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