Life, death and dollars in a small American town
By Brian Alexander
The disease problem is perverse. In too many cases, medical interventions are ineffective dressings. Other factors, like your position in the social, racial, and economic pecking order – and the zip code you were born into – determine your health much more. As Bertolt Brecht so aptly put it, in his “discourse from the worker to a doctor”:
When we are sick we hear
You are the one who will heal us.
When we come to you
Our rags are torn off
And you pat around our naked bodies.
As to the cause of our illness
A glance at our cloths
tell you more. It’s the same cause that wears out
Our bodies and our clothes.
In “The Hospital: Life, Death, and Dollars in a Small American Town,” Brian Alexander shares this reality from the roost of a struggling rural hospital, known to his community of Bryan, Ohio, as the name of “first aid station”. As the nonprofit hospital struggles to remain solvent and independent, each day brings new heartbreaking stories. From the tension-filled strategic planning meetings of the C-suite to the life and death moments at the bedside, Alexander agile and captivatingly translates the Byzantine world of American healthcare into a real-life narrative with people whose you care.
Reporting over a two-year period, which only ended last August, Alexander visited examination rooms, patient homes and pathology labs, and rode with the teams of ambulance. It provides an in-depth investigative account that chronicles the staff of nurses, doctors, technicians, and administrators trying to keep Northwestern Ohio patients alive.
You will be supporting the hospital CEO who tiptoes around minefields and the immigrant doctors who are decidedly unwelcome in Trump country, even as they are doing their best. But the work is exhausting and the lives are almost unbelievably hard to save. In sensitive portraits, Alexander explains how patients get sicker as care is delayed, costs spiral out of control, and too often patients die from preventable deaths. The whole disorder is rife with a malignancy of despair. Everyone in this story is drowning.
Just as Brecht captured him in 1938, what often makes patients sick are conditions we don’t see – or choose not to see. Alexander identifies them with surgical precision, the underlying pathogens of pernicious poverty and the growing chasm of income inequality. Add in systematic racism, early childhood trauma, and inequitable access to healthy food, clean air, and high quality health care, and you have a perfect storm.