Two very different doctors
are competing for a residency at Maimonides Medical Center in Brooklyn, but
they both made the same misstep: The hot-tempered South African Orthodox Jewish
leukemia survivor and the soft-spoken Pakistani Muslim both take time from
their rounds to speak to a New York Times reporter about their ambitions, brief
conversations which establish their rivalry even while they never mention their
competitors directly. These are the sort of chamber dramas that pepper the
non-fiction profile Hospital: Man, Woman, Birth, Death, Infinity, Plus Red
Tape, Bad Behavior, Money, God And Diversity On Steroids, and author Julie Salamon
draws the participants and dozens of other characters in such detail that she
can return to them a hundred pages later without having to remind readers who
they are. Her credentials have been put to good use in the service of a
surprisingly engrossing institutional portrait of the well-regarded private
hospital.
Founded by an Orthodox Jew
who lost family members in the 1918 flu pandemic, Maimonides today struggles to
balance its commitment to the Jewish community, which comprises 20 percent of
its patients—and which lobbied successfully for the hospital to serve
exclusively kosher food—and its increasingly diverse neighbors. In the
year Salamon reports from the hospital, eavesdropping on conversations, joining
training seminars, and even attending funerals, she chronicles the
institution's changes under the leadership of a new president, as excellent to
some as she is alienating to others. In addition, a new cancer center intended
to compete with better-known Manhattan institutions like NYU or Sloan-Kettering
strains to pick up momentum and justify the flood of donations which
established it. Salamon tracks the changes in hospital policy from the top
down, consulting with nurses and interns who see first-hand the results of
minute adjustments in the office wing.
Hospital is essentially the
biography of a bureaucracy, but that description doesn't do the book justice.
Salamon has a knack for catching her subjects unawares, from an anesthesiology
chief's gaffe in a seminar on respect to a social worker's description of when
a patient is "encouraged" to leave the hospital. Some of her attempts to shape
the book as a whole become heavy-handed, like the intermittent quotes from a
first-year intern's e-mail dispatches revealing his adjustment to New York
life, but Salamon tackles issues like the treatment of the uninsured and the
implementation of new technology with a fluid grace that improves its clumsy
subject.