By: Ricardo Nuila
Publisher: Simon & Schuster
Publication Date: March 14th, 2023
Reviewed by: Douglas C. MacLeod, Jr.
Review Date: March 6, 2023
Dr. Ricardo Nuila, an internal medicine doctor and hospitalist at Ben Taub Hospital in Houston, Texas, is tired. Admittedly, Nuila does not explicitly say he is tired in his new book The People’s Hospital: Hope and Peril in American Medicine; however, one gets the sense, based on his written assault against what he calls “Medicine Inc.,” he is exhausted with the politics, bureaucracy, and capitalization of the United States healthcare industrial complex. This book, which is sometimes repetitive but always engaging, exposes what Nuila sees as a uniquely American issue that needs serious attention from federal and state legislators down to the lowliest of patients, the ones who truly suffer and sometimes perish because of rising costs, lower standards, and uncaring corporate interests.
What Nuila claims throughout The People’s Hospital is healthcare workers need to provide “good care” to the sick and dying despite what is happening in Washington D.C. or in our nation’s Capital buildings, and he defines “good care” as simple human connectedness. He claims Ben Taub Hospital, a safety-net facility that mercifully takes in undocumented immigrants, the indigent, and the uninsured, succeeds in still providing “good care” because they are not as beholden to “Medicine Inc.” as for-profit hospitals are around the country. Nuila attempts to prove his argument by telling the traumatic stories of several of his patients throughout the years, all of whom had caring experiences not only at Ben Taub Hospital but in Texas’s Harris Health System. These individuals become examples and, on some levels, the focal point of Nuila’s book. Indeed, it is easy for the author to get lost in the industry’s noise by writing a 300-page diatribe, but our fair doctor does not fall into that trap; he does not give in to the temptation of giving the corporations more page-time than they deserve. He consciously places his subjects to the fore in an attempt to humanize humans who sometimes are identified more for their ailments and their ability to pay rather than for who they are as a mother, father, brother, sister, friend, etc.
In essence, Nuila is a humanist and a storyteller who practices medicine. In his book, readers are exposed to several severely-ill patients whom he had encounters with, all of them considered high-risk because of their afflictions and their problematic life/economic situations (a good portion of them were uninsured or relied on federal and state healthcare): Stephen, who has tonsil cancer; Roxana, who had gangrene and tumors; and, Ebonie, who had a high-risk pregnancy that resulted in massive blood loss, are those he starts with (later he provides more stories). It is in these moments where he successfully mixes their health issues with what is happening administratively and financially to them, specifically, being representations of how the system treats the infirmed: without the aid coming from a variety of sources, including empathic and charitable private donors, none of these three human beings would have survived. Nuila’s use of reliable resources from places like the New England Journal of Medicine, along with his expertise and his comprehensive examples, provides an in-depth understanding of what is medically happening in the United States, something many private and public doctors do not want to see happen to their patients. At the same time, he speaks about his own familial history, which includes a doctor-for-a-father who started his practice caring for his patients but unfortunately was forced to become a bureaucrat focused on where the money was coming from. The content itself works in this book on multiple levels; however, sometimes the flow of the book, although intentional, needs more of a written rationale to help readers follow his logic, especially because of the multitude of “characters” we are exposed to.
Ultimately, The People’s Hospital is a realistic look at medicine as business and political beachball, while we, as patients or potential patients, become numb to the exorbitant amounts of money we pay to ensure we survive. He is trying to wake readers up to what is happening in the United States as it pertains to our healthcare. The question is: Do we care enough to listen?
Quill says: Although organizationally confusing, The People’s Hospital significantly exposes “Medicine Inc.” as heartlessly capitalizing on those who need both treatment and compassion.
For more information on The People’s Hospital: Hope and Peril in American Medicine, please visit the author's website at: www.ricardonuila.com/
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