Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids

by Julie Salamon

Overview

Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God, and Diversity on Steroids

A warts-and-all exploration of the struggles suffered and triumphs achieved by America's health-care professionals, Hospital follows a year in the life of Maimonides Medical Center in Brooklyn, which serves a diverse multicultural demographic. Unraveling the financial, ethical, technological, sociological, and cultural challenges encountered every day, bestselling author Julie Salamon tracks the individuals who make this complex hospital run-from doctors, patients, and administrators to nurses, ambulance drivers, cooks, and cleaners. Drawing on her skills as an award-winning interviewer, observer, and social critic, Salamon reveals the dynamic universe of small and large concerns and personalities that, taken together, determine the nature of care in America.

Product Details

ISBN-13:	9780143115366
Publisher:	Penguin Publishing Group
Publication date:	04/28/2009
Pages:	384
Product dimensions:	5.40(w) x 8.20(h) x 0.90(d)
Age Range:	18 Years

About the Author

Julie Salamon is the author of several award-winning books for adults, including Wendy and the Lost Boys, as well as her debut novel for children, Cat in the City. Her writing has appeared in the Wall Street Journal, the New York Times, The New Yorker, Vanity Fair, and more.  She lives in Manhattan with her family.

Table of Contents

Cast of Characters     xiii
Prologue     1
Occam Lied     11
Pooh-Bah     25
Insults and Injuries     47
Safety Nets     73
The Fixer     109
Ability. Affability. Availability     137
We Speak Your Language     159
No Margin, No Mission     193
The Code of Mutual Respect     217
A Good Death     249
The Big Brass Ring     289
Medical Advances and Retreats     315
Acknowledgments     341
Annotated Book List     343
Author's Note     351
Index     353

What People are Saying About This

"Salamon goes beyond the sharp conflicts of ego, culture, and competition in a hospital and finds a community still rooted in compassion and caring. A unique and revealing book that captures the tensions and triumphs of today's medicine."
—Dr. Jerome Groopman, author of How Doctors Think

"Julie Salamon is simply one of our best writers. Her keen reportorial eye, her vivid and assured prose, and most of all, the tremendous compassion she shows for the people in her story, are on full display in Hospital. Here is an institution at the crossroads of humanity, into which Salomon inserted herself for a full year, capturing personal details of remarkable intimacy as well as the sweep of a great story."
—James B. Stewart, author of Den of Thieves

"There's 'ER,' there's 'Grey's Anatomy,' and then there's this real, true-life drama of the barely controllable chaos that actually rules in a huge metropolitan hospital, by one of America's best fly-on-the-wall reporters, Julie Salamon."
—Tom Wolfe, author of I Am Charlotte Simmons

From the Publisher

"A completely unique, three-dimensional and compellingly human perspective." —-Publishers Weekly Starred Review

Editorial Reviews

"A first-rate book . . . [Hospital] reads like a novel, elicits equal parts dismay and awe, yet never wavers from truth telling."
-Dan Cryer, Newsday

" Immensely heartening. . . . If there's hope for our overburdened health care system, Hospital suggests we can thank the decent, thoughtful men and women laboring overtime to improve the quality of life-and death-in our gloriously lumpy American melting pot."
-O, The Oprah Magazine

From the Publisher

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."

…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

Abigail Zuger

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)

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Publishers Weekly

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.

Kirkus Reviews

HOSPITAL is dispiriting. This portrait of Maimonides Medical Center in Brooklyn reminds us that hospital administrators spend an awful lot of time worrying about money, insurance, and paperwork. It also reminds us of America's diversity—an estimated 67 languages are spoken at the hospital; new residents in obstetrics learn to count to 10 in multiple languages. Karen White isn't quite equal to the task of delivering a book with little narrative thread that jumps around from drama to drama and doctor to staff person. Slightly longer pauses between the endless profiles of doctors and nurses and administrators (only a few patients) could help the listener keep up. Inauthentic accents are distracting—Irish nurses that don't sound Irish and South African doctors that don't sound South African. A.B. © AudioFile 2008, Portland, Maine

DECEMBER 2008 - AudioFile