Monday, April 23, 2012

Hospital by Julie Salamon

After reading a lighthearted memoir by Tina Fey, I decided to take on a "heavy" memoir regarding the crisis in health care, particularly our hospitals.  Julie Salamon spent a year following interns, residents, fellows, internists, administrators, nurses, and patients at a hospital in Brooklyn.  She gained an eyeful and earful of what is right and wrong with the current state of the U.S. health care system.  Since I have been acquainted with this same familiarity through my own adventures with my dad's stem cell transplant and unusual ailments I have endured myself, I felt like, if given the same assignment, I probably would have written something even more scathing yet revealing.  There's nothing like spending a vast amount of time inside a major hospital to make you acutely aware of what is and is not important when it comes to being a human being in great need.

Initially, the author observes insanity in the hospital emergency room.  People waiting for hours to be seen, to have tests run, and then sometimes many more hours before they can arrive to a hospital room should they need to be admitted.  There is such diversity at this hospital that you see people from every walk of life and seemingly from every part of the globe.  The administration does make an effort to have staff that can speak any of the sixty-seven different languages the patients may speak.  Residents are fascinating in that they believe that if they can make it at this one hospital, given all its crisis, they can make it anywhere.  This particular hospital tries incessantly to reach out and participate in the local community.  They take pride in being a state-of-the-art local hospital, and not one funded by generous endowments such as the hospitals in Manhattan.  They adamantly want the local community to utilize this local hospital as opposed to going to a hospital in Manhattan.

Throughout the book the reader witnesses insurance companies reducing reimbursements for treatments, administrators trying to fund fields that have higher profit returns, doctors behaving badly with other doctors as well as nurses, egos colliding, patients who arrive severely ill and are illegals with no way of paying for hospital services, the hospital President often becoming manic about "teamwork", "cleanliness", "building a cancer center", and uniquely, "having the first born baby of each new year arrive at their hospital (which has never happened).  Her heart is in the right place, but sometimes she is so overwhelmed that she fails to recognize the good that is happening within the hospital and the successes of many staff members. 

You also witness moving moments such as when staff overwhelmingly turn out at a funeral for a fellow staffer's wife who dies of cancer; staffers calling their fellow colleagues when something unexpected and horrible has happened such as a cancer diagnosis or a horrible accident. The hosptial runs like a family with all the ups and downs, arguments and celebrations it entails.  There are fiercely dedicated doctors not just those that are stellar surgeons, but those who are dedicated to treating the whole person.  There is even a meeting of doctors, social workers, and residents called the biopsychosocial team that meet on a volunteer basis when they have a patient who has immense needs.  They pull their talents to determine how to best help the patient given their respective specialties.  It's moving subject matter and it's real. If you haven't had the privilege and some would say horror of witnessing our health care system up close and personal, you definitely should read this book and become enlightened because sooner or later we all become acquainted with the U.S. health care system, its good and bad, either because of our own health or the health of someone we love. 

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