Two very different doctors are competing for a residency at Maimonides Medical Center in Brooklyn, but they both made the same misstep: The hot-tempered South African Orthodox Jewish leukemia survivor and the soft-spoken Pakistani Muslim both take time from their rounds to speak to a New York Times reporter about their ambitions, brief conversations which establish their rivalry even while they never mention their competitors directly. These are the sort of chamber dramas that pepper the non-fiction profile Hospital: Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God And Diversity On Steroids, and author Julie Salamon draws the participants and dozens of other characters in such detail that she can return to them a hundred pages later without having to remind readers who they are. Her credentials have been put to good use in the service of a surprisingly engrossing institutional portrait of the well-regarded private hospital.
Founded by an Orthodox Jew who lost family members in the 1918 flu pandemic, Maimonides today struggles to balance its commitment to the Jewish community, which comprises 20 percent of its patients—and which lobbied successfully for the hospital to serve exclusively kosher food—and its increasingly diverse neighbors. In the year Salamon reports from the hospital, eavesdropping on conversations, joining training seminars, and even attending funerals, she chronicles the institution's changes under the leadership of a new president, as excellent to some as she is alienating to others. In addition, a new cancer center intended to compete with better-known Manhattan institutions like NYU or Sloan-Kettering strains to pick up momentum and justify the flood of donations which established it. Salamon tracks the changes in hospital policy from the top down, consulting with nurses and interns who see first-hand the results of minute adjustments in the office wing.
Hospital is essentially the biography of a bureaucracy, but that description doesn't do the book justice. Salamon has a knack for catching her subjects unawares, from an anesthesiology chief's gaffe in a seminar on respect to a social worker's description of when a patient is "encouraged" to leave the hospital. Some of her attempts to shape the book as a whole become heavy-handed, like the intermittent quotes from a first-year intern's e-mail dispatches revealing his adjustment to New York life, but Salamon tackles issues like the treatment of the uninsured and the implementation of new technology with a fluid grace that improves its clumsy subject.