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

A review of Julie Salamon’s book on our fragmented health care

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Maimonides Medical Center in Brooklyn seems to be in a constant state of chaos. Patients from across New York crowd the lobby at all hours, speaking dozens of languages. Administrators try to bring in as many paying patients as they can and then rush to discharge them as quickly as possible. (“It’s all about turnover,” one doctor admits.) Nurses struggle to find free beds. Egos clash over how to run a new multimillion-dollar cancer center. Doctors burn out from the frenetic pace and get sloppy, often forgetting to wash their hands.

Journalist Julie Salamon spent a year at Maimonides, and her finely observed book captures how medical care is—and isn’t—delivered at a large urban hospital. Amid poignant vignettes of doctoring on the fly, Salamon analyzes the “market ethos” that prevails even at a nonprofit hospital like Maimonides. The doctors she meets spend as much time haggling over reimbursements as they do delivering care. Efficiency—getting patients out the door, rather than letting them fully recover—is prized above all. As one administrator sums up the system, “You treat a patient for pneumonia, and they go home and have a horrible course. They get readmitted, but the patients survive, so the mortality figures don’t look that bad.”

Yet Hospital explores only some of the pressures that our fragmented health care system places on urban hospitals. New York City medical centers are pursuing ways to dissuade the swelling ranks of the uninsured from showing up at their doorsteps; the Wall Street Journal has reported that financial strains are forcing hospitals to ration care. Salamon barely touches on these topics. She seems to prefer the vantage point of the doc who tells her, “You have to focus on the individual patient. You get involved with these larger social issues, and you can’t.” That focus makes sense for an overworked physician—less so for a book on the health care system.

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SIX TRUTHS

Reclaiming power from those who abuse it often starts with telling the truth. And in "This Is How Authoritarians Get Defeated," MoJo's Monika Bauerlein unpacks six truths to remember during the homestretch of an election where democracy, truth, and decency are on the line.

Truth #1: The chaos is the point.

Truth #2: Team Reality is bigger than it seems.

Truth #3: Facebook owns this.

Truth #4: When we go to work, we're in the fight.

Truth #5: It's about minority rule.

Truth #6: The only thing that can save us is…us.

Please take a moment to see how all these truths add up, because what happens in the weeks and months ahead will reverberate for at least a generation and we better be prepared.

And if you think journalism like Mother Jones'—that calls it like it is, that will never acquiesce to power, that looks where others don't—can help guide us through this historic, high-stakes moment, and you're able to right now, please help us reach our $350,000 goal by October 31 with a donation today. It's all hands on deck for democracy.

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