Bay Ridge's Anatomy

Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God, and Diversity on Steroids
By Julie Salamon
The Penguin Press, 363 pages, $25.95

For anyone with a healthy fear of death, disease or antibiotic-resistant bacteria, the idea of spending more than an hour in a hospital—let alone a day or a week—is deeply unnerving, about as terrifying as being forced to swim naked in a tank of leeches. It’s not just the in-your-face possibility of death at any moment, around every corner. It’s the stench of bodily fluids, the click and suck of oxygen machines, the boredom of waiting, the drama of waiting, the migraine-green hue of everything and, of course, those ubiquitous hand sanitizers that seem to do little beyond reminding you just how germ-ridden your local hospital is. No wonder the wild, life-and-death world of modern hospitals gets woefully little attention from the press.

Fortunately for the journalist Julie Salamon—as well as for those of us who fear hospitals yet crave information about them—she doesn’t seem to suffer from any crippling hospital neurosis. Indeed, in September 2005, Ms. Salamon, a former Wall Street Journal reporter and author of the Hollywood classic The Devil’s Candy (1991), blithely embarked on a yearlong reporting mission at Maimonides Medical Center in Borough Park, Brooklyn. Granted broad access to roam the halls and eavesdrop on conversations by the hospital’s brass, she embedded herself within the gears of the bureaucracy, observing everything from board meetings and budget discussions to emergency room shifts, bedside vigils and several profoundly disturbing cancer deaths. (After reading the story of a 24-year-old Hispanic mother suffering from lung cancer, I almost had to pop a Xanax, or five.) Once she’d collected a year’s worth of interviews, she bundled the whole experience into Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God, and Diversity on Steroids.

Despite its turgid subtitle, Hospital is not exactly a Grey’s Anatomy-style bodice ripper. (Or should we say, scrubs ripper?) Sure, it’s populated by some deeply kooky characters, like Dr. Cowboy Boots, the 63-year-old cardiothoracic surgeon with a Hemingway complex and leather boot fetish, and Pamela Brier, the waifish hospital president who flits around in Issey Miyake and eagerly doles out constipation advice. But Hospital is above all an earnest book, a sober examination of the workings of a decent local hospital that strives to compete with the Big Boys across the river—the Weill Cornells and the New York University Medical Centers—but often resembles nothing so much as a modern-day Tower of Babel.

The Tower of Babel aspect is of particular interest to Ms. Salamon, who dedicates chapters, if not verse, to the challenges of running a neighborhood hospital in a neighborhood (Borough Park and environs) that just happens to be cluttered with Orthodox Jews and devout Muslims, immigrants from China and immigrants from Russia, Haitians, Pakistanis, Bulgarians and dozens of other fractious, if not warring, ethnic groups. In fact, Hospital at times reads more like a book about the trials and exhilarations of 21st-century urban diversity than about, well, a hospital.

“It took just a few visits to see that Maimonides was … a petri dish of the post-9/11 world,” Ms. Salamon writes early on. And then several pages later: “There were rabbinic edicts to contend with as well as imams and herbalists and local politicians.”

Ms. Salamon milks this cross-cultural mayhem, citing it, along with various other mundane sources of contention (such as “anal-compulsive bosses” and “recalcitrant and greedy insurance-reimbursement systems”), as the force that through the green fuse drives Maimonides. Call it a chaos-theory analysis of the hospital. There’s no great villain, no overriding source of trouble or cause of evil, just a complex combination of individuals, egos, interests and cultures all rubbing up against each other, creating sparks.

“Every day at Maimonides,” Ms. Salamon writes, “I was reminded that the ‘health-care system’ wasn’t anonymous or abstract; it was the sum of individual human successes and failures, each of which could build or destroy.”

This approach has its virtues, in that Ms. Salamon comes off as an unusually balanced observer, at once loving and critical. But it also has some serious drawbacks, beginning with the fact that it doesn’t always translate very well into dramatic action or compelling narrative. Despite Ms. Salamon’s best storytelling efforts, Hospital sometimes feels diffuse, meandering. The stakes just don’t feel terribly high.

Part of the problem might be the enormity of the task she has set herself, but another part is that Ms. Salamon doesn’t seem to have embarked on her Maimonides adventure with any particular passion for the desperate, raw world of health and hospitals—a fact that she admits on the first page: “While I had visited hospitals often enough for the usual reasons, and had even been a candy striper in high school,” she writes, “I had no special interest in them.”

And yet, for all this, Hospital does offer rewards to its readers, including some classic New York characters and deeply affecting scenes. In fact, the book is not unlike the portrait Ms. Salamon draws of Maimonides itself: flawed, frustrating but capable of inspiring profound emotion.

Lizzy Ratner, now a freelance writer, was formerly a reporter at The Observer. She can be reached at books@observer.com.