Study Guide

Hospital

by Julie Salamon

Hospital Analysis

Hospital (Literary Masterpieces, Volume 2)

Julie Salamon had little interest in hospitals until a series of coincidencesa “karmic connection” (bashert in Yiddish)led her to write Hospital. First, Jo Ann Baldwin, an administrator at Maimonides Medical Center (MMC) in Brooklyn, asked to meet her after reading Rambam’s Ladder (2003), Salamon’s book about philanthropy and charity, based on the teachings of the medieval Jewish philosopher and physician Maimonides (known as Rambam to Hebrew scholars). They agreed to meet, and Salamon was impressed by Baldwin’s vivid description of the 750-bed MMC, trying to meet the needs of a constantly changing, multicultural neighborhood. A few months later, Salamon was invited by Dr. Alan Astrow, a hematologic oncologist at St. Vincent’s Hospital in Manhattan, to attend a series of lectures on the spiritual needs of patients. Astrow also had read Rambam’s Ladder. Impressed by Astrow’s sensitivity to patients, Salamon was drawn to him immediately. Soon afterward, she received an e-mail from a friend, suffering from ovarian cancer, who mentioned Astrow, a “smart and caring doctor,” and informed her that he would be moving to the new cancer center at MMC. A year after meeting Baldwin, Salamon contacted her and asked to spend a year at Maimonides, using the opening of the cancer center as the focus for a book. Pamela Brier, the president of the hospital, and Martin Payson, the chairman of the board, eventually agreed and encouraged staff to cooperate with her. They gave Salamon virtually unlimited access to personnel and patients, with the stipulation that she was to protect the privacy of patients.

Maimonides (originally Israel-Zion Hospital) had been founded a century earlier to meet the needs of Hasidic Orthodox Jewish immigrants in Borough Park, Brooklyn. Orthodox Jews still represent 20 to 25 percent of the hospital’s patients and, because of their historic ties to the hospital, they demand and wield a powerful say in its politics and practices. However, the neighborhood has come to include many other ethnic groups, including Chinese, Pakistanis, Russians, Eastern Europeans, and Hispanics. At the center of social change in the United States after 9/11, the neighborhood reflects conflicts between Jews and Muslims, Muslims and Hindus, and modernists and fundamentalists. Cultural differences patients presentlanguages, customs, health beliefs, and different care expectationsas well as their immigration and health insurance problems make extraordinary demands on administrators, staff, and caregivers. There are also conflicting demands from big business, consumers, and environmentalists.

Hospital, the result of Salamon’s year of virtual immersion in MMC, reads like a novel. Payson told her the hospital is like a film set, and Salamon has written a real-life medical drama, as vivid as any film or television series. Interactions between administrators and community; administrators and staff; and physician and staff and patients are depicted against the backdrop of their personal lives, exposing not only their strengths but also their problems, flaws, and errors. Salamon also explores the fears and heartaches of patients and families, dealing with serious illness. Her keen observations and skillful interviewsthe direct quotes are excellentreveal the acute and ongoing day-to-day personal and professional problems that dog dedicated hardworking people on the job. By focusing on selected colorful individualsphysicians, administrators, nurses, cleaners, social workers, technicians, and patientsSalamon, a consummate reporter, reveals the inner workings of the hospital, with its cross-cultural forces, its internal feuds, its situations of greed and comedy, its poignant life-and-death struggles, and its system’s politics, ethics, bureaucracy, and “screw-ups.” A helpful “cast of characters” sorts out the people through whom the story is told.

Drama in the emergency room focuses on lead character David Gregorius, a first-year resident from the Midwest and newcomer to New York City. His outgoing e-mails, “Suck Reports,”...

(The entire section is 1679 words.)

Hospital Bibliography (Literary Masterpieces, Volume 2)

Booklist 104, no. 18 (May 15, 2008): 9.

The Economist 387 (May 10, 2008): 94.

JAMA: Journal of the American Medical Association 300, no. 22 (December 10, 2008): 2679.

Kirkus Reviews 76, no. 6 (March 15, 2008): 293.

Mother Jones 33, no. 3 (May/June, 2008): 81.

The New York Times Book Review, July 6, 2008, p. 2.

Publishers Weekly 255, no. 13 (March 31, 2008): 48-49.

The Wall Street Journal 251, no. 116 (May 17, 2008): W8.