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County: Life, Death and Politics at Chicago's Public Hospital
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County: Life, Death and Politics at Chicago's Public Hospital

3.9  ·  Rating Details ·  479 Ratings  ·  75 Reviews
The amazing tale of "County" is the story of one of America's oldest and most unusual urban hospitals.

From its inception as a "Poor House" dispensing free medical care to indigents, Chicago's Cook County Hospital has been both a renowned teaching hospital and the healthcare provider of last resort for the city's uninsured. COUNTY covers more than thirty years of its histo
Hardcover, 221 pages
Published May 1st 2011 by Chicago Review Press (first published 2011)
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May 17, 2012 Wealhtheow rated it liked it
Dr. David Ansell came to Chicago's Cook County Hospital right out of medical school. County had once been an institution that boasted some of the finest doctors and most competitive internships in the country. But Chicago's black population quadrupled between 1930 and 1960, and thanks to racial segration, County Hospital became the de-facto hospital for black Chicagoans. ("Racial segregation was actively enforced and many Chicago hospitals refused to serve black patients until laws like the Hill ...more
Apr 27, 2012 Happyreader rated it really liked it
Shelves: bio-and-memoir
Focused on a single Chicago hospital, I’m curious how this book would resonate with someone not familiar with County healthcare or Chicago politics. Most of the book takes place in the old hospital, which no longer exists, but it’s ultimately an indictment of our racist, inequitable national healthcare system which sadly does still exist. Best chapter in the book deals with the County patient dumping study, a hopeful example of how being brave enough to present the facts and dire consequences ca ...more
Tim Friese
Jul 08, 2013 Tim Friese rated it it was ok
The book deals with an excellent topic and has some interesting stories along the way, but overall I was put off by poor organization, less depth than I wanted in talking about the issues at hand, and a style that did not work for me - alternately rambling and preachy.

The worst part was that this book could have been so much better. There is material for a very good or even great book in there, material that I think the author didn't adequately make use of.

Still recommended for people interested
Mar 09, 2012 Deana rated it it was ok
This subject has a lot of potential, but I wish it was written by a sociologist instead of a doctor. It was written like a 5th grade essay, took about an hour and a half to read, and was sprinkled with indications that the author thinks he's a serious rebel for having worn Birkenstocks at some point in his life.
Aug 14, 2011 umang added it
I read this more for historical content than for style, so I'm not going to rate it. I was familiar with much of the County history already, but this was still a good discussion of the politics of public health care in Chicago. It was somewhat limited in scope due to the focus on the institutions with which the author has been affiliated.
Mimi Wolf
Jul 08, 2011 Mimi Wolf rated it it was amazing
If only more health practitioners would expose the travesty of our health care system. This book will make you gasp and then break down crying.
Aug 03, 2011 Nicole rated it really liked it
Great read for anyone in the health care field, in health care policy, interested in social justice issues, or even just Chicago history.
Jun 28, 2011 Bree rated it really liked it
Read a great review on NPR.
John Gurney
Dr. David Ansell was passionate about healthcare. This manifested itself in positive ways such as moving from Syracuse to Chicago in 1978 for a residency at Cook County Hospital, specifically to serve poor and minority populations. He was disgusted by the racism widespread even in late 1970s Chicago, and by the abysmal care at Cook County. No question, he was a compassionate and engaged doctor, one who advocated for his patients. But, as some of the promo blurbs say, such as the Chicago Tribune, ...more
Feb 20, 2012 Ray rated it really liked it  ·  review of another edition
My interest in "County: Life, Death and Politics at Chicago's Public Health Hospital", by David Ansell was primarily parochial, because it's about the Cook County Hospital in Chicago, near where I was born and raised. I used to pass it all the time, and it's where my cousin did his Residency. I remember some of my cousin's stories, and was curious about this other doctor's take on the hospital for Chicago's downtrodden, primarily the uninsured poor urban blacks of the inner City. I initially tho ...more
Aug 21, 2011 Lobstergirl rated it it was ok

Ansell seems to be a terrific doctor, completely dedicated to the poor, uninsured, underserved populations of Chicago, but he's a terrible writer and should have had this ghostwritten.

Black women's faces are sometimes the color of "obsidian," sometimes "mahogany," sometimes "coffee." (No midnight? Rootbeer? Teak?) Eyes are "almond-shaped" and "coal-colored." One patient's complexion darkened from "cocoa" to "steel black." The whites of her eyes went from orange to "muddy ochre." Seriously, the b
Jun 05, 2012 Kate rated it really liked it
Shelves: 2012
"Hyper-segregation and poverty in Chicago contributed to a deterioration of health in many communities. Poor health was not just the result of random acts, bad luck, bad behavior or unfortunate genetics. Deliberate public policy decisions about housing, education, parks and streets were the key drivers of racial differences in mortality. Crime kept people off the streets and limited their ability to exercise. The lack of grocery stores limited dietary choices. The lack of primary care doctors an ...more
Dec 21, 2011 Joan rated it really liked it
I was on the waiting list for this book at the library for over 2 months. I remember the waiting list being long and given how quickly I've read the book, it is remarkable that it has only taken 2 months for me to have my turn.

I expected a longer book with more of the personal memories of medical education training, but the subtitle should have been a hint - the book is much more about the problems of delivery of health care to poor and disadvantaged people. Similar books could be written, I sus
Jul 30, 2014 BMR, MSW, LSW rated it it was amazing
This book should be required reading for anyone who shoots his or her mouth off about health insurance, Medicaid, and the cost of medical care for the poor.

In the years since I switched my career path to social work, I have seen consistently how people who work in public health try to provide the best care to patients who are the least welcome and the least respected in our society.

One of the lines in Dr. Ansell's book is so poignant, it makes me teary every time I think of it. It's a quote from
Tin Lizzy
May 03, 2012 Tin Lizzy rated it liked it
I enjoyed this book, but gave it 3-stars for seeming rather light (although don't mistake that for "fluffy") in content, and a bit disjointed at points.

That said, I much appreciated Ansell's perspective and experience over the arc of County's history for which he was present, particularly viewed through the glasses of his experience of the abhorrent health care conditions and inequity that went hand-in-hand with the particular brand of segregation and racial inequity prevalent in the North in t
Dec 18, 2011 Andrea rated it liked it
Being a big fan of Chicago history (whether good, bad, or neutral), I bought this book thinking I would get a bigger insight into the history of Cook County hospital and how it became what it was/is today. I suppose the title of the book is what is most misleading in that it's not so much a book ON the hospital, but rather one doctor's experiences with life, death, and politics AT the hospital. A better name might be "County: One doctor's memoir" or something to that effect.

Overall, I didn't co
Sep 16, 2016 emmejay rated it really liked it
County is a memoir of David Ansell’s medical training and career at Chicago’s Cook County [public] Hospital from 1978-95.

It’s also a glimpse into patronage politics; healthcare economics; 1910s-era hospital design and operation; and County’s patients and staff. I had been interested to read, in Isabel Wilkerson's The Warmth of Other Suns, that the most migrated-to cities during the African-American Great Migration became America’s most severely and enduring segregated cities; that is reinforced
Dec 04, 2011 Jamie rated it liked it
Shelves: read-in-2011
A quick read about a young doctor who ends up spending the majority of his career at the Cook County Hospital. I heard Dr. Ansell talking about his book on NPR. It was a good talk, and in fact I almost feel like I got everything from the book out of his talk...the book didn't really resonate with me, perhaps because I already knew what it was going to say.

I didn't care as much about the political elements such as the endless strikes, etc., but the book makes clear that health care is critically
Sep 10, 2014 Pat rated it really liked it
Don't read this book for the prose. Read it for the powerful and disturbing exposé it is about the disparities in health care for those who are uninsured and must rely on health care provided by a public hospitals as compared to those who are insured.

Imagine waiting more than eight hours, in excruciating, but not life-threatening, pain just to see a doctor. I've never had to wait days or even weeks to get a prescription filled. Heck, I'm impatient if I have to wait 15 minutes. Dr. Ansell vividl
Oct 13, 2011 Stephanie rated it liked it
An interesting memoir. I was a little disappointed, because the book's title presented it as a study of the hospital and its workings. I expected something a bit more like "Hospital", which I read earlier this month. Instead I learned a little bit about Cook County Hospital and a lot about Dr. David Ansell's life and decisions. This was the white doctor and hospital administrator speaking on behalf of his mostly black and indigent patients. Ansell has an admirable desire to change the system and ...more
Apr 10, 2014 Hillary rated it really liked it
This book was completely not what I expected. I had thought somehow that it would be a vivid retelling of tales that took place entirely within County's walls. It was, to an extent - however, the in-house politics and maneuvering on both the clinical and administrative side were simply a backdrop for a wider view of American healthcare policy (economic and political with a large amount of racism thrown in).

The book was pretty eye-opening. A coastal person myself, I was not particularly familiar
Jun 24, 2011 Ashley rated it it was ok
This book was more one man's tirade against the political machine than it was about the history of Cook County Hospital. I lost count of how many times he mentioned that we need a Single-Payer insurance program in this country. I feel if you are going to beat a dead horse, then at least offer up a plan or idea as to how this country would be best served by adopting such a policy, and how is should be implemented. Yet he never once, in 214 pages, laid out any such plan or idea. He also belittled ...more
Dec 27, 2011 Ann rated it really liked it
A memoir about a young doctor who trained at Cook County hospital in Chicago after King said "Of all the forms of inequality, injustice in health is the most shocking and the most inhumane." The author wrote about "patient dumping," the practice of sending the uninsured (even while in labor, even while dying) to Cook County straight from the ER. This practice is now outlawed, but _County_ is a great argument for single-payer health care. (Obama is featured as he advocated for public hospitals du ...more
Mar 02, 2014 Brian rated it really liked it
As a resident of Chicago and former volunteer at the Fantus Pharmacy, I had to read this. This book will definitely be interesting to anyone involved with health-care and especially anyone who has heard about Cook County Hospital, as it highlights its failures in taking care of the uninsured public and the political struggle that hospitals like it have to face. To me, the writing was repetitive at times and led me to set it down for awhile so I could still enjoy it later, but it will instill the ...more
Jun 15, 2011 Fran rated it really liked it
I wish that everyone who thinks that health reform is unnecessary or even wrong would read this book. And certainly, everyone who thinks that universal coverage is unacceptable, would be forced to read this book. How you could sustain those beliefs in the face of the realities of this book is far beyond me. While not the best writer, this is an important story and I'm glad to have read it. While he's preaching to the choir to me, some of his experiences in Cook County hospital in the 70's were s ...more
Feb 24, 2012 Pinky rated it really liked it
Shelves: read-in-12
This book was really great - clear and easy to read even though such a difficult topic. I'll admit I was drawn to it because of my many years of watching ER. Brought home a lot of what I studied in Urban Politics, as well. In terms of a 'one payer health care' - we are not there and lives are lost. Infuriating and disgusting. Those with resources receive care, those without do not. The poor, the elderly, the mentally ill, those new to our country and the under-insured are not being treated with ...more
Oct 10, 2011 Max rated it liked it
3.5*. A brave and solid debut from a first-time author. It was well-written, albeit a bit overwrought at times with all the power verbs and descriptive language. As memoir, it was a nice book, and I know the author quite well, so that made it all the more interesting. As history, it could have been a bit more substantive. The book tended to dwell on the author's own experiences and didn't provide much in the way of deeper contextual understanding. All in all, I would recommend this book as memoi ...more
Feb 25, 2013 Liz rated it it was amazing
Shelves: non-fiction
This was a great story about the County Hospital in Chicago, IL. My husband had been treated at Cook County Hospital for a broken arm as a child and it was interesting to read how the the hospital ran behind the scenes and how that coordinated with my husbands stories of a dormitory style room. It was also sad to see how one's ethnicity and/or economic status dictated what medical services were available to Chicago's residents.

Dr. Ansell made the situation at County real and had me feel the hor
Aug 01, 2011 Mlg rated it really liked it
Shelves: non-fiction
For those who don't believe that there are two medical systems in this country: One for the rich and one for the poor, you need to read this book. The author takes us from the 1970's when he comes to County as an intern, then he stays for years, trying to improve the health care for the poor. From the long lines in the Fantus Clinic, the automatic masectomies, to the horrors of the maternity ward, Ansell saw it all and documents it in this illuminating book. Chicago machine politics, union batt ...more
Dave Collard
Feb 18, 2013 Dave Collard rated it liked it
An interesting read about Cook County Hospital in downtown Chicago. I didn't always agree with some of his political views, but I felt it was well written and informative about the complex issues facing many of the poor in Chicago. I read this after a medical rotation through the hospital, which helped me to gain some insights into the many issues in the hospital. I would recommend it for anyone in the Chicago area or involved in public health or administration.
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David A. Ansell (born 1952) is a Chicago-based physician, health activist and author whose efforts at both the national and local levels have advanced concerns about health inequities and the structure of the US health care system.
More about David A. Ansell...

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“Poor health was not just the result of random acts, bad luck, bad behavior or unfortunate genetics. Deliberate public policy decision about housing, education, parks and streets were the key drivers of racial differences in mortality. Crime kept people off the streets and limited their ability to exercise. The lack of grocery stores limited dietary choices. The lack of primary care doctors and specialists in these communities made chronic disease care more difficult. The degradation and loss of hospital services in these communities affected hospital-based outcomes. … The chronic underfunding of critical health services at Cook County Hospital and other safety-net providers contributed to these poor outcomes as well. The deleterious impact of social structures such as urban poverty and racism on health has been called 'structural violence.” 3 likes
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