Book dossier

Hospital

by Julie Salamon

A fact of life is that one day, you or a loved one will be a patient in a hospital. When you walk through that door, you will enter a world where bureaucracy, miscommunication, budgets, politics, personalities, and religion can influence the medical attention you receive as much as seeing a doctor. The story of how hospitals actually run has never been told—until now—from the vantage point of the people who work inside. Bestselling author and award-winning journalist Julie Salamon follows a year in the life New York’s Maimonides Medical Center, painting a revealing portrait of how big medicine operates today in Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids. Noted for casting surprising new light on subjects we think we know, Salamon (author of The Devil’s Candy, Facing the Wind, and Rambam’s Ladder) was granted an astonishing “warts and all” level of access by the hospital. She followed doctors, patients, administrators, nurses, ambulance drivers, cooks and cleaning staff. The resulting narrative is not unlike a novel, with a richly detailed cast of characters: 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 systems foul-ups that keep blood test results from being delivered on time, compulsive bosses, careless record-keepers, shortages of everything except forms to fill, recalcitrant and greedy insurance reimbursement systems, and the unsettling difficulty of getting doctors to wash their hands. Located in a community where 67 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. How do the essential requirements of medicine—tending the sick—play out against the competing pressures of money, technology, multiculturalism, politics (internal and external) and religious differences? Layer by layer, Hospital unfolds the many variables at play in an institution that deals with people at their most vulnerable; an institution made up of hundreds of individuals, each of whom makes a difference, for better and sometimes for worse, and most of whom are unaware of what makes the entire place tick. 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.