Audiobook14 hours
Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God, and Diversity on Steroids
Written by Julie Salamon
Narrated by Karen White
Rating: 3.5 out of 5 stars
3.5/5
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About this audiobook
In 2005, Maimonides Hospital in Brooklyn, New York, unveiled a new state-of-the-art, 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 progess 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 astonishing 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 but also the financial, ethical, technological, socioloical, and cultural matters that the hospital commuity encounters every day.
Drawing on her skills as interviewer, observer, and social critic, Salamon presents the story of modern medicine. 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 such issues as adapting to the specific needs of immigrant groups that make up a large and growing portion of our society.
Salamon exposes struggles both profound and humdrum: bitter internal feuds, warm personal connections, comedy, egoism, greed, love, and loss; rabbinic edicts to contend with, as well as imams and herbalists and local politicians; system foul-ups, shortages of everything except forms to fill out, 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.
Drawing on her skills as interviewer, observer, and social critic, Salamon presents the story of modern medicine. 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 such issues as adapting to the specific needs of immigrant groups that make up a large and growing portion of our society.
Salamon exposes struggles both profound and humdrum: bitter internal feuds, warm personal connections, comedy, egoism, greed, love, and loss; rabbinic edicts to contend with, as well as imams and herbalists and local politicians; system foul-ups, shortages of everything except forms to fill out, 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.
Author
Julie Salamon
Julie Salamon was a film critic and a reporter for The Wall Street Journal for sixteen years and was recently appointed as a television critic for The New York Times. She is the author of The Devil's Candy: The Bonfire of the Vanities Goes to Hollywood, White Lies, The Net of Dreams, and the New York Times bestseller The Christmas Tree.
More audiobooks from Julie Salamon
The Devil's Candy: The Anatomy of a Hollywood Fiasco Rating: 5 out of 5 stars5/5Facing the Wind: A True Story of Tragedy and Reconciliation Rating: 4 out of 5 stars4/5
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Reviews for Hospital
Rating: 3.5833333333333335 out of 5 stars
3.5/5
36 ratings3 reviews
- Rating: 4 out of 5 stars4/5Interesting story of "a year in the life" of Maimonides Hospital in Brooklyn. Although it is a little dated due to the ever-changing picture of healthcare in the U.S., I found it to be a fascinating glimpse into the complexities of running a hospital. I work in a hospital myself (although I do not have direct patient contact) and many of the episodes described in the book ring true. Maimonides, however, is different from my hospital by the sheer volume of patients and variety of cultures that intersect in their facilities. It really is "diversity on steroids," as the title says. A few passages that stood out for me:New medicine demanded cultural competency, clinical excellence, and psychological awareness, but not at the expense of efficiency, coordination, and speed (none of which conformed to the vagaries of illness, insurance compensation, and the availability of aftercare for the elderly and the infirm).[Referring to 9/11/01] Not just the twin towers of the World Trade Center had been destroyed. The surprise invasion had shaken the sense of American invincibility that was the underpinning of its arrogance as well as its tolerance. Suddenly the large and growing Muslim population was no longer the latest colorful addition to New York's protean populace, but rather a potential menace.[Quoting Abraham Joshua Hershel's essay "The Patient as a Person"] "The truth of being human is gratitude, the secret of existence is appreciation, its significance is revealed in reciprocity. Mankind will not die for lack of information; it may perish for lack of appreciation.""I had to assimilate to this country," he told me. "I had to assimilate to Switzerland. I had to assimilate to France. Wherever I went. This disrespect for our country is what I hate. And this is my country now. We cater to this disrespect. Our health-care system completely embraces this kind of stuff. We can't expect these people to change because we do nothing to change them. When I was in France, they didn't bend in any way. You either learned French or else. Nothing. They can speak English, but they won't. Even if you go to a hospital, they expect you to speak French. Here you get translators. That kind of catering is why people have this attitude they can do anything they want.""Some things are easy to measure. Death. That's easy to measure. Readmissions. You have an electronic way of counting something and assume it's a proxy for the real thing. But how much happiness are you producing? Who the bleep knows? Think about it. It is very, very hard to measure...Thank the Lord we are designed, however we got here, whether Lord Darwin or the Creator, that most things tend to fix themselves, and it takes a lot to really fuck someone up. Most things do get better."The hospital, however, was populated by humans, imperfect men and women, existing in an imperfect world. Politicians started out believing in the social contract and then forgot their duty to fight for the people they represented. Drug and insurance executives said that their desire was to improve and protect health care, but their jobs and fortunes depended on profitability, not making medicine available to everyone. Technocrats worshipped faster and more efficient machines that helped prolong health and life, but they neglected empathy, understanding, and the probing that requires genuine conversation and time. Doctors planned to devote their lives to healing and then spent too much time analyzing their bank accounts or nursing bruised egos instead of making sure the system provided for their patients. Patients agreed with all of the above but failed to accept responsibility for the abuses they inflicted on themselves by working too hard, exercising too little, and smoking, drinking, and eating too much...Depending on the day or night, life in the hospital could seem full of exquisite promise or pointless despair."The solutions are not national. You can't wait and hope that model will change. The solutions are local. You have to look at your own hospital. What is its mission, what is its community, who does it serve--and scale it for that mission. Get it well managed and you can survive."I'm going to recommend this book to several other folks at my workplace. I enjoyed it immensely and found it informative.
- Rating: 4 out of 5 stars4/5Engrossing report of a year at a big city American hospital, focussing on the conflicting pressures and interests within it. An interesting real-life complement to more abstract discussions about America's health care problem(s).
- Rating: 2 out of 5 stars2/5Bland, aimless, superficial. Salamon seems more interested in befriending the hospital management and determining whether the president's purse is a Prada than in delving into the intricacies of a large private hospital. She never gets over multiculturalism, and she barely touches in passing the glaring ethical implications of running a hospital as a business. There's almost no numbers, few facts, some vague trends, and lots of gossip.