A year in the life of a hospital...

Julie Salamon was given an interesting opportunity! In Hospital, she has been able to document, from a "civilian" perspective, the workings of an institution that is influenced by seemingly all the forces of the cosmos, which come to focus on the common denominator of human illness and ultimately, death. But this work is also very much a celebration of life, and the lives that are committed to providing a measure of comfort and dignity to our very imperfect human existence.

As a physician, I didn't find that Hospital was a "must read" in order to make a better or more understanding practitioner, or to reveal some hidden truth that might be missed in the business of day-to-day practice. Residency and fellowship training are probably universally exhausting, and the clinical challenges that were presented at Maimonides Medical Center in Brooklyn seem relatively widespread in the hospitals I've had opportunity to staff. Power structures and physician personalities and grudges and egos rule large in any medical complex. The book details the frustrations of procedure and policy, but allows that reason and intuition can (on occasion) win the day, especially with certain personality-types at the helm. Hospital tells some great stories regarding the sometimes-precarious relationships (within and without the hospital) that keep the machine working, and it is worthwhile for us to consider that nothing that happens in this microcosm of society is apolitical.

However, I felt that what sets this hospital apart (and thus makes for an interesting read) is the story of its dependence on, and commitment to, a regional ethnic majority whose influence generates particular challenges for the providers and administration, and ultimately to the surrounding community in Brooklyn, New York. From automatic elevator buttons to influential ambulance drivers to kosher kitchen chefs, this hospital exists for the people of Maimonides. That said; the sheer volume of varying minority cultures arriving for care (and the accompanying mission to try to accommodate everyone) gave me pause. I think what I come back to time and again is the comment made by one of the oncology fellows from Malaysia, who had traveled the world, and within his experiences noted that America seemed to uniquely generate a patient attitude of "accommodate me" instead of "I'm grateful for the care I receive." It's hard for me to confirm this, because America is all I know.

I gave the book 4 stars--Perhaps this is unfair: I wish the story had further described the role and hospital life of the nursing staff and ancillary care providers. Within a hospital, these are the unsung heroes. I wish Julie Salamon would consider another volume that followed a year in the life of hospital nurses, from the newborn nursery to the emergency department to the ICUs and medical and surgical floors. And pharmacists who find and prevent the dosing errors, therapists, and housekeepers--these are all of my unsung heroes. A survey done at a major hospital in Salt Lake City confirmed that what made patients feel best about their stay (and what was most likely to generate high patient satisfaction) among many things, was the cleanliness of the hospital's appearance.

I came away from reading Hospital with a new understanding and a deep respect for Moses Maimonides (Rabbi Moses ben Maimon.) For a man who lived from 1135-1204, he was indeed a timeless jewel:
"Medical practice is not knitting and weaving and the labor of the hands, but it must be inspired with soul and be filled with understanding and equipped with the gift of keen observation; these together with accurate scientific knowledge are the indispensable requisites for proficient medical practice."

I highly recommend Hospital--meaty, slightly lengthy, but an enjoyable look at an institution we'll all likely experience at some point in our lives.

My favorite book of the summer was Hospital-- an extraordinary portrait of the doctors and administrators at Brooklyn's Maimonides Medical Center. Located in boro park, brooklyn (ethnically diverse but largely orthodox), Maimonides is filled w/ residents and staff who are struggling w/ many of the same issues we all struggle with: personality clashes in the workplace, political tensions, the desire to do good but also make money, ego, romance, failing health, language barriers, and the stress of being overworked... And It gets to the heart of all of my favorite themes: religion, politics, what it means to be an immigrant in the city, medicine, death, ethics, neighborhood, health, capitalism and community. And yet it still manages to feel like a light read!
Having worked in public radio for many years, this book was actually an adrenaline shot for me, reminding me of the power of story-telling and of journalism to get to the heart of all that matters most. great job!

A fascinating documentary with a drama twist of a real life Brooklyn hospital. For those who are curious about medicine and medical professionals, administrators, supportive personnel and the very sick patients who are given the best treatment regardless of their ability to pay. There are no heroes or villains in this book but the real people.
I could not put this book down until the end. Highly recommended.

I have always been fascinated by hospitals and reading this book allowed me to indulge my fascination. It basically depicts a year in the life of the administrators, doctors, social workers, and other personnel at a very busy Brooklyn hospital. Salamon depicts these characters so vividly, you'd think she was writing a novel. Her subjects definitely come alive on the page.

The primary function of the book is to depict the complexities of running a hospital. The secondary function is to depict the relationship between the hospital and the community it serves, which is traditionally centered on orthodox Jews. Thus, the book is also a fascinating study of orthodox Judaism, at least as lived out in Brooklyn. The area surrounding the hospital is increasingly multicultural (e.g., Chinese, Pakistani) and Salamon also does a great job of depicting these cultures with both clarity and sensitivity.

I have only a few caveats about the book. Much of its focus is on the hospital's cancer center, so it is very "heavy" reading material. It will have you thinking a lot about your own mortality. In no way is it a beach or bedtime read.

There is also a small section of the book concerned with "partial birth" abortion. I thought that it could have been more objective. (It seems clear from reading the section that Salamon is pro-choice, though she spares no gruesome detail in describing the procedure.)

Overall, though, I recommend this book. It packs a lot of interesting material into a reasonable number of pages. It will be a read you won't be able to put down.

Hospital is an amazing book, both as an stand-alone story and a exercise in the art of story telling. You'll enjoy "Hospital" if you enjoyed Salamon's "The Devil's Candy," only instead of experiencing juicy, morbid fascination via a Hollywood bomb, you'll experience a new sense of admiration for hospital workers and the author's talent.

In the beginning, I wondered whether it was possible for someone to bring a hospital to life. They're big, lifeless institutions that lack the drama and personality of similar organizations like a big business (Apple) with a rich history, right? Gay Talese was able to create magical stories about the Brooklyn Bridge and the New York Times, but he's Gay Talese. People loved those books and they helped form the foundation of his reputation. In my opinion, Salamon has reached that level as a storyteller with "Hospital." This is not an easy, cut-and-paste story. She pulls it off and proves she can write well about anything. Anything.

A great non- fiction book makes people do more than read to the end. With this one, I found myself searching out the origins of Hasidic vs. Orthodox Jews, and googling image after image of the characters. I HAD to see what Pam, Dr. Astrow and the others looked looked like.

Salamon became a word doctor, someone able to give life to what I considered to be nothing more than a lifeless institution. Anyone in the health care industry will relate to the travails, and those of us outside it will find a very informative snapshot into this world. As for Salamon, reading this story is like seeing Lenny Kravitz perform live; it's witnessing someone who was born with a gift and using it.

A great read. not only does this book give us an insiders look at healthcare in new york, but also shows us the struggles of new immigrants, and the problems that are facing our hospitals dealing with different languages and cultures. I think Ms. Salamom is a gifted writer and at the end of the day, you really beleive that everyone is trying to do the right thing, inspite of the red tape, bad behavior, money god and yes, diversity on steroids. Kudos to maimonides for allowing this to happen and giving us this wonderful opportunity to learn something new.

Although I was fascinated by the subject - having had relatives in the hospital, and I know many of the people mentioned, I found the book very hard to read.
There was no unifying theme, the book jumped from one subject to another. There was not a compelling narrative nor story line.
I was very disappointed!!

Do not buy this book. It makes patients look like a mass of whining, ungrateful people. Everyone from doctors to administration to hospital workers range from cynical to dissatisfied. Based on this book I would never go to this hospital.

Ive read lots of tales of doctors, nurses, patients

but this was the most boring book I have read. There was no color, hardly any case studies, no real examination of how the hospital works,
or doesnt work, and beyond brief description of the polyglot neighborhoods, devoid of human interest. The cover was interesting.

"Hospital" is an excellent discussion of contemporary health care and the multiplicity of competing needs that must be addressed if there is any hope of the system being effective. Because of its size and cultural diversity, Maimonides Medical Center provides a microcosm of what is good and not so good about the way this country provides both care and treatment. There is no simple, inexpensive or universally applicable solution to the rather tenuously controlled chaos and Julie Salamon does an excellent job of making this an experiential lesson for the reader. One of the things that stands out is the genuine desire on the part of the majority of health care workers, regardless of their job, to bring some measure of healing to the people they serve. It also tells the story of the patients and their families as individuals you care about rather than generic cases to be dispatched; which makes treatment decisions both easier and more difficult to make. This book clearly points out that there is far more to a person than their technical skills or their diagnosis and that the greatest danger is failing to at least attempt to see the multiple facets of self and others. It puts a human face on an institution that is often judged as being uncaring and opens the door for a serious and collaborative response to the we all face today.

As a physician who trained at Maimonides Hospital in Brooklyn, I found this book enjoyable....but I knew many of the physicians mentioned and it was a mini-reunion. It is amazing that the actual names are used! It gave me a keen insight into the inner workings of hospital politics and the boardroom battles that I have never witnessed. To non-physicians, the book would be somewhat boring. I am glad that I read it, but it will not be too memorable. (Dr. Warshawsky's review was very favorable (5 stars), but he is a very kind person. I am more realistic/critical!)

I am the President & CEO of a PointOne Systems, a start-up healthcare IT company ([...]), and I found Julie Salamon's book Hospital a unique and interesting peak under the hospital sheets which are either tucked so tightly you can't see it or so chaotic you can't make sense of it. However, Ms. Salamon approached the subject of diversity, economics, healthcare and human nature into an easy to read but insightful glimpse at some of our most important American issues. I included a brief review and my own perspective on my executive blog ([...]/). I highly recommend this book.

Takes what might have been a dry sociological study of a large Jewish-American metropolitan hospital and infuses it with life through well drawn vignettes of interns, executives, patients, physicians, nurses, hangers-on etc. A very moving and compelling document!

Goes on and on with background details of an endless parade of characters - I really don't know what useful point is served by the book, other than I would hate to work anywhere with a confusing multitude of languages and cultures.

Hospital is a true story: Julie Salomon spent a year being a pest around the hospital, talking to everybody and everyone, no restrictions besides not revealing patient names. She did a good job, but to anyone that has been working at hospitals, no big news: HMOs are really a pain, red tape increases and increases, physicians take home money is decreasing, personalities clash and some egos can't go inside the hospital, because they are bigger than the biggest door...Some hospitals are losing patients, patients are admited for less and less time and this is not always in their best interests. This is a good book to read if you are a hospital administrator or a young physician, still full of ideals. Mostly of those ideals will perish after fellowship anyway...

Most of us see hospitals only from a patient's bedside or though overheated TV medi-dramas. But if you want to know how these complex health care machines really work, pick up Julie Salamon's Hospital. It is a sometimes uplifiting, sometimes frightening, look at how a combustible mixture of skill, ego, money, and compassion somehow turns into good medical care.

Salamon, who spent a year roaming both the corporate offices and the patient floors of Maimonides Hospital in Brooklyn, nails it. In some ways, this place could only happen in New York, but in others, it is just like every other hospital in America. Salamon, a keen observer and writer, tells the story of Maimonides through the eyes of an unforgettable cast of characters. If you want to know what our crazy health care system means for those in the trenches, including the patients, read Hospital.

This is a fabulous book. It is easy to forget that it is not fiction; the characters and the situation and setting are fascinating and their depth and complexities so well portrayed. The story itself is at once inspiring, depressing, hopeful and overwhelming. Maimonides Hospital is unique, but really this book is about every medical practice. Over and over again I felt an odd sense that this was about my practice in a small Maine town... a practice that is homogenous in every way that is easily described in demographics, but as diverse as every face and family and experience. Ms. Salamon gets it exactly right: that health care is emotional and spiritual and about human dynamics, both beautiful and ugly. Her writing of the Maimonides story so perfectly shows how nothing is simple in health care and yet it really is all very simple. Because this book truly is about humankind and our survival together, it is certainly a great read for anyone, not just readers in the medical field. (But a must read for everyone in the medical field!) (Jennifer Oddleifson)

"Hospital" is an extraordinary accomplishment. Salamon's year at Maimonides Hospital illuminates Brooklyn, and clarifies everything. Readers will enjoy a privileged journey which inspires hope while never shrinking from the death which modern medicine cannot, and should not, defeat.

Speaking personally, every doctor will be a better doctor after they read this book.

Robert L. Cohen, MD
New York, NY

Usually when I hear someone mention health care, my eyes tend to glaze over. It's an issue that affects us all, but it's not always an interesting one. This book changed my mind about that. It offers a glimpse into the human side of health care by portraying an array of doctors, nurses, patients, administrators, and community leaders. Salamon thoroughly explains the interactions and conflicting interests of each group. She shines light on the things that are broken about health care in America and also reveals what is succeeding. Not only do I feel that I learned a great deal from reading this book, but I also found it quite entertaining. The rivalries, culture clashes, and money woes made for a satisfying read.

If you've ever been to a hospital, it would be worth your time to read Hospital.

...Julie Salamon's nonfiction writing, beginning with The Devil's Candy - still the best book about movie making I've ever read, and including her memoir about her parents' Holocaust experiences and emigration to the US, The Net of Dreams.

Salamon's writing is first-rate. The first three reviewers of this book - who also gave her five stars - actually describe the book better than I can.

Salamon is a truly "easy" writer. Reading her non-fiction is a true pleasure.

I purchased this book for my children to give to their father on Father's Day. He trained at Maimonides when we were newlyweds and I thought he would enjoy receiving it from his sons who were born there in Brooklyn.
I began to glance through it and I was compelled to cancel my appointments and read it completely. Wow, the memories came flooding back to me.
In the early and mid eighties, we spent a great deal of time interacting with a group of people who were foreign to me in both physical and spiritual identity. The Orthodox Jewish community provides an integral part of her story and it is fascinating.
Like the author, I am from Ohio. But, unlike Ms Salamon, I had no idea who Maimonides was and why would he have a hospital in Brooklyn named for him? It was a life-altering experience for me to learn the differences between various New York cultures and and this is the insight Ms Salamon provides throughout this book.
The reader becomes enthralled with the personalities of the physicians, administrators and staff and Ms Salamon is concise and accurate in recalling events that establish their identities. However, it is the wrenching descriptions of actual procedures as well as the reactions of young and terminally ill patients that keeps this book from becoming another hospital tell-all.
I am very impressed with this book and I greatly anticipate reading her earlier books and essays.

That Maimonides Medical Center granted this writer such unfettered access to the institution is indeed astonishing, and Salamon does not squander the opportunity. What she finds is a health care pressure cooker: Ludicrous insurance protocols, cultural divides among patients and an exhausted staff prone to ego and petty feuds, and sometimes profound compassion.

But General Hospital melodrama the book is not. What I found instead was an illuminating portrayal of our broken health care system, without the gross oversimplification that presidential political campaigns are apt to use in endless sound bytes.

Salamon's prose is at its best when she documents the experience of Maimonides cancer patients--real people in pain, often lacking insurance and citizenship, praying for miracles and avoiding the awful truth as best they can. Salamon thankfully avoids turning these tragic stories into overwrought narrative thread. Her voice is simple and frank, and therefore irresistible. A powerful work.

Ok so maybe I am a little biased because I actually work at the hospital where this book was conceived and written.
Seriously though, Ms. Salamon has has manged somehow to give an overview of Maimonides Hospital in Brooklyn that is both accurate and wonderfully descriptive. She has succesfully captured the flavour of Brooklyn and Maimonides in an entertaining yet authentic way.
This is not one of those PR stunts to try make Maimonides famous and rich, rather it is a soul searching account of the most horrendous and uplifting experiences that go hand in hand when an urban hospital meets multiple cultures.

At the end of the day it is a book about human emotions and human deficiencies.
Ego and humility, arrogance and compassion mixed with a healthy dose of back stabbing and genuine love for humanity.

Highly recomended.