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Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids
A bestselling author and award winning journalist follows a year in the life of a big urban hospital, painting a revealing portrait of how medical care is delivered in America today.
Most people agree that there are complicated issues at play in the delivery of health care today, but those issues may not always be what we think they are. In 2005, Maimonides Hospital in Brooklyn, New York, unveiled a new state-of-theart, multimillion-dollar cancer center. Determined to understand the whole spectrum of factors that determine what kind of medical care people receive in this country, bestselling author Julie Salamon spent one year tracking the progress of the center and getting to know the characters who make the hospital run. Located in a community where sixty-seven different languages are spoken, Maimonides is a case study for the particular kinds of concerns that arise in institutions that serve an increasingly multicultural American demographic. Granted an astonishing “warts and all” level of access by the hospital higher-ups, Salamon followed the doctors, patients, administrators, nurses, ambulance drivers, cooks, and cleaning staff. She explored not just the action on the ground—what happens between doctors and patients—but also the financial, ethical, technological, sociological, and cultural matters that the hospital community encounters every day.
Drawing on her skills as interviewer, observer, and social critic, Salamon presents the story of modern medicine, uniquely viewed from the vantage point of those who make it run. She draws out the internal and external political machinations that exist between doctors and staff as well as between hospital and community. And she grounds the science and emotion of medical drama in the financial realities of operating a huge, private institution that must contend with issues like adapting to the specific needs of immigrant groups that make up a large and growing portion of our society.
Salamon exposes struggles of both the profound and humdrum variety. There are bitter internal feuds, warm personal connections, comedy, egoism, greed, love, and loss. There are rabbinic edicts to contend with as well as imams and herbalists and local politicians. There are system foul-ups that keep blood test results from being delivered on time, careless record keepers, shortages of everything except forms to fill, recalcitrant and greedy insurance reimbursement systems, and the surprising difficulty of getting doctors to wash their hands.
This is the dynamic universe of small and large concerns and personalities that, taken together, determine the nature of our care and assume the utmost importance. As Martin Payson—chairman of the board at Maimonides and ex-Time-Warner vice chairman—puts it: “Hospitals have a lot in common with the movie business. You’ve got your talent, entrepreneurs, ambition, ego stroking, the business versus the creative part. The big difference is that in the hospital you don’t get second takes. Movies are make-believe. This is real life.”
Most people agree that there are complicated issues at play in the delivery of health care today, but those issues may not always be what we think they are. In 2005, Maimonides Hospital in Brooklyn, New York, unveiled a new state-of-theart, multimillion-dollar cancer center. Determined to understand the whole spectrum of factors that determine what kind of medical care people receive in this country, bestselling author Julie Salamon spent one year tracking the progress of the center and getting to know the characters who make the hospital run. Located in a community where sixty-seven different languages are spoken, Maimonides is a case study for the particular kinds of concerns that arise in institutions that serve an increasingly multicultural American demographic. Granted an astonishing “warts and all” level of access by the hospital higher-ups, Salamon followed the doctors, patients, administrators, nurses, ambulance drivers, cooks, and cleaning staff. She explored not just the action on the ground—what happens between doctors and patients—but also the financial, ethical, technological, sociological, and cultural matters that the hospital community encounters every day.
Drawing on her skills as interviewer, observer, and social critic, Salamon presents the story of modern medicine, uniquely viewed from the vantage point of those who make it run. She draws out the internal and external political machinations that exist between doctors and staff as well as between hospital and community. And she grounds the science and emotion of medical drama in the financial realities of operating a huge, private institution that must contend with issues like adapting to the specific needs of immigrant groups that make up a large and growing portion of our society.
Salamon exposes struggles of both the profound and humdrum variety. There are bitter internal feuds, warm personal connections, comedy, egoism, greed, love, and loss. There are rabbinic edicts to contend with as well as imams and herbalists and local politicians. There are system foul-ups that keep blood test results from being delivered on time, careless record keepers, shortages of everything except forms to fill, recalcitrant and greedy insurance reimbursement systems, and the surprising difficulty of getting doctors to wash their hands.
This is the dynamic universe of small and large concerns and personalities that, taken together, determine the nature of our care and assume the utmost importance. As Martin Payson—chairman of the board at Maimonides and ex-Time-Warner vice chairman—puts it: “Hospitals have a lot in common with the movie business. You’ve got your talent, entrepreneurs, ambition, ego stroking, the business versus the creative part. The big difference is that in the hospital you don’t get second takes. Movies are make-believe. This is real life.”
384 pages, Hardcover
First published May 19, 2008
44 people are currently reading
1200 people want to read
About the author
Julie Salamon
22 books93 followersJulie Salamon has written thirteen books in many genres, including Unlikely Friends, an Audible Original released summer 2021. Her new children's book One More Story, Tata, illustrated by Jill Weber, was published by Astra's Minerva imprint in July 2024. She is working on a nonfiction book for Ann Godoff at The Penguin Press, that involves the crisis of urban homelessness and its intersection with history. Julie's other books include New York Times bestsellers Wendy and the Lost Boys and The Christmas Tree (illustrated by Jill Weber) as well as Hospital, The Devil’s Candy, Facing the Wind , The Net of Dreams , Innocent Bystander and Rambam’s Ladder. She has written two children's books, Mutt's Promise, and Cat in the City, also illustrated by Jill Weber. Julie was a reporter and then the film critic for The Wall Street Journal and then a television critic and reporter on the staff of the New York Times. Julie is a graduate of Tufts University and New York University School of Law. She is chair of the BRC, a social services organization in New York City that provides care for people who are homeless and may suffer from addiction or mental disease.. Born in Cincinnati and raised in Seaman, Ohio, a rural town of 800; in 2008 she was inducted into the Ohio Women’s Hall of Fame. New York City has long been home; she lives in downtown Manhattan with her husband Bill Abrams, executive director of Trickle Up. They have two children, Roxie and Eli, and a dog named Frankie, most recent in a long line of feline and canine friends.
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Displaying 1 - 30 of 127 reviews
May 6, 2015
This book was about the administration of Maimonides Hospital in New York and just about as thrilling as that sounds! It was a long, hard slog but in the same way as hill-walking is pretty hard step by step, but worth it for the view, the interesting things you see along the way and the accomplishment, quite enjoyable.
It was a real eye-opener for me, a hospital which is a business first, the chosen product being health care, coming as I do from the UK where private insurance for health care is an option, not the default standard.
People say that you get what you pay for, that it is worth purchasing health insurance because you will be assured of a better standard of diagnosis, treatment and care. It isn't actually true. A year and a half ago my (late) mother underwent a couple of non-invasive tests in a National Health hospital that wasn't luxurious and made her wait but it was free. She waited a week for the results. She didn't want to believe the results so she went to a very high-ranking, very luxurious private hospital where endless tests were done over a three week period, some of the tests being extremely painful and $20,000 later they came up with exactly the same result as the 'free' hospital. Neither could offer her any treatment.
So this book was, as I said, a real eye-opener to medicine where the money you have does make a difference and where the chief executive earns well over a $1M a year (now), as do quite a few of the medical staff and other administrators approach that figure, and they bemoan the fact that their cancer centre is losing money at the rate of $8M a year because they are failing to attract the type of patient with good insurance.
No sympathy! If they cared that much, hey a small paycut for a dozen or so of them for a year or two would put the cancer centre back on its feet as the community cancer centre for Brooklynites. Community my arse, caring, my arse. Community and caring after pay. The doctors and administrators were efficient and often very empathetic but all of it was subservient to money and hospital politics. Who could jostle for the best position, who could get the most fame, who was recognised by the media as 'sexy' and charismatic and its rewards: the most money. A good career for a young person seeking to become rich, brains and manual dexterity necessary, compassion optional.
So it was interesting. But hell, I do feel for those who are poor and those who aren't quite poor enough for aid but not well-off enough for insurance.
I did learn one very interesting fact, that an emergency department is obliged to treat you no matter what your financial status. Like the Arab who flew all the way from the middle East, got a cab to Maimonides and went to the Emergency department knowing that his heart surgery would then be free. There's always someone, always a way to game the players!
4 May 2011
It was a real eye-opener for me, a hospital which is a business first, the chosen product being health care, coming as I do from the UK where private insurance for health care is an option, not the default standard.
People say that you get what you pay for, that it is worth purchasing health insurance because you will be assured of a better standard of diagnosis, treatment and care. It isn't actually true. A year and a half ago my (late) mother underwent a couple of non-invasive tests in a National Health hospital that wasn't luxurious and made her wait but it was free. She waited a week for the results. She didn't want to believe the results so she went to a very high-ranking, very luxurious private hospital where endless tests were done over a three week period, some of the tests being extremely painful and $20,000 later they came up with exactly the same result as the 'free' hospital. Neither could offer her any treatment.
So this book was, as I said, a real eye-opener to medicine where the money you have does make a difference and where the chief executive earns well over a $1M a year (now), as do quite a few of the medical staff and other administrators approach that figure, and they bemoan the fact that their cancer centre is losing money at the rate of $8M a year because they are failing to attract the type of patient with good insurance.
No sympathy! If they cared that much, hey a small paycut for a dozen or so of them for a year or two would put the cancer centre back on its feet as the community cancer centre for Brooklynites. Community my arse, caring, my arse. Community and caring after pay. The doctors and administrators were efficient and often very empathetic but all of it was subservient to money and hospital politics. Who could jostle for the best position, who could get the most fame, who was recognised by the media as 'sexy' and charismatic and its rewards: the most money. A good career for a young person seeking to become rich, brains and manual dexterity necessary, compassion optional.
So it was interesting. But hell, I do feel for those who are poor and those who aren't quite poor enough for aid but not well-off enough for insurance.
I did learn one very interesting fact, that an emergency department is obliged to treat you no matter what your financial status. Like the Arab who flew all the way from the middle East, got a cab to Maimonides and went to the Emergency department knowing that his heart surgery would then be free. There's always someone, always a way to game the players!
4 May 2011
August 8, 2011
I'm very much a biased reader, but I have to ask where are the nurses? It really should have been called Hospital Administration. The author says she spent a year observing the workings at Maimonides but not once does she talk about the employees that are the backbone of any hospital. Ignore me while I rant but, every other person quoted in the book gets named and even most get a few glib sentences about their background, appearance or character. The nurses are called just that, "said by a nurse." She gives one nurse a name. As a nurse working in a hospital I have to ask, are we part of the furniture? It calls the whole book into question because either she followed exactly what the administration wanted, and is therefore not unbiased, ignored nurses on purpose, but then needs to give a damn good reason as to why, or didn't notice the importance of the nursing staff, and is therefore an idiot.
April 10, 2013
This is a moving account of a hospital in Brooklyn. It is most rewarding when describing the plight of patients and their interactions with the doctors. To the credit of the author she never seems to take sides – or is unwilling to finger-point. There are emotional and excruciating passages – after all this is a hospital where there is death and prolonged dying. This is not a book one reads for extended durations of time (as one tends to do with a mystery novel) – it is too much to bear at times.
Coming from a country with universal health care – it is interesting to read how closely health-care and hospitals are linked to and a part of big business. I am not saying that health care in Canada is perfect (far from it), but some of the passages boggle – for example, patients in this Brooklyn hospital do not check-out because they cannot pay the bill and hence will not be re-admitted – these patients stay to die. A ‘referred’ patient is one who is covered by insurance and is a good business prospect.
Approximately one-third of the book is focused on the upper echelons of the hospital administration. Although this provides insights into business relations - this is only giving the view from a high altitude. There is not enough about ground level workers like nurses, orderlies and maintenance people – and there are many of these people in a hospital – and these are the people who make the hospital operational.
However the lives of the doctors and the intensity of their day-to-day existence is well brought out.
My favourite passage on page 149 taken from a Rabbi: “The truth of being human is gratitude, the secret of existence is appreciation, its significance is revealed in reciprocity. Mankind will not die for lack of information; it may perish for lack of appreciation.”
Also the bibliography is interesting – I am glad that ‘Of Human Bondage’ by Somerset Maugham is mentioned it is a work of eternal value.
Coming from a country with universal health care – it is interesting to read how closely health-care and hospitals are linked to and a part of big business. I am not saying that health care in Canada is perfect (far from it), but some of the passages boggle – for example, patients in this Brooklyn hospital do not check-out because they cannot pay the bill and hence will not be re-admitted – these patients stay to die. A ‘referred’ patient is one who is covered by insurance and is a good business prospect.
Approximately one-third of the book is focused on the upper echelons of the hospital administration. Although this provides insights into business relations - this is only giving the view from a high altitude. There is not enough about ground level workers like nurses, orderlies and maintenance people – and there are many of these people in a hospital – and these are the people who make the hospital operational.
However the lives of the doctors and the intensity of their day-to-day existence is well brought out.
My favourite passage on page 149 taken from a Rabbi: “The truth of being human is gratitude, the secret of existence is appreciation, its significance is revealed in reciprocity. Mankind will not die for lack of information; it may perish for lack of appreciation.”
Also the bibliography is interesting – I am glad that ‘Of Human Bondage’ by Somerset Maugham is mentioned it is a work of eternal value.
January 28, 2009
Read about 1/2. This book is desperately in need of a good editor...or at least a central point. It appears to be simply a brain dump of all the information collected by the author. Long conversations are repeated in their entirety.
Also, we get the fact that the hospital is unique in its cultural and ethnic diversity. The reader doesn't have to be repeatedly bludgeoned with the fact.
Also, we get the fact that the hospital is unique in its cultural and ethnic diversity. The reader doesn't have to be repeatedly bludgeoned with the fact.
September 12, 2008
This really isn't a two-star book -- it's well-written and, I'm sure, very valuable -- but it wasn't what I was expecting. Policy meetings, fund-raising efforts, and departmental politics are no more interesting (to me) just because they take place in a hospital and not at Nabisco or Walmart or any other business. I was expecting more gritty, human, behind-the-scenes stories of life in a big urban hospital. But hey, my fault for not reading the blurbs and reviews more carefully!
March 20, 2017
Too bogged down in statistics and numbers- more of a budgetary look at managing a hospital, the author should have focused more on stories about individual patients.
July 11, 2011
This is big picture hospital stuff--focusing on dozens of people in a major metropolitan area (Brooklyn) where 60 languages can be spoken in the ER. Founded as a Jewish hospital, the hospital still caters to the Orthodox who live in the neighborhood, but also a plethora of immigrants--some legal and some not--and a huge number of diseases and insurance coverages or lack thereof. I am generally interested in individual patient and doctor and nurse stories, but this was a compelling big picture look at a complex system that is a hospital. It includes reflections on patients from social worker, doctor, and nurse perspectives, and it includes a lot of reflection on the red tape in place that prevents poor people from getting care, plus the tensions on the hospital to get enough people with "good" insurance in the door to keep their doors open.
It points out how complex health care changes are to implement--how many people need to change to say, keep the hospital cleaner or to provide free cancer testing for at risk populations. By looking at one hospital's conflicts, feuds, and successes, I felt like I learned a lot about contemporary hospitals.
Salamon spent a year going to the hospital every day, observing people, trailing them, and interviewing them. She did a big picture book, but with deep knowledge. I appreciated her insights and the depth of her writing.
It points out how complex health care changes are to implement--how many people need to change to say, keep the hospital cleaner or to provide free cancer testing for at risk populations. By looking at one hospital's conflicts, feuds, and successes, I felt like I learned a lot about contemporary hospitals.
Salamon spent a year going to the hospital every day, observing people, trailing them, and interviewing them. She did a big picture book, but with deep knowledge. I appreciated her insights and the depth of her writing.
March 12, 2022
HMOs put a big financial strain on hospitals because they deny a lot of admissions due to no authorization. It's a method of postponing payment to the hospital, and if the hospital doesn't appeal, there's a time element which means money in HMO pockets.
Ob/gyn a money loser: reimbursements low, malpractice premiums enormous.
Astrow: Hospitals "are almost like department stores, where some departments make money and some don't make money or lose money. If you decide to take a profit and loss mentality for the whole system, you focus on the things that make money. If you're looking at the system in that way, how you maximize profits, that makes sense. But you would think that in health care you wouldn't want to look at it that way. But the whole market ethos has become so dominant that people don't really have another way of understanding what health care is all about, and it causes all kinds of problems."
Hospital staff complains about patients who come to the hospital directly from JFK Airport, looking for free emergency room care.
The insurance companies had become as insidious and detrimental to the national health as any illness was. The contractual obligation to cover illness and catastrophe had become submerged in a growing mountain of catch-22s that seemed minted to justify nonpayment.
Read
July 5, 2008Today I enjoyed reading an article adapted from this book. I always love these New York diversity stories. http://www.nytimes.com/2008/05/11/nyr...
Update: the book was interesting, but I only recommend it if you are passionately interested in reading about hospitals. I felt the author never really found the story she was looking for, and the book lacked direction. It was also difficult to keep track of the various people (hospital staff) who are introduced. The author didn't exhibit the gift of writing a memorable thumbnail sketch of each character, finding the thing that makes them unique and unforgettable. To summarize: readable but not one of your nonfiction classics. (Also, I read the book, not the CD, despite this GoodReads record.)
This led me to consider which nonfiction I DO consider modern classics. I came up with my two favorite nonfiction writers: Michael Ruhlman and Anne Fadiman. Incidentally, both have written books about medical care (Walk on Water and The Spirit Catches You and You Fall Down, respectively) that are excellent.
Update: the book was interesting, but I only recommend it if you are passionately interested in reading about hospitals. I felt the author never really found the story she was looking for, and the book lacked direction. It was also difficult to keep track of the various people (hospital staff) who are introduced. The author didn't exhibit the gift of writing a memorable thumbnail sketch of each character, finding the thing that makes them unique and unforgettable. To summarize: readable but not one of your nonfiction classics. (Also, I read the book, not the CD, despite this GoodReads record.)
This led me to consider which nonfiction I DO consider modern classics. I came up with my two favorite nonfiction writers: Michael Ruhlman and Anne Fadiman. Incidentally, both have written books about medical care (Walk on Water and The Spirit Catches You and You Fall Down, respectively) that are excellent.
September 2, 2010
Actually, mostly just red tape and money. The inner workings of a hospital are naturally fraught with human drama and literal life-and-death situations, so it's a shame that Salamon couldn't make this more engaging. She focuses on the bureaucratic wrangling of doctors and directors and neglects the human interest, to a large extent, of the patients themselves. Maybe if you work in medicine, this will resonate more deeply with you than it did with me. I wandered numbly through it, waiting to be moved in some way, and never really was.
December 18, 2025
It is an unusual & exciting experience to read a book about the behind the scenes drama of your exact workplace
March 7, 2014
I picked up this book hoping to get a better sense of how hospitals are run. This is not that book. There is a lot of talk about administrative politics at Maimonides Medical Center in Brooklyn, but the politics are so particular to this hospital that you can't really glean leanings about the industry as a whole just from these observations.
To be frank, it is an extremely boring subject matter. I almost put the book down multiple times, but it is a testament to Salamon's writing skill that I slogged through to the end. Her strength comes in interviewing the major players at the hospital, but when it comes to understanding how the department's interact with each other, there is not much there.
While the book gave me a very general sense of the health industry (pain management is a money loser, higher discharge rates mean higher revenues, bed turnover is a huge aspect of the business), I felt that Salamon barely scratched the surface on these kinds of interesting industry observations. If these topics were focused on more instead of how one of the chiefs feels about spirituality and medicine (this felt like an entire third of the book), it would have been much more interesting.
To be frank, it is an extremely boring subject matter. I almost put the book down multiple times, but it is a testament to Salamon's writing skill that I slogged through to the end. Her strength comes in interviewing the major players at the hospital, but when it comes to understanding how the department's interact with each other, there is not much there.
While the book gave me a very general sense of the health industry (pain management is a money loser, higher discharge rates mean higher revenues, bed turnover is a huge aspect of the business), I felt that Salamon barely scratched the surface on these kinds of interesting industry observations. If these topics were focused on more instead of how one of the chiefs feels about spirituality and medicine (this felt like an entire third of the book), it would have been much more interesting.
April 7, 2024
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Across the world from athletics, developing your muscles, perhaps even remedy, having steroids is definitely some contentious trouble. With the help of comments from much better functioning not to mention rapid body steroids-usa.org progression, steroids obtain his or her's process towards the famous, with the help of plenty of services presented for the reason that "steroids available on the market. inches But, right behind typically the draw from instant rewards untruths some situation fraught with the help of negative aspects not to mention honest dilemmas.
Typically the Provide from Functioning Betterment
Steroids, or longer adequately, anabolic-androgenic steroids (AAS), are actually synthetic models of this a mans having sex hormone testosterone. Earlier introduced in your 1930s to improve medical conditions along the lines of retarded puberty not to mention body decrease owing to sicknesses prefer tumor not to mention TOOLS, steroids subsequently seen his or her's process towards the vein from functioning betterment. Joggers searching a good edge reevaluated steroids to elevate muscular body, robustness, not to mention fitness level, believing the products might possibly hugely explode it to the premium health of their respected spheres.
Typically the Negative aspects from Steroid Use
Whereas steroids might possibly send out on their provide from functioning betterment, typically the negative aspects affiliated with his or her's usage shouldn't be sublte. Extensive steroid usage cause a bunch of illness issues, among delicate towards major. Examples of these are poorly liver impairment, center factors, hormonal imbalances, infertility, not to mention mind disruptions along the lines of violence not to mention sadness. Through young ones, steroid usage are able to stunt progression not to mention affect average hormonal expansion. At the same time, typically the quest for rewards might possibly disk drive most people to have interaction through perilous practitioners along the lines of high-dose sessions not to mention polypharmacy, exacerbating typically the negative aspects a little more forward.
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Other than this negative aspects, typically the good discounts not to mention entry to steroids heighten problematic 100 % legal not to mention honest thoughts. Many cities, typically the non-medical entry to steroids might be bootlegged, with the help of major outcomes for the purpose of title, division, not to mention trafficking. It has took some clandestine economy whereby subway labs build not to mention offer for sale unregulated not to mention essentially risky products, sometimes defined as "steroids available on the market. inches No oversight not to mention good influence through this charcoal economy poses some other negative aspects towards the general public, what individuals might possibly unwittingly eat contaminated and / or counterfeit services.
What is more, having steroids through affordable athletic seems to have sparked dialogues associated with considerable take up and then the stability from athletic competing firms. Doping scandals need tarnished typically the reputations of several joggers not to mention players doubting at the legitimacy health of their feats. Typically the difficulty to ensure success and then the draw from recognition not to mention lots of money might possibly disk drive joggers to try negative aspects not to mention undermine his or her's basics looking for success.
Navigating typically the Greyish Sections
In your vein from remedy, steroids go on to take up an integral character through dealing a number of medical conditions. Because of organizing inflammatory difficulties towards assisting through hormone supplement healing, steroids make available invaluable rehabilitation amazing benefits when ever chosen below the supervision from licensed medicine and health gurus. But, perhaps even through this wording, typically the possibility use not to mention improper use looms good sized, underscoring the value from reliable prescribing practitioners not to mention calm coaching.
For the reason that the community grapples aided by the complexities associated with steroids, uncovering standard earth has become absolutely essential. Gorgeous some debt relating to particular autonomy not to mention people health problems 's no convenient chore, and yet from your should we've been towards reduce typically the harms affiliated with steroid usage. Coaching not to mention comprehension efforts can really help dispel misconceptions not to mention the wrong idea associated with steroids, empowering most people to help with making smart judgments on the subject of his or her's health and well-being. Besides that, fostering offered talk not to mention working with injure burning ideas can help through protecting typically the basic causes driving a motor vehicle steroid use, along the lines of overall body look factors not to mention societal demands.
Ending
Steroids available on the market might possibly make available tantalizing hype from much better functioning not to mention vigorous improvement, nonetheless negative aspects not to mention honest dilemmas many implicate shouldn't be forgotten. Out of your future side effects in the 100 % legal not to mention moral dangers, having steroids is inside of a problematic web site from matters. As we fully grasp such murky fishing holes, from your towards prioritize healthiness, defense, not to mention stability, striving on a forthcoming the spot where the pursuit of efficiency will never can be purchased from the tremendous cost from particular well-being not to mention societal figures.
Across the world from athletics, developing your muscles, perhaps even remedy, having steroids is definitely some contentious trouble. With the help of comments from much better functioning not to mention rapid body steroids-usa.org progression, steroids obtain his or her's process towards the famous, with the help of plenty of services presented for the reason that "steroids available on the market. inches But, right behind typically the draw from instant rewards untruths some situation fraught with the help of negative aspects not to mention honest dilemmas.
Typically the Provide from Functioning Betterment
Steroids, or longer adequately, anabolic-androgenic steroids (AAS), are actually synthetic models of this a mans having sex hormone testosterone. Earlier introduced in your 1930s to improve medical conditions along the lines of retarded puberty not to mention body decrease owing to sicknesses prefer tumor not to mention TOOLS, steroids subsequently seen his or her's process towards the vein from functioning betterment. Joggers searching a good edge reevaluated steroids to elevate muscular body, robustness, not to mention fitness level, believing the products might possibly hugely explode it to the premium health of their respected spheres.
Typically the Negative aspects from Steroid Use
Whereas steroids might possibly send out on their provide from functioning betterment, typically the negative aspects affiliated with his or her's usage shouldn't be sublte. Extensive steroid usage cause a bunch of illness issues, among delicate towards major. Examples of these are poorly liver impairment, center factors, hormonal imbalances, infertility, not to mention mind disruptions along the lines of violence not to mention sadness. Through young ones, steroid usage are able to stunt progression not to mention affect average hormonal expansion. At the same time, typically the quest for rewards might possibly disk drive most people to have interaction through perilous practitioners along the lines of high-dose sessions not to mention polypharmacy, exacerbating typically the negative aspects a little more forward.
Typically the 100 % legal not to mention Honest Quagmire
Other than this negative aspects, typically the good discounts not to mention entry to steroids heighten problematic 100 % legal not to mention honest thoughts. Many cities, typically the non-medical entry to steroids might be bootlegged, with the help of major outcomes for the purpose of title, division, not to mention trafficking. It has took some clandestine economy whereby subway labs build not to mention offer for sale unregulated not to mention essentially risky products, sometimes defined as "steroids available on the market. inches No oversight not to mention good influence through this charcoal economy poses some other negative aspects towards the general public, what individuals might possibly unwittingly eat contaminated and / or counterfeit services.
What is more, having steroids through affordable athletic seems to have sparked dialogues associated with considerable take up and then the stability from athletic competing firms. Doping scandals need tarnished typically the reputations of several joggers not to mention players doubting at the legitimacy health of their feats. Typically the difficulty to ensure success and then the draw from recognition not to mention lots of money might possibly disk drive joggers to try negative aspects not to mention undermine his or her's basics looking for success.
Navigating typically the Greyish Sections
In your vein from remedy, steroids go on to take up an integral character through dealing a number of medical conditions. Because of organizing inflammatory difficulties towards assisting through hormone supplement healing, steroids make available invaluable rehabilitation amazing benefits when ever chosen below the supervision from licensed medicine and health gurus. But, perhaps even through this wording, typically the possibility use not to mention improper use looms good sized, underscoring the value from reliable prescribing practitioners not to mention calm coaching.
For the reason that the community grapples aided by the complexities associated with steroids, uncovering standard earth has become absolutely essential. Gorgeous some debt relating to particular autonomy not to mention people health problems 's no convenient chore, and yet from your should we've been towards reduce typically the harms affiliated with steroid usage. Coaching not to mention comprehension efforts can really help dispel misconceptions not to mention the wrong idea associated with steroids, empowering most people to help with making smart judgments on the subject of his or her's health and well-being. Besides that, fostering offered talk not to mention working with injure burning ideas can help through protecting typically the basic causes driving a motor vehicle steroid use, along the lines of overall body look factors not to mention societal demands.
Ending
Steroids available on the market might possibly make available tantalizing hype from much better functioning not to mention vigorous improvement, nonetheless negative aspects not to mention honest dilemmas many implicate shouldn't be forgotten. Out of your future side effects in the 100 % legal not to mention moral dangers, having steroids is inside of a problematic web site from matters. As we fully grasp such murky fishing holes, from your towards prioritize healthiness, defense, not to mention stability, striving on a forthcoming the spot where the pursuit of efficiency will never can be purchased from the tremendous cost from particular well-being not to mention societal figures.
July 17, 2015
[2.75 stars]
Some of "Hospital" is fascinating, but much of it drags. This was an in-depth look at one hospital, Maimonides, and the people who make it run, both on a day-to-day basis and in the big picture. The author goes into great detail into the personalities, work habits, and politics of hospital employees, which gets pretty tedious.
I was expecting more stories about life in the hospital, rather than the individuals involved. As a result, the book starts to feel like propaganda for the hospital. Granted, it's sort of a pro/con list, balancing the idiosyncrasies of one doctor against the expertise of another.
I guess what I imagined was that the author would skulk around the hospital and write about what she saw, rather than scheduling meetings with people to discuss office gossip.
Some of "Hospital" is fascinating, but much of it drags. This was an in-depth look at one hospital, Maimonides, and the people who make it run, both on a day-to-day basis and in the big picture. The author goes into great detail into the personalities, work habits, and politics of hospital employees, which gets pretty tedious.
I was expecting more stories about life in the hospital, rather than the individuals involved. As a result, the book starts to feel like propaganda for the hospital. Granted, it's sort of a pro/con list, balancing the idiosyncrasies of one doctor against the expertise of another.
I guess what I imagined was that the author would skulk around the hospital and write about what she saw, rather than scheduling meetings with people to discuss office gossip.
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June 17, 2011I was really looking forward to this book--and then I put it down halfway through. I love books about workplaces that are unfamiliar to me, and I did find some of the actual hospital stuff interesting, especially since Maimonides is the one where I was born, and I'm very familiar with the neighborhood. But occasionally the author would add in these asides that were extremely judgemental, and it bugged me. The rest of the book would be fairly detached and objective, and then she'd introduce a person, like assemblyman Dov Hikind, with the aside that she thinks he's actually a terrible person (that is only slightly off from the exact quote.) After it happened a few times, I put it down, because it made me trust her entire assessments of the situation less.
March 8, 2015
Life is too short to read books you don't enjoy. And for that reason I gave up on this one about half way through. I work in healthcare, I find healthcare interesting. That being said, I did not find this book interesting. There were far too many passages that I couldn't figure out why they were included. Even half way through I wasn't sure what the point was other than to be a history book for the hospital.
January 1, 2022
Fascinating look at the bureaucracy of a hospital, but not just any hospital--a hospital that encompasses one of the most diverse populations in the country or the world. It was a very interesting read. I define a good non-fiction read as one that makes me want to learn more about the topic--or any part of it. I found myself looking up many aspects of the story as I read. READS Audio: https://reads.overdrive.com/reads-was...
July 29, 2009
I'm giving up on this. Too many people to keep track of and it is all about the political in-fighting. I'd be more interested in reading about the challenges the hospital faces while serving such a diverse population.
December 16, 2009
I'm not done with this non-fiction book yet, but it is intriguing and well-written by the well-known journalist Julie Salamon. Comparing Mamoinides to life at St. Vincent's is a trip, and it was a real bargain on remainder at the CCC bookstore for only 4.95 (originally in hardback) for $25.95!
January 20, 2016
B O R I N G ZZZZZZZZZZZ
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September 16, 2024another one where the prologue was far more interesting than anything in the chapters.
In the prologue, Salamon introduces a hospital where 67 languages are spoken. They had to replace all white blankets with beige due to the Chinese superstitions that being covered in white is symbolic of death. The kitchen is fully kosher, but also there's a second kitchen with Chinese food. They have to play nice with the Jewish ambulance service, because otherwise they'll take their business elsewhere. (And the ambulance service is not there to drop off, but advocate for each patient.) This is not a hospital with a population heavy on preventive care; they deal with many late-stage diseases and situations you wouldn't find in a rural hospital.
All of that to say: there is a lot going on, and I was interested in how they might address these challenges. What challenges have they overcome, and what challenges do they still face?
The chapters, though, are heavily about the admins. Ok, fine, the admins are needed. But instead, it's about the administrator's personal and professional lives (every hospital they've ever worked at), their hobbies and families. And what everyone at work thinks of them and why.
For my purposes, I am always hoping for books that offer insights into worlds unknown. Like I said - I'm interested in stories of how they solved challenges, like business books or marketing. Stuff that makes me think about my surroundings in new ways. This book offered none of that, so I didn't make it past chapter two.
In the prologue, Salamon introduces a hospital where 67 languages are spoken. They had to replace all white blankets with beige due to the Chinese superstitions that being covered in white is symbolic of death. The kitchen is fully kosher, but also there's a second kitchen with Chinese food. They have to play nice with the Jewish ambulance service, because otherwise they'll take their business elsewhere. (And the ambulance service is not there to drop off, but advocate for each patient.) This is not a hospital with a population heavy on preventive care; they deal with many late-stage diseases and situations you wouldn't find in a rural hospital.
All of that to say: there is a lot going on, and I was interested in how they might address these challenges. What challenges have they overcome, and what challenges do they still face?
The chapters, though, are heavily about the admins. Ok, fine, the admins are needed. But instead, it's about the administrator's personal and professional lives (every hospital they've ever worked at), their hobbies and families. And what everyone at work thinks of them and why.
For my purposes, I am always hoping for books that offer insights into worlds unknown. Like I said - I'm interested in stories of how they solved challenges, like business books or marketing. Stuff that makes me think about my surroundings in new ways. This book offered none of that, so I didn't make it past chapter two.
April 10, 2025
This is a book about Maimonides Medical Center in Brooklyn, New York. The author, Julie Salamon spent a year at Maimonides observing the patients, doctors, nurses, and other staff as they interacted with each other. The book calls itself partly sociological, and it is, in describing the Hatzolah Jewish population that it serves and their strict rules which govern everything from the dairy refrigerator in the cafeteria to the elevators on the Sabbath.
The thing which I did not like about this book is that it focused quite a bit on the administrative side of the house and delicate balancing games in keeping doctors happy when one was more concerned with patients while another was more interested in donations. Patients were only discussed briefly, they were obviously not the focus of this story. But it is interesting to note, like someone else mentioned, nurses are almost entirely absent from this story, although the hospital should be absolutely teeming with them. This story is focused more on administrators and doctors, and janitors. Someone else likened this book to climbing a steep hill: a a trudge with occasional nice views. And that's about the best way to put it. The views are nice, but it's mostly a steep hill. I am giving this book three stars.
The thing which I did not like about this book is that it focused quite a bit on the administrative side of the house and delicate balancing games in keeping doctors happy when one was more concerned with patients while another was more interested in donations. Patients were only discussed briefly, they were obviously not the focus of this story. But it is interesting to note, like someone else mentioned, nurses are almost entirely absent from this story, although the hospital should be absolutely teeming with them. This story is focused more on administrators and doctors, and janitors. Someone else likened this book to climbing a steep hill: a a trudge with occasional nice views. And that's about the best way to put it. The views are nice, but it's mostly a steep hill. I am giving this book three stars.
September 30, 2019
3.75/5, rounded up
I guess I didn't know exactly what I was in for, expecting more of an "in the trenches" account of a major urban hospital. Instead, HOSPITAL gives us more the bird's eye view of the Maimonides Medical Center in Brooklyn, every so often touching down with a patient, doctor, nurse, administrator, providing a slice of life that compliments the larger story.
The author is also far more present in the book than anticipated, but only a few times does that throw you out of the narrative she's building.
It's a time capsule of a sort, written in the shadow of 9/12, several years prior to passage of the ACA/Obamacare, and more than a decade before our present renewed debate over health care, insurance, cost, and what they mean in the US. For all that, not much has changed.
I guess I didn't know exactly what I was in for, expecting more of an "in the trenches" account of a major urban hospital. Instead, HOSPITAL gives us more the bird's eye view of the Maimonides Medical Center in Brooklyn, every so often touching down with a patient, doctor, nurse, administrator, providing a slice of life that compliments the larger story.
The author is also far more present in the book than anticipated, but only a few times does that throw you out of the narrative she's building.
It's a time capsule of a sort, written in the shadow of 9/12, several years prior to passage of the ACA/Obamacare, and more than a decade before our present renewed debate over health care, insurance, cost, and what they mean in the US. For all that, not much has changed.
February 7, 2023
More of a 3.5 for me! This book is very much more about the administration and bureaucracy of an American hospital than it is about medicine. The book did lag in a few parts, especially when getting into the long-forgotten nitty gritty of some beefs (who cares?), but I appreciated the general look at the business side of things (I’m not American and find their health system baffling). I can totally see why this isn’t a book for everyone though and don’t blame anyone for giving it up. It’s a bit of a slog.
July 23, 2020
The daughter was working as an Emergency Room Tech and getting ready to start a PA program. Dad figured he should read up. This wasn't what I was looking for, but good background. Provided some discussion points with the daughter and now that she is a PA - a lot of this turned out to be good information for her as she works across hospitals in her urban area. Not a bad place to get background on a modern hospital, but you need to be a motivated reader. Or maybe from Brooklyn.
October 5, 2023
Journalists need to stop writing books. This book needs a better editor. There were so many weird tangents that had nothing important with the story. I didn't need the story of Astrow's wife. I didn't need to hear that this woman leaned forward and revealed her decolletage, these are not pertinent to the story.
March 15, 2025
This is a thorough and interesting book about various aspects of a modern hospital in an extremely diverse section of New York City. The author follows the stories of several people through a year, or even their whole lives. Recommended for those interested in medicine, social work, sociology, or business!
June 19, 2025
Started my residency at maimo this week, so figured I’d read this book about Maimonides hospital as they navigated opening a cancer center in the early 2000s on a friend’s recommendation. It was interesting as someone familiar with the hospital but not sure that it would appeal to a wider audience and is a bit dated at this point.
December 1, 2016
The book is about hospital politics in Maimonides hospital in Brooklyn New York. I thought the book was simply okay some interesting stories other stories were petty and uninspiring unworthy of being stories about the healer class.
June 24, 2019
An interesting look at a year spent at the Maimonides Medical Center in Brooklyn. Reads more like a documentary, if that makes sense, but offers a fascinating look at how incredibly complex running a hospital is.
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