Epic Trauma

Review of The Comfort Garden: Tales from the Trauma Unit, by Laurie Barkin, San Francisco: Fresh Pond Press, 2011, 364 pp.

The word “epic” kept coming to mind as I read Laurie Barkin’s The Comfort Garden: Tales from the Trauma Unit. Not that the book is precious or pretentious, but as Barkin, a psych nurse in a major urban hospital trauma unit, revealed the narrative, she seemed by turns Dante accompanying readers through the Inferno of patients’ lives, the Purgatorio of the hospital, and the occasional Paradiso of her life with her husband and children, or the “skilled tactician” Odysseus, whose skill defies gods and monsters in the long journey homeward.

Barkin begins in media res, bringing readers into the chaos of the emergency department and trauma unit, as she begins her employment orientation to the hospital. We learn that the chaos of the hospital is symptomatic of the chaos of the patients’ lives, shaped by poverty, drug addiction, and violence.

Dedicated healthcare professionals are overwhelmed by the complexities of their patients’ lives and the paucity of resources, particularly as (mis)managed care insinuates itself throughout the hospital, requiring all health professionals to provide only billable services.

Conflicts among healthcare professionals are related with candor and clarity. Despite the shared sense of mission, careerism rears its head, undermining the mutual values and work. Attempts to create support mechanisms for staff and patients are met with resistance, either because of meagre resources or the dominance of pharmaceutical mental health care. Post traumatic stress? We have a pill for that.

The freshness and sincerity of this well crafted narrative prevents Barkin’s candor from descending into ax grinding. Toward the end she struggles with the question “Who will take care of the caregivers?” and with the deeply ingrained role identity, “If I am not a nurse, who am I?” But in the end she listens to her somatic signs and nightmares, deciding to leave the hospital.

Barkin’s The Comfort Garden will appeal to all healthcare professionals, especially those engaged in acute care, but it should also be read by nursing and medical students as well as by lay readers who need to understand the ways in which our healthcare institutions are framed by the socio-economic dimensions of patients’ lives.

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