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What’s it like inside an ER? This doctor and author shares raw, honest stories

The cover of "The Beauty in Breaking" and author Michele Harper.
“The Beauty in Breaking” is Michele Harper’s first book.
(LaTosha Oglesby / Riverhead Books)

It’s 11 a.m., and Michele Harper has just come off working a string of three late shifts at an emergency room in Trenton, N.J. The past few nights she’s treated heart and kidney failure, psychosis, depression, homelessness, physical assault and a complicated arm laceration in which a patient punched a window and the glass won.

“I’ve never been so busy in my life,” says Harper, an ER physician who also is the author of “The Beauty in Breaking,” a bestselling memoir about her experience working as Black woman in a profession that is overwhelmingly white and male.

“It’s a blessing, a good problem to have. But I’m trying to figure out how to detonate my life to restructure and find the time to write the next book.”

Harper joins the Los Angeles Times Book Club June 29 to discuss “The Beauty in Breaking,” which debuted last summer as the nation reeled from a global pandemic and the pain of George Floyd’s murder.

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Touching on themes of race and gender, Harper gives voice and humanity to patients who are marginalized and offers poignant insight into the daily sacrifices and heroism of medical workers.

In one chapter, she advocates for a Black man who has been brought in in handcuffs by white police officers and refuses an examination — a constitutional right that Harper honors despite a co-worker calling a representative from the hospital’s ethics office to report her. (The officers did not have a court order and the hospital administration confirmed Harper had made the correct call.) She writes that the moment was an important reminder 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.”

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In another passage, Harper recounts an incident in which a patient unexpectedly turns violent and attacks her during an examination. The experience leads her to reflect on the often underreported assaults on front-line medical workers and her own healing and growth as a physician. She writes, “If I were to evolve, I would have to regard his brokenness genuinely and my own tenderly, and then make the next best decision.”

Harper, who has worked as an ER physician for more than a decade, said she found her own life broken when she began writing “The Beauty in the Breaking.” Her marriage had ended, and she had moved to Philadelphia to begin a new job. She says writing became not only a salve to dramatic life changes but a means of healing from the journey that led her to pursue emergency medicine as a career.

A teenage Harper had newly received her learner’s permit when she drove her brother, bleeding from a bite wound inflicted by their father during a fight, to the ER. While she waited for her brother she watched and marveled as injured patients were rushed in for treatment, while others left healed. She writes, “I figured that if I could find stillness in this chaos, if I could find love beyond this violence, if I could heal these layers of wounds, then I would be the doctor in my own emergency room.”

After a childhood in Washington, D.C., she studied at Harvard University and the Renaissance School of Medicine at Stony Brook University. She went on to work at Lincoln Hospital in the South Bronx and the Veterans Affairs Hospital in Philadelphia.

Harper’s memoir explores her own path to healing, told with compassion and urgency through interactions with her patients.

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Her story is increasingly relevant as the aftermath of the pandemic continues to profoundly affect the medical community.

“What’s interesting and tragic is that a lot of us are feeling demoralized,” Harper says. “As we are hopefully coming out of the pandemic, after people stopped clapping for us at dusk, we’re at a state where a lot of [intensive care unit] providers are out of work. Our hours have been cut, our pay has been cut because healthcare in America is a for-profit system. All of those heroes trying to recover from the trauma of the pandemic are trying to figure out how to live and how to survive.”

Emergency room doctor Michele Harper brings her memoir, “The Beauty in Breaking,” to the L.A. Times Book Club June 29.

One of the gifts of her literary journey, she says, are the conversations she is having across the country and around the world about healthcare. That has inspired her to challenge a system that she says regards healthcare providers as more disposable than their protective equipment.

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“It doesn’t have to be this way of course. When I speak to people in the U.K. about medical bills, they are shocked that the cost of care [in the U.S.] can be devastating and insurmountable,” she says. “We’ve bought into a collective delusion that healthcare is a privilege and not a right. That’s why I have to detonate my life. I feel people in this nation deserve better.”

While Harper says she’s superstitious about sharing the topic of her next book so early in the process, she is yearning to continue writing.

“When I was in high school, I would write poetry,” she says. “Then I started the medical path, and it beat the words out of me. I felt I’d lost the capacity to write or speak well, but there were stories that stayed with me — this sense of humanity and spirituality that called to me from my work in the medical practice.

“I was really scared because I didn’t know that I could write a book. I didn’t know the endgame. Once I finished the book, I realized the whole time I’d been learning.”

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A recurring theme in “The Beauty in Breaking” is the importance of boundaries, which has become more essential as Harper juggles a demanding ER schedule and her writing.

“All the stuff I used to do for self-care — yoga, meditation, eating healthy — I’ve had to double down and increase clarity about my boundaries,” she says. “It’s been an interesting learning curve, I’m quicker on the uptake about choosing who gets my energy. I am famously bad at social media. It’s really hard to get messages all the time and respond.

“What’s more important is to be happy, to give myself permission to live with integrity so that I am committed to loving myself, and in showing that example it gives others permission to do the same.”

Heather John Fogarty is a Los Angeles writer whose work is anthologized in “Slouching Towards Los Angeles: Living and Writing and by Joan Didion’s Light.” She teaches journalism at USC Annenberg.

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Join us: Book Club

Michele Harper, the author of “The Beauty in Breaking,” will be in conversation with Times reporter Marissa Evans at the Los Angeles Times Book Club.

When: June 29 at 6 p.m. PT

Where: Free live streaming event on Facebook, YouTube and Twitter. Sign up on Eventbrite.

More info: latimes.com/bookclub


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