Product Description A bestselling author and award winning journalist follows a year in the life of a big urban hospital, painting a revealing portrait of how medical care is delivered in America today
Most people agree that there are complicated issues at play in the delivery of health care today, but those issues may not always be what we think they are. In 2005, Maimonides Hospital in Brooklyn, New York, unveiled a new state-of-theart, multimillion-dollar cancer center. Determined to understand the whole spectrum of factors that determine what kind of medical care people receive in this country, bestselling author Julie Salamon spent one year tracking the progress of the center and getting to know the characters who make the hospital run. Located in a community where sixty-seven different languages are spoken, Maimonides is a case study for the particular kinds of concerns that arise in institutions that serve an increasingly multicultural American demographic. Granted an astonishing ?warts and all? level of access by the hospital higher-ups, Salamon followed the doctors, patients, administrators, nurses, ambulance drivers, cooks, and cleaning staff. She explored not just the action on the ground?what happens between doctors and patients?but also the financial, ethical, technological, sociological, and cultural matters that the hospital community encounters every day.
Drawing on her skills as interviewer, observer, and social critic, Salamon presents the story of modern medicine, uniquely viewed from the vantage point of those who make it run. She draws out the internal and external political machinations that exist between doctors and staff as well as between hospital and community. And she grounds the science and emotion of medical drama in the financial realities of operating a huge, private institution that must contend with issues like adapting to the specific needs of immigrant groups that make up a large and growing portion of our society.
Salamon exposes struggles of both the profound and humdrum variety. There are bitter internal feuds, warm personal connections, comedy, egoism, greed, love, and loss. There are rabbinic edicts to contend with as well as imams and herbalists and local politicians. There are system foul-ups that keep blood test results from being delivered on time, careless record keepers, shortages of everything except forms to fill, recalcitrant and greedy insurance reimbursement systems, and the surprising difficulty of getting doctors to wash their hands.
This is the dynamic universe of small and large concerns and personalities that, taken together, determine the nature of our care and assume the utmost importance. As Martin Payson?chairman of the board at Maimonides and ex-Time-Warner vice chairman?puts it: ?Hospitals have a lot in common with the movie business. You?ve got your talent, entrepreneurs, ambition, ego stroking, the business versus the creative part. The big difference is that in the hospital you don?t get second takes. Movies are make-believe. This is real life.?
A year in the life of a hospital... November 17, 2008 1 out of 1 found this review helpful
A year in the life of a hospital...
Julie Salamon was given an interesting opportunity! In Hospital, she has been able to document, from a "civilian" perspective, the workings of an institution that is influenced by seemingly all the forces of the cosmos, which come to focus on the common denominator of human illness and ultimately, death. But this work is also very much a celebration of life, and the lives that are committed to providing a measure of comfort and dignity to our very imperfect human existence.
As a physician, I didn't find that Hospital was a "must read" in order to make a better or more understanding practitioner, or to reveal some hidden truth that might be missed in the business of day-to-day practice. Residency and fellowship training are probably universally exhausting, and the clinical challenges that were presented at Maimonides Medical Center in Brooklyn seem relatively widespread in the hospitals I've had opportunity to staff. Power structures and physician personalities and grudges and egos rule large in any medical complex. The book details the frustrations of procedure and policy, but allows that reason and intuition can (on occasion) win the day, especially with certain personality-types at the helm. Hospital tells some great stories regarding the sometimes-precarious relationships (within and without the hospital) that keep the machine working, and it is worthwhile for us to consider that nothing that happens in this microcosm of society is apolitical.
However, I felt that what sets this hospital apart (and thus makes for an interesting read) is the story of its dependence on, and commitment to, a regional ethnic majority whose influence generates particular challenges for the providers and administration, and ultimately to the surrounding community in Brooklyn, New York. From automatic elevator buttons to influential ambulance drivers to kosher kitchen chefs, this hospital exists for the people of Maimonides. That said; the sheer volume of varying minority cultures arriving for care (and the accompanying mission to try to accommodate everyone) gave me pause. I think what I come back to time and again is the comment made by one of the oncology fellows from Malaysia, who had traveled the world, and within his experiences noted that America seemed to uniquely generate a patient attitude of "accommodate me" instead of "I'm grateful for the care I receive." It's hard for me to confirm this, because America is all I know.
I gave the book 4 stars--Perhaps this is unfair: I wish the story had further described the role and hospital life of the nursing staff and ancillary care providers. Within a hospital, these are the unsung heroes. I wish Julie Salamon would consider another volume that followed a year in the life of hospital nurses, from the newborn nursery to the emergency department to the ICUs and medical and surgical floors. And pharmacists who find and prevent the dosing errors, therapists, and housekeepers--these are all of my unsung heroes. A survey done at a major hospital in Salt Lake City confirmed that what made patients feel best about their stay (and what was most likely to generate high patient satisfaction) among many things, was the cleanliness of the hospital's appearance.
I came away from reading Hospital with a new understanding and a deep respect for Moses Maimonides (Rabbi Moses ben Maimon.) For a man who lived from 1135-1204, he was indeed a timeless jewel: "Medical practice is not knitting and weaving and the labor of the hands, but it must be inspired with soul and be filled with understanding and equipped with the gift of keen observation; these together with accurate scientific knowledge are the indispensable requisites for proficient medical practice."
I highly recommend Hospital--meaty, slightly lengthy, but an enjoyable look at an institution we'll all likely experience at some point in our lives.
I loved this book so much! September 25, 2008 1 out of 1 found this review helpful
My favorite book of the summer was Hospital-- an extraordinary portrait of the doctors and administrators at Brooklyn's Maimonides Medical Center. Located in boro park, brooklyn (ethnically diverse but largely orthodox), Maimonides is filled w/ residents and staff who are struggling w/ many of the same issues we all struggle with: personality clashes in the workplace, political tensions, the desire to do good but also make money, ego, romance, failing health, language barriers, and the stress of being overworked... And It gets to the heart of all of my favorite themes: religion, politics, what it means to be an immigrant in the city, medicine, death, ethics, neighborhood, health, capitalism and community. And yet it still manages to feel like a light read! Having worked in public radio for many years, this book was actually an adrenaline shot for me, reminding me of the power of story-telling and of journalism to get to the heart of all that matters most. great job!
Hospital September 16, 2008 2 out of 2 found this review helpful
A fascinating documentary with a drama twist of a real life Brooklyn hospital. For those who are curious about medicine and medical professionals, administrators, supportive personnel and the very sick patients who are given the best treatment regardless of their ability to pay. There are no heroes or villains in this book but the real people. I could not put this book down until the end. Highly recommended.
A great read August 26, 2008 2 out of 2 found this review helpful
I have always been fascinated by hospitals and reading this book allowed me to indulge my fascination. It basically depicts a year in the life of the administrators, doctors, social workers, and other personnel at a very busy Brooklyn hospital. Salamon depicts these characters so vividly, you'd think she was writing a novel. Her subjects definitely come alive on the page.
The primary function of the book is to depict the complexities of running a hospital. The secondary function is to depict the relationship between the hospital and the community it serves, which is traditionally centered on orthodox Jews. Thus, the book is also a fascinating study of orthodox Judaism, at least as lived out in Brooklyn. The area surrounding the hospital is increasingly multicultural (e.g., Chinese, Pakistani) and Salamon also does a great job of depicting these cultures with both clarity and sensitivity.
I have only a few caveats about the book. Much of its focus is on the hospital's cancer center, so it is very "heavy" reading material. It will have you thinking a lot about your own mortality. In no way is it a beach or bedtime read.
There is also a small section of the book concerned with "partial birth" abortion. I thought that it could have been more objective. (It seems clear from reading the section that Salamon is pro-choice, though she spares no gruesome detail in describing the procedure.)
Overall, though, I recommend this book. It packs a lot of interesting material into a reasonable number of pages. It will be a read you won't be able to put down.
Julie Salamon's Hospital August 25, 2008 2 out of 2 found this review helpful
Hospital is an amazing book, both as an stand-alone story and a exercise in the art of story telling. You'll enjoy "Hospital" if you enjoyed Salamon's "The Devil's Candy," only instead of experiencing juicy, morbid fascination via a Hollywood bomb, you'll experience a new sense of admiration for hospital workers and the author's talent.
In the beginning, I wondered whether it was possible for someone to bring a hospital to life. They're big, lifeless institutions that lack the drama and personality of similar organizations like a big business (Apple) with a rich history, right? Gay Talese was able to create magical stories about the Brooklyn Bridge and the New York Times, but he's Gay Talese. People loved those books and they helped form the foundation of his reputation. In my opinion, Salamon has reached that level as a storyteller with "Hospital." This is not an easy, cut-and-paste story. She pulls it off and proves she can write well about anything. Anything.
A great non- fiction book makes people do more than read to the end. With this one, I found myself searching out the origins of Hasidic vs. Orthodox Jews, and googling image after image of the characters. I HAD to see what Pam, Dr. Astrow and the others looked looked like.
Salamon became a word doctor, someone able to give life to what I considered to be nothing more than a lifeless institution. Anyone in the health care industry will relate to the travails, and those of us outside it will find a very informative snapshot into this world. As for Salamon, reading this story is like seeing Lenny Kravitz perform live; it's witnessing someone who was born with a gift and using it.
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