The Hospital

Life, Death, and Dollars in a Small American Town

By: Brian Alexander

Narrated by: Nick Landrum

Length: 14 hrs and 51 mins

Publisher's summary

An intimate, heart-wrenching portrait of one small hospital that reveals the magnitude of America’s health care crises.

“With his signature gut-punching prose, Alexander breaks our hearts as he opens our eyes to America’s deep-rooted sickness and despair by immersing us in the lives of a small town hospital and the people it serves." (Beth Macy, bestselling author of Dopesick)

By following the struggle for survival of one small-town hospital, and the patients who walk, or are carried, through its doors, The Hospital takes listeners into the world of the American medical industry in a way no audiobook has done before. Americans are dying sooner, and living in poorer health. Alexander argues that no plan will solve America’s health crisis until the deeper causes of that crisis are addressed.

Bryan, Ohio's hospital, is losing money, making it vulnerable to big health systems seeking domination and Phil Ennen, CEO, has been fighting to preserve its independence. Meanwhile, Bryan, a town of 8,500 people in Ohio’s northwest corner, is still trying to recover from the Great Recession. As local leaders struggle to address the town’s problems, and the hospital fights for its life amid a rapidly consolidating medical and hospital industry, a 39-year-old diabetic literally fights for his limbs, and a 55-year-old contractor lies dying in the emergency room. With these and other stories, Alexander strips away the wonkiness of policy to reveal Americans’ struggle for health against a powerful system that’s stacked against them, but yet so fragile it blows apart when the pandemic hits. Culminating with COVID-19, this audiobook offers a blueprint for how we created the crisis we're in.

A Macmillan Audio production from St. Martin's Press

"A brilliantly imaginative and creative way of telling the story of today's America and the roots of what ails it, through the travails of a small-town hospital. In The Hospital, Brian Alexander does again so well what he did in Glass House - telling the big story from the small place." (Sam Quinones, author of Dreamland: The True Tale of America's Opiate Epidemic)

©2021 Brian Alexander (P)2021 Macmillan Audio

Critic reviews

“With his signature gut-punching prose, Alexander breaks our hearts as he opens our eyes to America’s deep-rooted sickness and despair by immersing us in the lives of a small town hospital and the people it serves.“ (Beth Macy, best-selling author of Dopesick)

“In this clear-eyed biography of a community hospital, Brian Alexander offers a powerful indictment of the American health care system. The Hospital will break your heart.” (Andrea Pitzer, author of One Long Night)

interesting listen

Interesting listen. The narrator needs to learn how to pronounce some of the cities correctly, most notibly Lima

amazing insight into the American Pathology

great book that provides an incredible look into the conditions that lower american life expectancy and increase cost

Wow! Makes you really think about our HC system

Grew up in Ohio and used to work for a local hospital in Ohio. Wow have things change. I love the way the author weaves the socioeconomic maladies of our county with that of the Bryan hospital. Thoroughly written and researched. Unfortunately the narrator should have spent a little time in Ohio and learned how to pronounce some of our Senator and city names.

Everyone should read this book

This book is so very important and explains a lot of the problems in healthcare and our society at large. My only criticism is the narrator's mispronunciation of some Ohio specific words. Still, I am recommending this book to everyone.

Must read

Well written, well read audible book. I learned much about the complexities of the health care system. Sadly, the author’s assumption that a single payer government run insurance plan as the panacea to solve all that is wrong, seems simplistic and naive. Systems like Kaiser Permanente, Imtermountain Health, and others show that integrated health care delivery systems which include insurance plans work to reduce cost and improve quality.
Still the book is a must read.

A facinating look at the failure if American health care

I started this book thinking I would learn about the struggles that have lead to the closures of so many rural hospitals. I did get that view, but I learned even more about hoe badly our healthcare system is failing the American public.

The unfortunate story of real medicine in America

I have been practicing real medicine for the past 35 years. This book is a truthful look at the inner workings of any rural hospital in America today. It characterizes the difficulties that these facilities have been providing care to a population in significant need and the difficulty in competing against Megacenter whose only interest is in profit margin. It should serve us a wake up call for everyone

Slanted, but still great book

I respect this author greatly for the time dedication he put into researching these stories. The money-side of the hospital business is very accurately portrayed. The struggle the remaining rural hospital managers holding their shops together with both hands is real, as well as the constant pressure of health system takeovers and monopolostic, anti-trust behavior.

The financial hardship stories are heart wrenching. I'm a grown man, and I had to stop a half dozen times to cry at unforgiving series of tragedies and bad fortune that befell some of the unlucky poor patients in rural, northwest Ohio. Thank you for helping us understand how bad this has gotten.

The strong political slant was unnecessary, but I understand why he included it. The book is still great without the political jabs.

Listen now!

This book shares important truths about the American healthcare system. This book is long over due.

What’s gone wrong with American healthcare

As a physician in an independent community hospital that was eventually absorbed into another larger system I could identify with much of this story. The stories of the individuals related here are heart breaking and bring to light the crisis we face in this country regarding health care and its associated costs