Book Review of Julie Salamon’s Hospital

Julie Salamon’s book Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids presents an informative and revelatory portrayal of how medicine and the U. S. health care system operates within the confines of our modern and multicultural society. The book offers a unique perspective as the story is told from the standpoint of those who manage, organize and run the inner workings of the Maimonides Medical Centre.

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Thus offering her readers not only an investigation of the relationship between doctors and their patients but also presents the financial, multicultural and ethical concerns and issues faced by the hospital staff and patients. In her book Salamon raises the important issue of how medical institutions, which are put in place to serve and aid the sick and the wounded, are constantly competing against external and internal pressures of money and politics.

She explores the expectations imposed by a fragile health care system upon hospitals that are simply overwhelmed by the urgency and needs of their communities. This reality is presented in the very first chapter of her book where she introduces the reader to a young doctor named Gregorius who has come to Maimonides Medical Center to complete his residency. Here the reader is given the first impressions of the new comer who describes the emergency area as “Crowded. Really crowded.
Stretchers with patients were lined up two-and three-deep, with the lucky ones semi-secluded behind curtains that barely closed…had he landed in the Third World country or a developing nation…” (p. 16) Salamon reveals that “Overcrowding had become commonplace in American emergency rooms which had, for people without medical insurance, become the doctor’s office. ” (p. 16) She reveals a system which encourages the over flooding of emergency rooms with paying patients who are then rushed through the process of discharge as quickly as possible, so as to create a continual flow of turn over, she says admits one doctor.
(p. ) Consequently, the continual over flooding then leads to a destructive cycle of nurses and doctors mending the ill and the wounded at a hurried pace thus giving way to possible neglect and carelessness of patient care and the eventual overload and burnout of the medical staff. In her book, Salamon conveys how the infrastructure within our health care system is being governed by a marketplace philosophy whereby doctors are just as concerned about profits and reimbursements as they are about delivering care.
How efficient is a system which is more concerned with getting patients out the door than allowing them to fully recover in an environment which has their best interest at heart. Not only has the system been shown to be faulty and inefficient but on what level is the process to be challenged in respect to morality? Should society look the other way simply because in the end the patient does receive care and survives? Overall Salamon offers an emotional account of the trials and tribulations of the various medical and administrative staff of the Maimonides Medical Centre.
However, Salamon’s investigation of the inner workings of urban hospitals neglects to demonstrate how certain financial and social issues plague the average American seeking hospital treatment. The topic of the uninsured and their treatment within the hospital setting is barely spoken of by Salamon; she fails to address the issues that afflict so many lower and middle class individuals who are clearly dissuaded from showing up at local hospitals simply because they do not have insurance.
Instead she chooses to present the reader with a medical staff that is focused on the individual patient rather than with the larger social issues which doesn’t make very much sense for a book whose main purpose is to investigate the functioning of the U. S. health care system. In summary, the fact of the matter is that one day either you or a loved one will be a patient in a hospital and despite the fact that you were led to believe that hospitals are institutions free of any bureaucracy, politics and cultural influence this is simply not the case.
The medical attention received by any individual within the United Sates health care system is inevitably influenced by the multiculturalism that surrounds us, the constant evolution of technology and the economics which engulfs any private or public institution. These are aspects which as demonstrated in Salamon’s book, prevail even in a non-profit medical facility like the Maimonides Medical Centre. References Salamon, J. (2008). Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids. N

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