own life and shared his findings with unimaginable courage.
“Know My Name,” by Chanel Miller. At first glance, this memoir by a sexual assault survivor may not appear to have much in common with “The Beauty in Breaking.” But the cover of Chanel Miller’s book was inspired by the Japanese art of kintsukuroi, where broken pottery is repaired by filling the cracks with gold, silver or platinum. Harper writes about this concept when she describes her own survival. As she puts it, “In life, too, even greater brilliance can be found after the mending.”