28 February 2012

'County', by David Ansell

What's an idealistic medical student to do? Upon graduating from medical school in the 1970s, David Ansell and three of his classmates from SUNY Syracuse had the wild idea of interning at Cook County hospital in Chicago. County was the hospital for Chicago's poor: shamefully underequipped, understaffed, and overstuffed. Despite its problems (or more accurately, because of them), Ansell stayed on at County for decades, growing into a mature physician as he and his colleagues worked desperately to reverse the shocking health inequities they encountered. While at County, Ansell co-authored a famous study that alerted the medical world to the phenomenon of "patient dumping" (private hospitals transferring uninsured patients to county hospitals, sometimes killing them in the process). The paper led to the passage of EMTALA, which requires all emergency rooms to treat deathly ill patients rather than sending them elsewhere.

Ansell's profile of Cook County hospital makes for compelling reading. He clearly loves the hospital, loves his patients, and hates the unfair health and political system that has failed both. I recommend the book for medical students and for those interested in minority health.