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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)

What listeners say about The Hospital

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  • 042850
  • 11-03-2021

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.

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  • Russell Thomas
  • 19-05-2021

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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  • Bruce Jugan
  • 22-06-2021

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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  • EaglesFan
  • 20-06-2021

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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  • TK Bridgeman
  • 28-05-2021

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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  • Cwestlake
  • 12-05-2021

Listen now!

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

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  • Jacey Davis
  • 11-05-2021

Meandering plotless tripe with biased liberal agenda

Highly biased liberal attack piece masquerading as an “insiders documentary.” I’ll save you the time and money and highlight the repeated themes:
- anti capitalism
- anti religion
- anti personal responsibility
- anti Trump or any other Republican person or ideology
I’m a pretty open minded healthcare worker, but had to stop listening to this garbage. Don’t buy this book!

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  • Nicholas Newsad
  • 26-04-2021

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.

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  • Bentley S. Davis
  • 20-04-2021

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.

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  • Dave Renz
  • 17-04-2021

An accurate depiction of my hometown and rural America

I grew up 15 min out side Bryan, OH, the town featured in this book. I attended The First Baptist Church before it was sold and converted into Father John’s, restaurant noted many times. I’ve been to the Bryan hospital for treatment of the minor childhood accidents that required stitches or an X-ray. My family members trusted and were treated by many of the doctors mentioned in this book.

It was surreal how accurately Alexander depicted the town, it’s residents and their struggles. The central focus of this book is the town’s hospital and the US healthcare system, but the story was about the people of small town America.

I left the area for college in Cincinnati and have lived in Connecticut, New York City and Southern California for the past 15 years. I rarely return, except for holidays and the occasional wedding. Partly because the depressing reality described in this book makes it hard to face. But the area and its wonderful people grounded me in the reality of places like Bryan that the “coastal elites” I’ve been surrounded by can’t understand. I’ve always thought of Bryan as a microcosm of what’s been happening to the rural US in the past 30 years.

Being from this area, I also resonated with other books like Hillbilly Elegy, but I think The Hospital clearly paints the picture of the tragedy of what’s happening to the US in such human terms that I recommend to anyone interested in understanding the middle of America.

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