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

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A bestselling author and award winning journalist follows a year in the life of a big urban hospital, painting a revealing portrait of how medical care is delivered in America today Most people agree that there are complicated issues at play in the delivery of health care today, but those issues may not always be what we think they are. In 2005, Maimonides Hospital in Broo A bestselling author and award winning journalist follows a year in the life of a big urban hospital, painting a revealing portrait of how medical care is delivered in America today Most people agree that there are complicated issues at play in the delivery of health care today, but those issues may not always be what we think they are. In 2005, Maimonides Hospital in Brooklyn, New York, unveiled a new state-of-theart, 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 progress 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 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 not just the action on the ground—what happens between doctors and patients—but also the financial, ethical, technological, sociological, and cultural matters that the hospital community encounters every day. Drawing on her skills as interviewer, observer, and social critic, Salamon presents the story of modern medicine, uniquely viewed from the vantage point of those who make it run. 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 issues like adapting to the specific needs of immigrant groups that make up a large and growing portion of our society. Salamon exposes struggles of both the profound and humdrum variety. 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 system foul-ups that keep blood test results from being delivered on time, careless record keepers, shortages of everything except forms to fill, 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 and assume the utmost importance. As Martin Payson—chairman of the board at Maimonides and ex-Time-Warner vice chairman—puts it: “Hospitals have a lot in common with the movie business. You’ve got your talent, entrepreneurs, ambition, ego stroking, the business versus the creative part. The big difference is that in the hospital you don’t get second takes. Movies are make-believe. This is real life.”


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A bestselling author and award winning journalist follows a year in the life of a big urban hospital, painting a revealing portrait of how medical care is delivered in America today Most people agree that there are complicated issues at play in the delivery of health care today, but those issues may not always be what we think they are. In 2005, Maimonides Hospital in Broo A bestselling author and award winning journalist follows a year in the life of a big urban hospital, painting a revealing portrait of how medical care is delivered in America today Most people agree that there are complicated issues at play in the delivery of health care today, but those issues may not always be what we think they are. In 2005, Maimonides Hospital in Brooklyn, New York, unveiled a new state-of-theart, 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 progress 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 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 not just the action on the ground—what happens between doctors and patients—but also the financial, ethical, technological, sociological, and cultural matters that the hospital community encounters every day. Drawing on her skills as interviewer, observer, and social critic, Salamon presents the story of modern medicine, uniquely viewed from the vantage point of those who make it run. 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 issues like adapting to the specific needs of immigrant groups that make up a large and growing portion of our society. Salamon exposes struggles of both the profound and humdrum variety. 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 system foul-ups that keep blood test results from being delivered on time, careless record keepers, shortages of everything except forms to fill, 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 and assume the utmost importance. As Martin Payson—chairman of the board at Maimonides and ex-Time-Warner vice chairman—puts it: “Hospitals have a lot in common with the movie business. You’ve got your talent, entrepreneurs, ambition, ego stroking, the business versus the creative part. The big difference is that in the hospital you don’t get second takes. Movies are make-believe. This is real life.”

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

  1. 5 out of 5

    Petra-X Off having adventures

    This book was about the administration of Maimonides Hospital in New York and just about as thrilling as that sounds! It was a long, hard slog but in the same way as hill-walking is pretty hard step by step, but worth it for the view, the interesting things you see along the way and the accomplishment, quite enjoyable. It was a real eye-opener for me, a hospital which is a business first, the chosen product being health care, coming as I do from the UK where private insurance for health care is This book was about the administration of Maimonides Hospital in New York and just about as thrilling as that sounds! It was a long, hard slog but in the same way as hill-walking is pretty hard step by step, but worth it for the view, the interesting things you see along the way and the accomplishment, quite enjoyable. It was a real eye-opener for me, a hospital which is a business first, the chosen product being health care, coming as I do from the UK where private insurance for health care is an option, not the default standard. People say that you get what you pay for, that it is worth purchasing health insurance because you will be assured of a better standard of diagnosis, treatment and care. It isn't actually true. A year and a half ago my (late) mother underwent a couple of non-invasive tests in a National Health hospital that wasn't luxurious and made her wait but it was free. She waited a week for the results. She didn't want to believe the results so she went to a very high-ranking, very luxurious private hospital where endless tests were done over a three week period, some of the tests being extremely painful and $20,000 later they came up with exactly the same result as the 'free' hospital. Neither could offer her any treatment. So this book was, as I said, a real eye-opener to medicine where the money you have does make a difference and where the chief executive earns well over a $1M a year (now), as do quite a few of the medical staff and other administrators approach that figure, and they bemoan the fact that their cancer centre is losing money at the rate of $8M a year because they are failing to attract the type of patient with good insurance. No sympathy! If they cared that much, hey a small paycut for a dozen or so of them for a year or two would put the cancer centre back on its feet as the community cancer centre for Brooklynites. Community my arse, caring, my arse. Community and caring after pay. The doctors and administrators were efficient and often very empathetic but all of it was subservient to money and hospital politics. Who could jostle for the best position, who could get the most fame, who was recognised by the media as 'sexy' and charismatic and its rewards: the most money. A good career for a young person seeking to become rich, brains and manual dexterity necessary, compassion optional. So it was interesting. But hell, I do feel for those who are poor and those who aren't quite poor enough for aid but not well-off enough for insurance. I did learn one very interesting fact, that an emergency department is obliged to treat you no matter what your financial status. Like the Arab who flew all the way from the middle East, got a cab to Maimonides and went to the Emergency department knowing that his heart surgery would then be free. There's always someone, always a way to game the players! 4 May 2011

  2. 5 out of 5

    Kate

    I'm very much a biased reader, but I have to ask where are the nurses? It really should have been called Hospital Administration. The author says she spent a year observing the workings at Maimonides but not once does she talk about the employees that are the backbone of any hospital. Ignore me while I rant but, every other person quoted in the book gets named and even most get a few glib sentences about their background, appearance or character. The nurses are called just that, "said by a nurse I'm very much a biased reader, but I have to ask where are the nurses? It really should have been called Hospital Administration. The author says she spent a year observing the workings at Maimonides but not once does she talk about the employees that are the backbone of any hospital. Ignore me while I rant but, every other person quoted in the book gets named and even most get a few glib sentences about their background, appearance or character. The nurses are called just that, "said by a nurse." She gives one nurse a name. As a nurse working in a hospital I have to ask, are we part of the furniture? It calls the whole book into question because either she followed exactly what the administration wanted, and is therefore not unbiased, ignored nurses on purpose, but then needs to give a damn good reason as to why, or didn't notice the importance of the nursing staff, and is therefore an idiot.

  3. 4 out of 5

    Mikey B.

    This is a moving account of a hospital in Brooklyn. It is most rewarding when describing the plight of patients and their interactions with the doctors. To the credit of the author she never seems to take sides – or is unwilling to finger-point. There are emotional and excruciating passages – after all this is a hospital where there is death and prolonged dying. This is not a book one reads for extended durations of time (as one tends to do with a mystery novel) – it is too much to bear at times This is a moving account of a hospital in Brooklyn. It is most rewarding when describing the plight of patients and their interactions with the doctors. To the credit of the author she never seems to take sides – or is unwilling to finger-point. There are emotional and excruciating passages – after all this is a hospital where there is death and prolonged dying. This is not a book one reads for extended durations of time (as one tends to do with a mystery novel) – it is too much to bear at times. Coming from a country with universal health care – it is interesting to read how closely health-care and hospitals are linked to and a part of big business. I am not saying that health care in Canada is perfect (far from it), but some of the passages boggle – for example, patients in this Brooklyn hospital do not check-out because they cannot pay the bill and hence will not be re-admitted – these patients stay to die. A ‘referred’ patient is one who is covered by insurance and is a good business prospect. Approximately one-third of the book is focused on the upper echelons of the hospital administration. Although this provides insights into business relations - this is only giving the view from a high altitude. There is not enough about ground level workers like nurses, orderlies and maintenance people – and there are many of these people in a hospital – and these are the people who make the hospital operational. However the lives of the doctors and the intensity of their day-to-day existence is well brought out. My favourite passage on page 149 taken from a Rabbi: “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.” Also the bibliography is interesting – I am glad that ‘Of Human Bondage’ by Somerset Maugham is mentioned it is a work of eternal value.

  4. 4 out of 5

    Terrie

    Read about 1/2. This book is desperately in need of a good editor...or at least a central point. It appears to be simply a brain dump of all the information collected by the author. Long conversations are repeated in their entirety. Also, we get the fact that the hospital is unique in its cultural and ethnic diversity. The reader doesn't have to be repeatedly bludgeoned with the fact. Read about 1/2. This book is desperately in need of a good editor...or at least a central point. It appears to be simply a brain dump of all the information collected by the author. Long conversations are repeated in their entirety. Also, we get the fact that the hospital is unique in its cultural and ethnic diversity. The reader doesn't have to be repeatedly bludgeoned with the fact.

  5. 5 out of 5

    Ann

    This is big picture hospital stuff--focusing on dozens of people in a major metropolitan area (Brooklyn) where 60 languages can be spoken in the ER. Founded as a Jewish hospital, the hospital still caters to the Orthodox who live in the neighborhood, but also a plethora of immigrants--some legal and some not--and a huge number of diseases and insurance coverages or lack thereof. I am generally interested in individual patient and doctor and nurse stories, but this was a compelling big picture lo This is big picture hospital stuff--focusing on dozens of people in a major metropolitan area (Brooklyn) where 60 languages can be spoken in the ER. Founded as a Jewish hospital, the hospital still caters to the Orthodox who live in the neighborhood, but also a plethora of immigrants--some legal and some not--and a huge number of diseases and insurance coverages or lack thereof. I am generally interested in individual patient and doctor and nurse stories, but this was a compelling big picture look at a complex system that is a hospital. It includes reflections on patients from social worker, doctor, and nurse perspectives, and it includes a lot of reflection on the red tape in place that prevents poor people from getting care, plus the tensions on the hospital to get enough people with "good" insurance in the door to keep their doors open. It points out how complex health care changes are to implement--how many people need to change to say, keep the hospital cleaner or to provide free cancer testing for at risk populations. By looking at one hospital's conflicts, feuds, and successes, I felt like I learned a lot about contemporary hospitals. Salamon spent a year going to the hospital every day, observing people, trailing them, and interviewing them. She did a big picture book, but with deep knowledge. I appreciated her insights and the depth of her writing.

  6. 5 out of 5

    Laurie

    Today I enjoyed reading an article adapted from this book. I always love these New York diversity stories. http://www.nytimes.com/2008/05/11/nyr... Update: the book was interesting, but I only recommend it if you are passionately interested in reading about hospitals. I felt the author never really found the story she was looking for, and the book lacked direction. It was also difficult to keep track of the various people (hospital staff) who are introduced. The author didn't exhibit the gift of Today I enjoyed reading an article adapted from this book. I always love these New York diversity stories. http://www.nytimes.com/2008/05/11/nyr... Update: the book was interesting, but I only recommend it if you are passionately interested in reading about hospitals. I felt the author never really found the story she was looking for, and the book lacked direction. It was also difficult to keep track of the various people (hospital staff) who are introduced. The author didn't exhibit the gift of writing a memorable thumbnail sketch of each character, finding the thing that makes them unique and unforgettable. To summarize: readable but not one of your nonfiction classics. (Also, I read the book, not the CD, despite this GoodReads record.) This led me to consider which nonfiction I DO consider modern classics. I came up with my two favorite nonfiction writers: Michael Ruhlman and Anne Fadiman. Incidentally, both have written books about medical care (Walk on Water and The Spirit Catches You and You Fall Down, respectively) that are excellent.

  7. 4 out of 5

    Nette

    This really isn't a two-star book -- it's well-written and, I'm sure, very valuable -- but it wasn't what I was expecting. Policy meetings, fund-raising efforts, and departmental politics are no more interesting (to me) just because they take place in a hospital and not at Nabisco or Walmart or any other business. I was expecting more gritty, human, behind-the-scenes stories of life in a big urban hospital. But hey, my fault for not reading the blurbs and reviews more carefully! This really isn't a two-star book -- it's well-written and, I'm sure, very valuable -- but it wasn't what I was expecting. Policy meetings, fund-raising efforts, and departmental politics are no more interesting (to me) just because they take place in a hospital and not at Nabisco or Walmart or any other business. I was expecting more gritty, human, behind-the-scenes stories of life in a big urban hospital. But hey, my fault for not reading the blurbs and reviews more carefully!

  8. 5 out of 5

    Jason Robinson

    Too bogged down in statistics and numbers- more of a budgetary look at managing a hospital, the author should have focused more on stories about individual patients.

  9. 5 out of 5

    Matt

    I picked up this book hoping to get a better sense of how hospitals are run. This is not that book. There is a lot of talk about administrative politics at Maimonides Medical Center in Brooklyn, but the politics are so particular to this hospital that you can't really glean leanings about the industry as a whole just from these observations. To be frank, it is an extremely boring subject matter. I almost put the book down multiple times, but it is a testament to Salamon's writing skill that I slo I picked up this book hoping to get a better sense of how hospitals are run. This is not that book. There is a lot of talk about administrative politics at Maimonides Medical Center in Brooklyn, but the politics are so particular to this hospital that you can't really glean leanings about the industry as a whole just from these observations. To be frank, it is an extremely boring subject matter. I almost put the book down multiple times, but it is a testament to Salamon's writing skill that I slogged through to the end. Her strength comes in interviewing the major players at the hospital, but when it comes to understanding how the department's interact with each other, there is not much there. While the book gave me a very general sense of the health industry (pain management is a money loser, higher discharge rates mean higher revenues, bed turnover is a huge aspect of the business), I felt that Salamon barely scratched the surface on these kinds of interesting industry observations. If these topics were focused on more instead of how one of the chiefs feels about spirituality and medicine (this felt like an entire third of the book), it would have been much more interesting.

  10. 4 out of 5

    Anna Engel

    [2.75 stars] Some of "Hospital" is fascinating, but much of it drags. This was an in-depth look at one hospital, Maimonides, and the people who make it run, both on a day-to-day basis and in the big picture. The author goes into great detail into the personalities, work habits, and politics of hospital employees, which gets pretty tedious. I was expecting more stories about life in the hospital, rather than the individuals involved. As a result, the book starts to feel like propaganda for the hosp [2.75 stars] Some of "Hospital" is fascinating, but much of it drags. This was an in-depth look at one hospital, Maimonides, and the people who make it run, both on a day-to-day basis and in the big picture. The author goes into great detail into the personalities, work habits, and politics of hospital employees, which gets pretty tedious. I was expecting more stories about life in the hospital, rather than the individuals involved. As a result, the book starts to feel like propaganda for the hospital. Granted, it's sort of a pro/con list, balancing the idiosyncrasies of one doctor against the expertise of another. I guess what I imagined was that the author would skulk around the hospital and write about what she saw, rather than scheduling meetings with people to discuss office gossip.

  11. 4 out of 5

    Erica

    I was really looking forward to this book--and then I put it down halfway through. I love books about workplaces that are unfamiliar to me, and I did find some of the actual hospital stuff interesting, especially since Maimonides is the one where I was born, and I'm very familiar with the neighborhood. But occasionally the author would add in these asides that were extremely judgemental, and it bugged me. The rest of the book would be fairly detached and objective, and then she'd introduce a per I was really looking forward to this book--and then I put it down halfway through. I love books about workplaces that are unfamiliar to me, and I did find some of the actual hospital stuff interesting, especially since Maimonides is the one where I was born, and I'm very familiar with the neighborhood. But occasionally the author would add in these asides that were extremely judgemental, and it bugged me. The rest of the book would be fairly detached and objective, and then she'd introduce a person, like assemblyman Dov Hikind, with the aside that she thinks he's actually a terrible person (that is only slightly off from the exact quote.) After it happened a few times, I put it down, because it made me trust her entire assessments of the situation less.

  12. 4 out of 5

    Nathan

    Actually, mostly just red tape and money. The inner workings of a hospital are naturally fraught with human drama and literal life-and-death situations, so it's a shame that Salamon couldn't make this more engaging. She focuses on the bureaucratic wrangling of doctors and directors and neglects the human interest, to a large extent, of the patients themselves. Maybe if you work in medicine, this will resonate more deeply with you than it did with me. I wandered numbly through it, waiting to be m Actually, mostly just red tape and money. The inner workings of a hospital are naturally fraught with human drama and literal life-and-death situations, so it's a shame that Salamon couldn't make this more engaging. She focuses on the bureaucratic wrangling of doctors and directors and neglects the human interest, to a large extent, of the patients themselves. Maybe if you work in medicine, this will resonate more deeply with you than it did with me. I wandered numbly through it, waiting to be moved in some way, and never really was.

  13. 5 out of 5

    Nancy

    Fascinating look at the bureaucracy of a hospital, but not just any hospital--a hospital that encompasses one of the most diverse populations in the country or the world. It was a very interesting read. I define a good non-fiction read as one that makes me want to learn more about the topic--or any part of it. I found myself looking up many aspects of the story as I read. READS Audio: https://reads.overdrive.com/reads-was... Fascinating look at the bureaucracy of a hospital, but not just any hospital--a hospital that encompasses one of the most diverse populations in the country or the world. It was a very interesting read. I define a good non-fiction read as one that makes me want to learn more about the topic--or any part of it. I found myself looking up many aspects of the story as I read. READS Audio: https://reads.overdrive.com/reads-was...

  14. 5 out of 5

    Christine

    I'm not done with this non-fiction book yet, but it is intriguing and well-written by the well-known journalist Julie Salamon. Comparing Mamoinides to life at St. Vincent's is a trip, and it was a real bargain on remainder at the CCC bookstore for only 4.95 (originally in hardback) for $25.95! I'm not done with this non-fiction book yet, but it is intriguing and well-written by the well-known journalist Julie Salamon. Comparing Mamoinides to life at St. Vincent's is a trip, and it was a real bargain on remainder at the CCC bookstore for only 4.95 (originally in hardback) for $25.95!

  15. 5 out of 5

    Erik M

    3.75/5, rounded up I guess I didn't know exactly what I was in for, expecting more of an "in the trenches" account of a major urban hospital. Instead, HOSPITAL gives us more the bird's eye view of the Maimonides Medical Center in Brooklyn, every so often touching down with a patient, doctor, nurse, administrator, providing a slice of life that compliments the larger story. The author is also far more present in the book than anticipated, but only a few times does that throw you out of the narrati 3.75/5, rounded up I guess I didn't know exactly what I was in for, expecting more of an "in the trenches" account of a major urban hospital. Instead, HOSPITAL gives us more the bird's eye view of the Maimonides Medical Center in Brooklyn, every so often touching down with a patient, doctor, nurse, administrator, providing a slice of life that compliments the larger story. The author is also far more present in the book than anticipated, but only a few times does that throw you out of the narrative she's building. It's a time capsule of a sort, written in the shadow of 9/12, several years prior to passage of the ACA/Obamacare, and more than a decade before our present renewed debate over health care, insurance, cost, and what they mean in the US. For all that, not much has changed.

  16. 5 out of 5

    Jwt Jan50

    The daughter was working as an Emergency Room Tech and getting ready to start a PA program. Dad figured he should read up. This wasn't what I was looking for, but good background. Provided some discussion points with the daughter and now that she is a PA - a lot of this turned out to be good information for her as she works across hospitals in her urban area. Not a bad place to get background on a modern hospital, but you need to be a motivated reader. Or maybe from Brooklyn. The daughter was working as an Emergency Room Tech and getting ready to start a PA program. Dad figured he should read up. This wasn't what I was looking for, but good background. Provided some discussion points with the daughter and now that she is a PA - a lot of this turned out to be good information for her as she works across hospitals in her urban area. Not a bad place to get background on a modern hospital, but you need to be a motivated reader. Or maybe from Brooklyn.

  17. 5 out of 5

    Patrick

    The book is about hospital politics in Maimonides hospital in Brooklyn New York. I thought the book was simply okay some interesting stories other stories were petty and uninspiring unworthy of being stories about the healer class.

  18. 4 out of 5

    Rav Sav

    An interesting look at a year spent at the Maimonides Medical Center in Brooklyn. Reads more like a documentary, if that makes sense, but offers a fascinating look at how incredibly complex running a hospital is.

  19. 5 out of 5

    Dee

    The writing is not bad but I just couldn’t bring myself to care so much about the political lives and maneuverings of hospital administrators. And that’s all this book is about. It just wasn’t for me.

  20. 5 out of 5

    TJ

    Interesting. Not quite what I expected

  21. 4 out of 5

    Rosanna

    Couldn't finish it, it was so boring. Not at all what the cover and (long) title suggested. It was all about the administration people, and I couldn't remember who was who. Couldn't finish it, it was so boring. Not at all what the cover and (long) title suggested. It was all about the administration people, and I couldn't remember who was who.

  22. 4 out of 5

    Farah

    I am unsure what this book was trying to do/say.

  23. 4 out of 5

    Carin

    While I never was able to pronounce the name of Maimonides Hospital in Brooklyn, I thoroughly enjoyed reading about it. The last bit of the subtitle: "and Diversity on Steroids" initially had me rolling my eyes, and even made me think twice about buying the book, as it seemed flip and unserious, but after reading it, it's quite seriously true and was the fact about the hospital that left the biggest impression on me. Now I lived in Queens for five years, so I thought I knew diversity, but what Ma While I never was able to pronounce the name of Maimonides Hospital in Brooklyn, I thoroughly enjoyed reading about it. The last bit of the subtitle: "and Diversity on Steroids" initially had me rolling my eyes, and even made me think twice about buying the book, as it seemed flip and unserious, but after reading it, it's quite seriously true and was the fact about the hospital that left the biggest impression on me. Now I lived in Queens for five years, so I thought I knew diversity, but what Mainmonides has to deal with on a daily basis is truly astonishing. More than seventy languages are regularly spoken by patients, and the hospital needs to have translators in all of those languages. The cafeteria is kosher and also serves goat and Chinese food - but you can't get a cheeseburger. One elevator is set up that on Saturdays (the Sabbath), Orthodox Jews won't have to push the buttons in it - it just stops at every single floor. The difficulties and complications of dealing with such a variety of religions, ethnicities, and backgrounds floored me. Unlike all other books about the medical field that I've read, this one is not from the point of view of a doctor. Ms. Salamon is a journalist and has as much understanding of the medicine going on, as I do. So understandably she focuses on the other lay people in the hospital - the administrators and staff. Running a business of this size with this quantity of employees and moving parts is a daunting task, which was made worse by the brand-new CEO being in a terrible car accident just weeks after taking over, yet she impressively muscled on with her duties, despite pain and multiple surgeries. She was a rather prickly person as well, with a variety of odd quirks, and yet she seemed to have a handle on things even if not everyone liked the way she worked. In a lot of ways, this book reminded me of different offices I've worked in, with the politics, personality conflicts, and endless meetings which showed that a hospital is not some glorified exalted workplace, but just a regular, normal business environment where the business happens to be saving lives. With an extra-large cast of characters, I was at times confused, and yet I found it fairly easy reading (and there's a helpful list of the people at the beginning). It's not for someone looked for a light read or a medical thriller, but it is a must-read for anyone looking to go into the medical field, to learn more about what their day-to-day workplace will be like.

  24. 4 out of 5

    Lynh

    The first chapter was really interesting. It made me think I was going to get a lot of interesting perspective. I think I thought I was getting an idea of a hospital from a medical student / doctor/ nurse's / administrator's / outsider's / community member's / immigrant's point of view. The anatomy of a hospital, I guess? Instead this book turned into one about its politics. The politics behind building a new cancer wing, the dissent between separate specialized practices over money and personal The first chapter was really interesting. It made me think I was going to get a lot of interesting perspective. I think I thought I was getting an idea of a hospital from a medical student / doctor/ nurse's / administrator's / outsider's / community member's / immigrant's point of view. The anatomy of a hospital, I guess? Instead this book turned into one about its politics. The politics behind building a new cancer wing, the dissent between separate specialized practices over money and personality, and how to shepherd a "star" doctor from one hospital to another. Less universality of experience and more (in my opinion) petty drama. Yeah, it takes place in a hospital. Kind of like opening a yankees / sports book expecting to hear about people like joe dimaggio and babe ruth and instead learning about how their agents decided to compensate them. is it really a surprise that our health care system is grossly inefficient? and that hospitals have figured out how to work the health care system to make money off of terminally ill immigrants? Maybe the only interesting piece of information is that when you donate to a hospital, your healthcare may help purchase software that will help them increase bed turnover. $200,000 software. So in conclusion, if you're one of those people who romanticizes medicine you should check this out. Like, "hey, you thought you were avoiding an awful office job by becoming a doctor? Guess what? You're simply moving from beezelbub to lucifer!" Maybe I didn't give this enough of a chance - it was really well reviewed by the new york times. the review is here, for those who are interested, http://www.nytimes.com/2008/07/06/boo... I should have been more skeptical - can you really trust a reviewer who says, "To me, the big surprise in this book — I can hear the doctors out there laughing — is how much hospitals, even nonprofit community hospitals like Maimonides, think about money." probably not.

  25. 4 out of 5

    miteypen

    There was far too much about hospital politics in this book and not enough about what a hospital stands for: healing. (Or at least should stand for--after reading Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids, I wasn't so sure.) Not that the administrative side of running a hospital wasn't interesting, but in my opinion the author overdid it (or should have titled it differently!). I think the book would have been better if the aut There was far too much about hospital politics in this book and not enough about what a hospital stands for: healing. (Or at least should stand for--after reading Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids, I wasn't so sure.) Not that the administrative side of running a hospital wasn't interesting, but in my opinion the author overdid it (or should have titled it differently!). I think the book would have been better if the author had focused on one or two people instead of trying to cover all the major players because it was hard to follow so many different story lines. There are some personalities that stand out more than others, but the overall effect is dizzying. I did enjoy reading about this particular hospital: its history and background, special challenges, and overall effectiveness. It was especially interesting to learn about how the Orthodox Jewish community impacts the hospital and the health care it dispenses. To be honest, I was not left with a favorable impression of this particular hospital, which probably isn't fair because I imagine all hospitals have similar problems. I did like the suggested reading list at the back of the book. The author added the first line of each book to its listing, which I've never seen before and really enjoyed. I've put a couple of the listed books on hold at the library because I'd like to get a more well-rounded picture of what hospitals are like. I read this book right after finishing The House of Hope and Fear: Life in a Big City Hospital and although the latter book had its flaws as well, I thought it gave a better overall view of hospitals.

  26. 5 out of 5

    711Isabel B

    So far, I'm really enjoying HOSPITAL: MAN WOAMN BIRTH DEATH INFINITY, PLUS RED TAPE, BAD BEHAVIOR, MONEY, GOD, AND DIVERSITY ON STEROIDS, by Julie Salamon. It is interesting, because so far, I think that an important idea is that people can cause chaos. For example, Pamela Brier, the CEO and president of Maimonides Medical Center. She has a sort of nervous energy, where she can't sit still during a meeting. She is a strong CEO, but she also has strong ideals, which she has trouble letting down a So far, I'm really enjoying HOSPITAL: MAN WOAMN BIRTH DEATH INFINITY, PLUS RED TAPE, BAD BEHAVIOR, MONEY, GOD, AND DIVERSITY ON STEROIDS, by Julie Salamon. It is interesting, because so far, I think that an important idea is that people can cause chaos. For example, Pamela Brier, the CEO and president of Maimonides Medical Center. She has a sort of nervous energy, where she can't sit still during a meeting. She is a strong CEO, but she also has strong ideals, which she has trouble letting down a bit. That causes some form of chaos, because she has conflicts with other workers. Another place where people cause chaos is in the ER [Emergency Room]. It is completely packed. People come from all over Brooklyn. They serve a very diverse community, so diverse that they have to have translators for 67 languages. There are points where apparently the beds and gurneys in the ER are five or six deep. "Maimonides...would process 84,000 patients in Gregorius' [a resident; doctor in training] first year," According to a statistic by Steven Davidson, used a formula that "measured the concentration of humanity in terms of patients per square foot per year," Maimonides had six patients to square foot. "The average at other hospitals seeing comparable numbers of patients was two or three. The next-worst he [Steven Davidson] could find logged a mere four and a half." They had ultimate chaos. So far, the book has been very intriguing, covering Hatzolah ambulance services, and ER overcrowding to higher up issues.

  27. 4 out of 5

    Kathy

    This book covers all that goes on behind the scenes at Maimonides Hospital in NYC--as the cover says: "Man, woman, birth, death, infinity, plus red tape, bad behavior, money, God, and diversity on steroids." Quite accurate! There are eye-popping details in the area of departmental feuds over funding, the personality conflicts between doctors who are also department heads, and the incredible power & control of insurance companies. Maimonides is also unique in that it was founded by and intended t This book covers all that goes on behind the scenes at Maimonides Hospital in NYC--as the cover says: "Man, woman, birth, death, infinity, plus red tape, bad behavior, money, God, and diversity on steroids." Quite accurate! There are eye-popping details in the area of departmental feuds over funding, the personality conflicts between doctors who are also department heads, and the incredible power & control of insurance companies. Maimonides is also unique in that it was founded by and intended to serve the largest community of Hasidic Jews outside of Israel! Over time, the neighborhood has changed and now the Hasidic Jews represent only 20% of the hospital's clientele although they still exert great control over policy. 75% of the neighborhood now encompasses large populations of non- English speaking Chinese, Jamaicans, Puerto Ricans and Middle Easterners and, like most hospitals nowadays--where PR has become the overriding concern & more patients means more dollars--Maimonides struggles to appeal to these diverse groups. It was quite a fascinating book although it occasionally bogged down in corporate minutiae.

  28. 5 out of 5

    Rhonda Sue

    This is an interesting sort of expose of Maimonides Medical Center in Brooklyn. The author spent a year following folks around the hospital and more. From myriad interviews of interns to the president of the hospital and others throughout the organization, she gives you an inside look into what a community hospital deals with. In this case, you're dealing with major diversity or as she aptly states, "diversity on steroids" and 67 different languages. From a large Orthodox contingent to illegal i This is an interesting sort of expose of Maimonides Medical Center in Brooklyn. The author spent a year following folks around the hospital and more. From myriad interviews of interns to the president of the hospital and others throughout the organization, she gives you an inside look into what a community hospital deals with. In this case, you're dealing with major diversity or as she aptly states, "diversity on steroids" and 67 different languages. From a large Orthodox contingent to illegal immigrants from various countries, it is quite the challenge. I'm surprised the folks there allowed the author to shadow them around and expose personal details. Healthcare has mega challenges. Sadly, the author takes shots at political opponents and reveals her bias for left wingers. I wish authors would stay away from that line of thinking as it pollutes the story. Doctors and other healthcare workers are human like the rest of us and they are imperfect. That said, I enjoyed the anecdotes and stories of the real people in the book, the good and the bad. If you work in a hospital as an administrator in the C-Suite or a trustee, I would highly recommend this book.

  29. 4 out of 5

    Jon Silver

    Fascinating book. An in-depth and beautifully written look inside a hectic Brooklyn hospital (Maimonides), focusing mostly on the executives but also the senior doctors, residents, fellows, nurses, and other parts of this gargantuan healthcare enterprise. The accounts of the petty rivalries were juicy and a joy to read, as was learning the intricacies of positioning a hospital as a community beacon in a community as radically diverse as South Central Brooklyn. Indeed, like the hospital it descri Fascinating book. An in-depth and beautifully written look inside a hectic Brooklyn hospital (Maimonides), focusing mostly on the executives but also the senior doctors, residents, fellows, nurses, and other parts of this gargantuan healthcare enterprise. The accounts of the petty rivalries were juicy and a joy to read, as was learning the intricacies of positioning a hospital as a community beacon in a community as radically diverse as South Central Brooklyn. Indeed, like the hospital it describes (or any hospital in Brooklyn for that matter, and likely NYC or any large city), trudging through each chapter of this book is a journey through a sprawling mess. A chapter may ostensibly be about the establishment of the new cancer center, for instance, but during the chapter we are taken through the personal rivalries of the oncologists, the health misfortunes of other staff in the hospital, and a personal account of a day in the life of an ER resident. This book is all over the place, but when it was done, I felt I was in a better place than when I started.

  30. 4 out of 5

    Carolyn

    I really loved this book. As a libarian who spends 40+ hours per week in a health care setting, I usually avoid books and tv shows about hospitals. But this book was the exception that proves the rule. A nonfiction work written by a woman who was given full access to all hospital departments over a full year, it reads more like a novel than a sociological treatise. A lot was familiar -- turf battles over space, struggles for profitability -- but I also learned a lot about the inner workings of h I really loved this book. As a libarian who spends 40+ hours per week in a health care setting, I usually avoid books and tv shows about hospitals. But this book was the exception that proves the rule. A nonfiction work written by a woman who was given full access to all hospital departments over a full year, it reads more like a novel than a sociological treatise. A lot was familiar -- turf battles over space, struggles for profitability -- but I also learned a lot about the inner workings of hospitals. While many of the operational issues were universal, the multicultural environment at Maimonides Hospital in Brooklyn (and how both patients and physicians/staff dealt with it) brought up some unique and fascinating patient care dilemmas. Certainly, I've never worked at a hospital where the social workers took the administrator hostage to get more support for social programs. Hospital is not only well-written and thought-provoking, it's a fun read. I couldn't put it down.

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