CODE GRAY: DEATH, LIFE, AND UNCERTAINTY IN THE ER
FARZON A. NAHVI, MD
© 2023 Simon & Schuster
$27.99
256 pages

It was only supposed to be a friends-catching-up kind of text thread, but for Farzon A. Nahvi, MD, and his colleagues around the country, the flurry of messages they exchanged during the pandemic became a lifeline. For each, it was good to know that their hospital's reaction to the COVID-19 pandemic wasn't the only one lacking.

And yet, Nahvi said, "The most challenging circumstances I faced during the pandemic... had little to do with the virus itself."

More than a decade ago, Nahvi went to medical school because he "wanted to help people," which is "a meaningless catchphrase" with good intentions, he says. Indeed, he was "surprised at how hard it was to truly help anyone at all." Sometimes, it made Navhi wonder if a goofy Labrador retriever might be the "doctor" his patients really needed.

Patients, in a way, are surprised, too: treatment for a disease can save a life, but it comes with sometimes-hidden strings attached — and despite all that doctors do, people still die. A patient's family can rally around a bed and cheer as though they're in a race, but coaching and bargaining can't restart a pulse that's been missing for 20 minutes. And sometimes, getting what you want can be the worst thing of all.

Medicine can sometimes be rather arbitrary. Manuals are written for certain procedures but not for others, which goes doubly when things are not always black and white. In fact, says Navhi, "the code that most often applies in the emergency room, as in life, is code gray."

So you try to take care of yourself. You eat right, give up your vices, spend time exercising. And look: you're going to die someday anyhow. As you'll see in Code Gray, that's not at all for a lack of effort.

Beginning with text messages and a story of a 43-year-old New York woman who comes to his ER with no pulse, Nahvi writes about the daily struggles of life, health, and being completely truthful to patients versus doing what's easiest. There's frustration in this, of course — and with the medical system in America — but also with decision-making that's never clear and maybe never will be. What Nahvi writes about here may be things your doctor wishes she could say; for sure, these are things every patient and family-member needs to hear.

Medical drama fans will love everything about this book, as will those who enjoy thoughtful meditations on humanity, life, and death. If that's you, then you'll find that Code Gray is gold.