• The Hospital

  • Life, Death, and Dollars in a Small American Town
  • By: Brian Alexander
  • Narrated by: Nick Landrum
  • Length: 14 hrs and 51 mins
  • 4.6 out of 5 stars (108 ratings)

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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)

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What listeners say about The Hospital

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  • Overall
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This book says it all about what is wrong with healthcare

Brian Alexander does an amazing job of taking a very complicated topic like healthcare and creating an easy to understand narrative using great characters, relatable stories, history and current events. The timeliness of the book couldn’t be better. He was at CHWC and watched leadership struggle with changing their economic approach from a “we deserve to be here because we’re nice people and work hard” mentality to “maybe we should ask a professional”. The conflicts between the executives epitomized the conflicts that small hospitals face in general. The story of Keith, the hard working, smart but unhealthy diabetic that he followed, was heartbreaking. I hope Keith is okay today.
The pandemic epilogue was perfect. It was almost as if to say, “see, I told you”, as the whole book pointed out the perils of the corporate healthcare economy. He used so many examples of how big hospitals and insurance companies, have the advantage over small ones, how public health is being neglected, and how government bureaucracy fails the American people again and again and again. The pandemic helped to illustrate these perfectly. The narration was really good too. A great listen and it should be required reading for everyone with an opinion about the cost of healthcare.

4 people found this helpful

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Deep and powerful.

This book is gut wrenching. It’s a powerful read that illustrates connections we work hard to avoid. Highly recommended for anyone who wants to “understand” our current climate. Not a light read. Worth the paradigm shift.

1 person found this helpful

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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

1 person found this helpful

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Magnificent

Perfectly captures the inequities and perverse incentives in modern medicine. Describes my own hospital's struggles.

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An ailing health care system

A depressing look at the obscene struggle millions of Americans face to obtain medical care/services, in no small part because of for-profit businesses (“health industry”) controlling access to critically needed services. Millions of ill people are forced to access services provided amidst societal prejudices that blame the poor for their sicknesses, profit-driven decision-making, unconstrained medical costs, poor and often overly expensive insurance options, emphasis of profit over care, excessive if not prohibitively high prescription costs, rural/urban disparities, poor governmental oversight, widespread victim-blaming, and so much more. Our health care system is broken for a significant portion of the population, and this book explains many of the reasons why.

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Broken Healthcare

A view into the extremely profitable world of not for profit hospitals . Right on point.

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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.

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Shallow & superficial analysis

A shallow and superficial analysis of a complex set of problems. The Leftist bias of the author is overt and unprofessional.

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amazing insight into the American Pathology

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

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Listen now!

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