The House of Hope and Fear: Life in a Big City Hospital Review

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(More customer reviews)Dr. Young's new book is an engaging account of life at the large mission-driven county hospital in Seattle. I spent most of my 3rd year med school rotations there myself 12 years ago and am now working in a mission-driven community health center 18 miles away. My desire to serve the poor was a direct result of the dedication from the doctors and staff that I witnessed at Harborview. Now, I spend more than half my time educating and mentoring medical students and I plan on incorporating this book into our 2nd year curriculum.
The stories are diverse: some are about incredible patients and their challenging situations - socially, medically, psychologically; some are really more about the ethical dilemmas faced by providers, and faced by patient's families; other stories point out the inequities in healthcare, while demonstrating how this institution has creatively found a way to thrive financially while serving the least able to pay.
Most importantly to me - this book is hugely interesting, well written, easy to read, hard to put down and deserving of high praise. The reason this book is so good and the messages conveyed so well is that Dr. Young has incredible skill at portraying the humanity of her subjects. This is a book of true characters; unforgettable characters. The characters are patients, their loved ones and families, the infamous ER director, a remarkable specialist in nephrology, Dr. Young herself, and the staff of the hospital. I read their stories and can picture them on a gurney, in their offices, on the wards, in the ER; I can smell the smells again; and hear the sounds in the ICU.
This text can easily and effectively (each chapter is pretty well able to stand on its own as a separate reading - though together it reads as a cohesive story) be used regularly with medical students and public health and policy students - the examples in it are perfect for igniting debate about healthcare inequality, social justice, medical ethics, professional development, difficult patients, allocation of resources and care for the underserved.

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Opening with the view of an idealistic, young doctor entering her first post-graduate job at the local county hospital, The House of Hope and Fear explores not only the personal journey of one doctor's life and career, but also examines the health care system as a whole. The county hospital setting provides the author with a second education. With clear, eloquent text, she chronicles attempts made to treat those tossed aside by society along with the personal and ideological shifts that accompany this daunting task. All of the political aspects of the hospital's executive board are detailed in a gripping account of the hospital's inner workings, and a human face is expertly given to the healthcare crisis in America.

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