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The Hospital

Life, Death, and Dollars in a Small American Town

Brian Alexander

St. Martin's Press

The Hospital Download image

ISBN10: 1250237351
ISBN13: 9781250237354


320 Pages



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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 readers into the world of the American medical industry in a way no book 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 book offers a blueprint for how we created the crisis we're in.


Praise for The Hospital

"The Hospital shows how fragile our country’s health care was even before the pandemic, and how that fragility affects staff and administration as well as patients."—The Washington Post

"The Hospital is a heart-rending and unforgettable real-time journalistic deep dive. With the Affordable Care Act at the center of our national debate, I can't think of a more timely book. The doctors, nurses and medical technicians in these pages are front-line heroes."—Douglas Brinkley, Katherine Tsanoff Brown Chair in Humanities and Professor of History at Rice University, author of The Great Deluge: Hurricane Katrina, New Orleans and the Mississippi Gulf Coast

"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

“Brian Alexander, a master storyteller, delivers an extraordinary tale about a community hospital fighting for its life in America’s heartland. He shows us why rural hospitals matter.”—Eric Eyre, Pulitzer Prize winner and author of Death In Mud Lick

“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 Icebound: Shipwrecked at the Edge of the World

"The Hospital shows us the deep connections between health care, the economy, and people's lives. Brian Alexander masterfully weaves national history and events into the story of a small local hospital and its community. This book is devastating, gripping, and beautiful."—Beatrix Hoffman, Professor of History, Northern Illinois University and author of Health Care for Some

"A superb account of a small-town hospital whose first priority is delivering high-quality medical care . . . In this eye-opening investigative study, [Alexander] offers vivid portraits of a dozen individuals, including the hospital’s CEO, Phil Ennen, and readers will receive an expert education in his duties . . . A deeply insightful . . . portrait of America’s diseased health care system."—Kirkus Reviews (starred review)

“Alexander’s scorching reportage provides a distressing, infuriating picture of health care delivery and highlights the heroic fight of a little hospital and humble hamlet to stay vital.”Booklist (starred review)

"The time Alexander spent embedded in the community gives continuity and depth to the stories of the individuals he connected with and puts a human face on broader issues of social inequality. This expertly reported account will resonate and find a wide audience.”—Library Journal (starred review)

"This wrenching account brilliantly diagnoses the flaws in America’s healthcare system."—Publishers Weekly (starred review)

Reviews from Goodreads


Read an Excerpt


A Ready Haven of Refuge

The Battle to Control Health

Them old Dutchmen, them old Germans—they’d work all day in a factory in Bryan, then head home to work on the farm. It was like they couldn’t...

About the author

Brian Alexander

Brian Alexander, the author of Glass House and winner of the Ohioana Book Awards, is a contributing writer to The Atlantic. He’s written for the New York Times, Los Angeles Times, Esquire, among others. He’s spoken at The Obama Foundation Summit, and in Washington to members of the Senate and House of Representatives. He lives in San Diego.

Courtesy of the author

Brian Alexander

Official Links

Glass House book web site