Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God andDiversity on Steroids / Edition 1

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Overview

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."
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Editorial Reviews

From Barnes & Noble
Consider this book a full-immersion experiment. Instead of examining health care from afar, investigative journalist Julie Salamon spent one-year tracking activities at Brooklyn's Maimonides Hospital, which has the only cancer center in a borough of 2.5 million people. What she discovered there was more complicated and less formulaic than any politician's nostrums. (For instance, how can one hospital effectively respond to the health needs of a community where 67 different languages are spoken?) Salamon's Hospital has all the drama of ER or House, with even more human complexity. That shouldn't surprise us: As Maimonides' chairman of the board noted, "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 chances. Movies are make-believe. This is real life."
Abigail Zuger
…journalists are inexorably drawn to hospitals, moths to the flame of all the great stories lurking inside (or flies on the wall to deliver that full "you are there" experience). All these eyewitness accounts are flawed to a greater or lesser degree, and Julie Salamon's energetic Hospital is no exception. But her scope is more ambitious than most, and even the book's problems wind up telling the astute reader a great deal about these troubled modern institutions.
—The New York Times
Publishers Weekly

In this remarkable portrait of the doctors and administrators at Brooklyn's Maimonides Medical Center, bestselling author Salamon (The Devil's Candy; The Christmas Tree) illustrates the complex machine that is the modern hospital, vying to provide cutting-edge facilities and compassionate care, while making money doing it. Salamon compares Maimonides to a factory, where medicine is "industrialized," streamlined for efficiency and as dependent on skilled administrators as on talented physicians. Located in a Brooklyn neighborhood known for its simmering mix of ethnicities and cultures, particularly its influential ultra-Orthodox Jewish community, Maimonides is insanely busy, with perhaps the most densely packed emergency room of its size. A new resident in obstetrics learns to "count to ten and say 'push' in Cantonese, Mandarin, Russian, and at least two other languages that I'm not sure what they were." Administrators juggle budgets, politics and feuding staff while insurance paperwork increases mistakes and steals treatment time. Although it's "hard to deconstruct the Tower of Babel when you're standing in the middle of it," Salamon succeeds in providing a completely unique, three-dimensional and compellingly human perspective of the demanding work-both frustrating and rewarding-that is not always apparent to hospital patients and their families. (May 19)

Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Kirkus Reviews
A portrait of Maimonides Medical Center in Brooklyn, N.Y., that, like the hospital's own emergency room, is overflowing and overextended. Salamon (Rambam's Ladder: A Meditation on Generosity and Why It Is Necessary to Give, 2003, etc.) was permitted to roam Maimonides from waiting room to executive office in 2005 and 2006. Armed with a tape recorder and notebook, she talked to the chairman of the board, doctors, nurses, social workers, patients and members of the community involved in the hospital's affairs. Woven into her wide-ranging account of the financial, ethical, scientific and sociological factors that shape a big metropolitan hospital's operations are dozens of revealing profiles (most notably of president and CEO Pam Brier); her front-of-the-book cast of characters lists nearly 70 names. Salamon calls Maimonides "a petri dish of the post 9/11 world," an apt description for a hospital founded to serve a community of Orthodox Jews in a neighborhood rapidly filling with immigrants from all over the world. Cultural conflicts are ever-present, as are those caused by human ego and ambition. The author recounts racial and religious prejudices that affect patient care, personality clashes and turf wars between doctors. Patients come and go, live or die, and fights with insurance companies are won or lost. Adding color but cluttering up her canvas are myriad irrelevant details from the administrative and professional staff's lives and social and professional relationships. Readers learn not only who said what to whom at a staff meeting, but who wore what to whose funeral. Excerpts from the author's daily log also pad this meandering account. However, some frank and chatty e-mails from anew emergency-room resident, a Midwesterner trying to adjust to the big-city life and work in a huge urban hospital, provide a welcome additional perspective. Ambitious, unwieldy and unfocused.
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Product Details

  • ISBN-13: 9781594201714
  • Publisher: Penguin Group (USA) Incorporated
  • Publication date: 5/15/2008
  • Edition number: 1
  • Pages: 384
  • Product dimensions: 6.44 (w) x 9.42 (h) x 1.23 (d)

Meet the Author

Julie Salamon
Julie Salamon is the author of six books, including The Devil's Candy, considered a Hollywood classic about filmmaking gone awry, and The Christmas Tree, a New York Times bestseller. Her other books are the nonfiction, true crime book Facing the Wind, the novel White Lies, a family memoir, The Net of Dreams, and Rambam's Ladder for which she won the 2005 Ohioana book award. Salamon was a culture writer for The New York Times and a critic and reporter for The Wall Street Journal. In 2006–2007 she was a Kaiser Media Fellow. Her journalism has appeared in The New Yorker, Vanity Fair, Vogue, Bazaar, and The New Republic.
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Table of Contents

Cast of Characters

Prologue 1

1 Occam Lied 11

2 Pooh-Bah 25

3 Insults and Injuries 47

4 Safety Nets 73

5 The Fixer 109

6 Ability. Affability. Availability 137

7 We Speak Your Language 159

8 No Margin, No Mission 193

9 The Code of Mutual Respect 217

10 A Good Death 249

11 The Big Brass Ring 289

12 Medical Advances and Retreats 315

Acknowledgments 341

Annotated Book List 343

Author's Note 351

Index 353

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Customer Reviews

Average Rating 4.5
( 27 )
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(21)

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Sort by: Showing 1 – 8 of 7 Customer Reviews
  • Posted January 12, 2009

    READ THIS BOOK

    I spent two days reading the Hospital and was blown away by this amazing institution. I even sent them a thank you note today. It will make you see the hospital system in a new light.

    0 out of 1 people found this review helpful.

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  • Anonymous

    Posted June 5, 2008

    A reviewer

    Ms. Salamon is about as accurate about the culture, patients and employees at Maimonides as it gets. As a former employee who knows many of the characters in her book, I was surprised by the remarkable truth Ms. Salamon exhibited through her writing in Hospital. Like it or not, it's so accurate I am deeply shocked that Pam Brier would have ever thought to allow a writer unlimited access to Maimo for a year. Then again, knowing Ms. Brier, her ego got the better of her. Kudos to Ms. Salamon for holding almost nothing back. This is life in an outer-borough hospital, folks.

    0 out of 1 people found this review helpful.

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  • Anonymous

    Posted June 8, 2008

    Not Grey's Anatomy but the Real Deal

    Almost all the patients on Grey's Anatomy speak English. But that's hardly true in the real world of big city hospitals. How this hospital adapts - to its past, present and future - would warrant yet another look, a year from now, by this talented author.

    0 out of 1 people found this review helpful.

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  • Anonymous

    Posted June 10, 2008

    A reviewer

    Reading this story made me feel better aware and capable of understanding how Right and Wrong and Kindness and Rightfulness are being redefined in our daily lives. Playing out in a hospital setting makes it fascinating because so many world-ish issues are brought into close proximity and gives the reader a compelling place to see ourselves and others more deeply than the surfaces scratched in less intense workplaces. The drama of personalities, politics, histrionic ethnic backgrounding and stereotyping, Love and Fear, good and evil behaviors like this may only play out as powerfully in stories about life and death in wars. Salamon is artful in revealing the multi-faceted, multi-tasked personalities of the people here. More quality and less quantity is refreshing when reading about patients and people. I felt humbled and connected to these people as they struggle to behave well under pressure to achieve what's necessary for existing in a culture fraught with frustrating differences of intelligence, ethnic backgrounds, socioeconomic and professional inequalities. It's not easy to know what's most appropriate and true to ourselves whether cooking for minimum wage or doing risky surgery for six-figures. The people and issues in 'Hospital' changed my thinking about the possibilities and difficulties we face as old-school and modernized people in 21st century America and Planet Earth. Take your time and Read This Book!

    0 out of 1 people found this review helpful.

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  • Anonymous

    Posted June 10, 2008

    Intriguing

    I picked up this book because I was intrigued by part of the title, 'Diversity on steroids.' I began reading about the daily events and unique personalities that make up Brooklyn Maimonides Hospital. Simply put, I couldn't put it down. Salamon is a gifted writer who is able to brilliantly descibe the enigmatic individuals that contribute to the success of this unique community. From the 27 year old Nebraska intern, who rides the subway with his surfboard to 'catch a wave,' to the brilliant and complicated Pam Brier, president of Maimonides, one immediately gets the sense that the diversity in the staff more than matches the heterogenous community it serves. Upon finishing this book, the reader is struck by the raw compassion,commitment, and intelligence that drive this unusual institution. It was a terrific read!

    0 out of 1 people found this review helpful.

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    Posted July 20, 2009

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    Posted January 24, 2010

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    Posted January 25, 2011

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