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Emergency Room Doctor Returns to His Roots in ‘Brick City’

March 20, 2013 at 12:00 AM EDT
In his new book, "Living and Dying in Brick City," Dr. Sampson Davis recounts his return to his hometown of Newark, N.J., as an emergency room physician. Ray Suarez talks with Davis about working on the front lines of his community and his insights on the systematic public health challenges he sees his patients facing each day.
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JEFFREY BROWN: Next: An emergency room doctor returns to Newark and grapples with pressing public health issues. 

Ray Suarez has our conversation. 

RAY SUAREZ: Dr. Sampson Davis is the fifth of six children in his family. He was raised in Newark, N.J., in the 1970s. He was surrounded by crime, drugs, and murders and by the notorious high-rise projects that earned Newark its nickname, Brick City. 

Many of those high-rises have since been torn down. Dozens of other buildings in the city’s neighborhoods have been abandoned. Newark remains one of the tougher urban areas in the country, with a third of its residents living below the poverty line. The city’s medical system also is under stress. 

WOMAN: Not ignoring you. It’s just that it’s been very busy. 

RAY SUAREZ: Many residents lack access to primary care. The city’s three remaining emergency rooms — three others were shut down in the last decade — are often packed to capacity with patients. 

After making a pact with two of his high school friends graduate medical school, Dr. Sampson Davis returned to Newark to work in the E.R. to try to make a difference. 

DR. SAMPSON DAVIS, “Living and Dying in Brick City: An E.R. Doctor Returns Home”: All right, let’s go see another patient and fast-track. Want to go out towards the waiting room. 

RAY SUAREZ: The lessons he learned there and the stories of the people he met and treated are the subject of a new book, “Living and Dying in Brick City: An E.R. Doctor Returns Home.”

SAMPSON DAVIS: We’d see about 100 patients, 125 patients a day. 

RAY SUAREZ: I spoke with him recently at Saint Michael’s Medical Center in downtown Newark, New Jersey. 

Dr. Davis, welcome to the program. 

SAMPSON DAVIS: Thank you. Thank you for having me. 

RAY SUAREZ: The stories are gripping, memorable. The people you meet along the way are the kind of people who, I can see why they stick with you forever. 

But the thing that’s unusual about the book is that, along with these stories, there’s all sorts of resources and diagnostic guides, and information digests, where to get help for certain kind of illnesses. It makes it an unusual book, really, in that way, the way it’s structured. 

SAMPSON DAVIS: It was definitely a tough book to write, in the sense that I feel like it’s part memoir, part self-help, part anecdotal, so I think it’s a lot of different moving pieces that came together. 

But I feel like it sort of was important to tell the story of a person who had a certain ailment, vs. talking about the ailment, because if you tell the story about the mother who’s a nurse, who works in a hospital, who calls the ambulance because she’s having some shortness of breath, and the ambulance isn’t arriving in time, and now she’s succumbing, and she’s having difficulty breathing, her husband puts her in a car, drives her to the hospital, and before she reaches the hospital, she succumbs and passes out. 

I rush out with a gurney, place her in a gurney, and we rush her back into the emergency department. She’s full-term pregnant. We do a stat C-section, remove the baby, and then unfortunately we were unable to resuscitate her. 

So you have this person who is a part of the community, who’s here to help the community. When she called the ambulance, the ambulance for whatever reason, it didn’t show up in an expeditious way. So now at the end of that chapter, you talk about some of the signs and symptoms when you’re having shortness of breath and what to do.

But then you also get to the issue, the social issue at hand. We have an overflux of patients coming into the emergency department, and if you’re using the ambulance system for a non-emergent issue, you are taking away from that person who’s not able to breathe. Now, imagine that was your grandmother, imagine that was your father who was having trouble to breathe. 

RAY SUAREZ: Reading your book reminded me that living in the poorest neighborhoods in this country is not only unpleasant, but it’s bad for you. It can shorten your life. 

SAMPSON DAVIS: It absolutely can. 

I mean, these stories, collection of stories in this book really chronicles patients that I have seen throughout my career practicing emergency medicine. And it’s always issues around health care and access to health care in inner cities. 

RAY SUAREZ: Access ends up being an enormous issue, because very sick people land in the E.R.s where you have worked, and it’s a lifetime of accumulated effects, and now you have to fix them. 

SAMPSON DAVIS: Right, and fix them fast, in that split-second. 

So I see patients come in who are suffering from heart attacks, obviously, who have strokes, but the strokes are a result of uncontrolled high blood pressure, who maybe are on dialysis, and that’s an effect of their uncontrolled diabetes and high blood pressure. 

I see trauma cases, gunshot — young gunshot victims who prematurely lose their lives on the streets. I see cases of patients who don’t have health insurance, and so they try to doctor themselves at home. And when all else fails, they just sort of finally give in and cave and come to the emergency department for treatment. 

On the other side of the spectrum, I’m also seeing mental illness, exacerbation of mental illness, depression, schizophrenia untreated, undiagnosed, where the patients have chronically suffered from these ailments and never seek treatment. Society just sort of passed them by, and there’s no outlet for them to sort of tap into, so that they can treat their depression or their illness that they’re suffering from. 

RAY SUAREZ: That’s a lot of the tension in the stories that you tell. 

As an emergency room doctor, you’re seeing people in a fleeting, rather than longitudinal, way, and your frustration comes through a lot, because you can’t change their lives in one night together. 

SAMPSON DAVIS: Right. And that’s exactly the point. 

So, for me, it’s important to say, what can we do, what can be done, and to step outside the emergency part, to step outside the confines of my comfort zone, the hospital, and reach into the community and say, hey, listen, you need to take your medications every day, you need to be a champion of your ailment. 

As a family, everyone needs to sort of bond together and help treat dad who may be suffering from cancer or who hasn’t gone for his precancerous screening. Prevention is so key. And a lot of the patients unfortunately that I see, they don’t go for the preventative care. And by the time they’re diagnosed, it’s too late. 

And then the frustration comes through from my end, because I’m saying, I could have been — diagnosed you with the throat cancer, or told you to stop smoking, or been an advocate in your health care and have the screening that you needed to sort of diagnose this early. You could have had treatment, and lived long enough to see your kids grow up and your grandchildren born, and see them thrive. 

There’s sort of fear sometimes and apprehension when it comes to medicine because of the lack of what are — difficult to perceive and understanding what’s going on with your body. And it’s truly — it’s not. Once you invest that time and that energy, you can take better care of yourself than any physician or nurse practitioner or health care worker can do for you. 

RAY SUAREZ: But you can’t fix some of the original causes of these illnesses, the malnutrition that’s driven by poverty, the asthma that’s made worse by life in an aging tenement home. 

There are causes that you know very well since you grew up in Newark that can’t be changed even by the best health care. It’s too late by that time. 

SAMPSON DAVIS: I agree. 

And so the issue is multifaceted. It’s not one sort of spot that you can fix and change everything. But I think this is a start. I’m also advocating education, because I feel that, if we educate ourselves, the more we educate ourselves, that we can overcome poverty, and the fact that if we do it as a community, and we stick together, we bond together, and we support one another with education, with health, then we can start to fix some of the issues at the root of the cause. 

And so we can erase — we can erase families who are struggling to get by on minimum wage. We can erase the drug abuse that we see on the streets and in the home. We can erase the gun violence and the domestic violence, and we can start to bring attention to mental illness. 

But this can only be done if everyone in the community is invested. And so I think it has to be a position that we all take in which we say, yes, take better care of yourself. Yes, go for your pre-screening to make sure that you don’t have any ailment that can be detrimental to you down the road. 

But we also can then turn to our youth and our adults and say, it’s OK to get educated on these matters. It’s OK to do well in school for the young person that’s in school. It’s OK to achieve and be academically successful and show your academic excellence. 

Sometimes, in the inner cities, especially amongst the adolescent peer group, there’s some tension where it comes to you doing well in school. It’s almost perceived as you’re being a nerd, or you’re corny, you’re trying to do better than everyone else. And so I wanted to erase that sort of issue and take away and empower the youth and say if they call you a nerd today for doing well in school, that’s OK, because they will be calling you boss tomorrow. 

RAY SUAREZ: The book is “Living and Dying in Brick City.”

Dr. Sampson Davis, thanks a lot. 

SAMPSON DAVIS: Thank you.