A searing and sobering indictment of the public health care system that highlights the inequality of treatment.
In the spirit of investigative journalism, this assessment of public hospitals paints a grim picture of health care for the poor in America.
Debut author King, a former newspaper reporter, focuses primarily on Atlanta’s Grady Memorial Hospital, showing that the public hospital in general has become “the symbol of how the poor are cared for in the United States.” This book traces Grady’s history and compares it to the evolution of four other public hospitals, demonstrating the challenges such centers face in serving their communities. Grady’s story is deftly interwoven with the advents of Medicare and Medicaid and, more recently, the Affordable Care Act. Perhaps most disturbing is King’s insightful exploration of the intersection of race, poverty, and health care, particularly in the South. Grady, for example, which started as “White Grady” and “Black Grady,” was desegregated after the 1964 Civil Rights Act; still, “remnants of Grady’s segregated past lingered for years.” The larger issue, however, was Grady’s compensation for taking impoverished patients. Grady’s Emergency Room, like those of other public hospitals, couldn’t turn away patients with life-threatening ailments. King notes, however, that nonprofit and private hospitals routinely “send patients without life-threatening conditions who come to their ERs to a public hospital for what they deem to be nonemergency care.” Public hospitals typically receive payment for these poor patients via Medicaid—but in the South, “state Medicaid programs have been unusually restrictive.” In fact, the author reports, “by refusing to expand Medicaid, Georgia was leaving about $9 million a day on the table, unclaimed for use by the neediest people in the state and the hospitals that treat them.” Grady survived, writes King, because of the efforts of local business leaders rather than county or state governments. In this important book, the author more briefly recounts similar stories of the other four public hospitals: Parkland Memorial Hospital in Dallas, Jackson Memorial Hospital in Miami, the John H. Stroger Hospital of Cook County in Chicago, and Charity Hospital in New Orleans. Carefully documented, journalistically crafted, and artfully told, this account illuminates the myriad struggles of public hospitals to effectively treat the indigent. King bluntly asks: “Have we reached the point where public officials, particularly those in the South, are frozen in the ice of their own indifference when it comes to the government’s responsibility in caring for the poor?”
A searing and sobering indictment of the public health care system that highlights the inequality of treatment.Pub Date: May 31, 2016
ISBN: 978-1-944962-06-7
Page Count: 352
Publisher: Secant Publishing
Review Posted Online: May 4, 2016
Kirkus Reviews Issue: June 15, 2016
Review Program: Kirkus Indie
This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”
The powerful story of a father’s past and a son’s future.
Atlantic senior writer Coates (The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood, 2008) offers this eloquent memoir as a letter to his teenage son, bearing witness to his own experiences and conveying passionate hopes for his son’s life. “I am wounded,” he writes. “I am marked by old codes, which shielded me in one world and then chained me in the next.” Coates grew up in the tough neighborhood of West Baltimore, beaten into obedience by his father. “I was a capable boy, intelligent and well-liked,” he remembers, “but powerfully afraid.” His life changed dramatically at Howard University, where his father taught and from which several siblings graduated. Howard, he writes, “had always been one of the most critical gathering posts for black people.” He calls it The Mecca, and its faculty and his fellow students expanded his horizons, helping him to understand “that the black world was its own thing, more than a photo-negative of the people who believe they are white.” Coates refers repeatedly to whites’ insistence on their exclusive racial identity; he realizes now “that nothing so essentialist as race” divides people, but rather “the actual injury done by people intent on naming us, intent on believing that what they have named matters more than anything we could ever actually do.” After he married, the author’s world widened again in New York, and later in Paris, where he finally felt extricated from white America’s exploitative, consumerist dreams. He came to understand that “race” does not fully explain “the breach between the world and me,” yet race exerts a crucial force, and young blacks like his son are vulnerable and endangered by “majoritarian bandits.” Coates desperately wants his son to be able to live “apart from fear—even apart from me.”
This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”Pub Date: July 8, 2015
ISBN: 978-0-8129-9354-7
Page Count: 176
Publisher: Spiegel & Grau
Review Posted Online: May 5, 2015
Kirkus Reviews Issue: July 1, 2015
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A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
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