Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids Hardcover - 2008

by Julie Salamon

A bestselling author and award winning journalist follows a year in thelife of a big urban hospital, painting a revealing portrait of how medicalcare is delivered in America today

Most people agree that there are complicated issuesat play in the delivery of health care today, but those issues maynot always be what we think they are. In 2005, MaimonidesHospital in Brooklyn, New York, unveiled a new state-of-theart,multimillion-dollar cancer center. Determined to understandthe whole spectrum of factors that determine what kindof medical care people receive in this country, bestselling authorJulie Salamon spent one year tracking the progress of the centerand getting to know the characters who make the hospital run.Located in a community where sixty-seven different languagesare spoken, Maimonides is a case study for the particular kindsof concerns that arise in institutions that serve an increasinglymulticultural 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 notjust the action on the ground what happens between doctorsand patients but also the financial, ethical, technological,sociological, and cultural matters that the hospital communityencounters every day.

Drawing on her skills as interviewer, observer, andsocial critic, Salamon presents the story of modern medicine,uniquely viewed from the vantage point of those who make itrun. She draws out the internal and external political machinationsthat exist between doctors and staff as well as betweenhospital and community. And she grounds the science andemotion of medical drama in the financial realities of operatinga huge, private institution that must contend with issues likeadapting to the specific needs of immigrant groups that makeup a large and growing portion of our society.

Salamon exposes struggles of both the profound andhumdrum variety. There are bitter internal feuds, warm personalconnections, comedy, egoism, greed, love, and loss. There arerabbinic edicts to contend with as well as imams and herbalistsand local politicians. There are system foul-ups that keep bloodtest results from being delivered on time, careless record keepers,shortages of everything except forms to fill, recalcitrant andgreedy insurance reimbursement systems, and the surprisingdifficulty of getting doctors to wash their hands.

This is the dynamic universe of small and largeconcerns and personalities that, taken together, determinethe nature of our care and assume the utmost importance. AsMartin Payson chairman of the board at Maimonides andex-Time-Warner vice chairman puts it: 'Hospitals have a lotin common with the movie business. You've got your talent,entrepreneurs, ambition, ego stroking, the business versus thecreative part. The big difference is that in the hospital you don'tget second takes. Movies are make-believe. This is real life.'