The Hospital

Life, Death, and Dollars in a Small American Town

By: Brian Alexander

Narrated by: Nick Landrum

An intimate, heart-wrenching portrait of one small hospital that reveals the magnitude of America’s health care crises.

“With his signature gut-punching prose, Alexander breaks our hearts as he opens our eyes to America’s deep-rooted sickness and despair by immersing us in the lives of a small town hospital and the people it serves." (Beth Macy, bestselling author of Dopesick)

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

A Macmillan Audio production from St. Martin's Press

"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)

©2021 Brian Alexander (P)2021 Macmillan Audio

Critic reviews

“With his signature gut-punching prose, Alexander breaks our hearts as he opens our eyes to America’s deep-rooted sickness and despair by immersing us in the lives of a small town hospital and the people it serves.“ (Beth Macy, best-selling author of Dopesick)

“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 One Long Night)

interesting listen

Interesting listen. The narrator needs to learn how to pronounce some of the cities correctly, most notibly Lima

amazing insight into the American Pathology

great book that provides an incredible look into the conditions that lower american life expectancy and increase cost

Wow! Makes you really think about our HC system

Grew up in Ohio and used to work for a local hospital in Ohio. Wow have things change. I love the way the author weaves the socioeconomic maladies of our county with that of the Bryan hospital. Thoroughly written and researched. Unfortunately the narrator should have spent a little time in Ohio and learned how to pronounce some of our Senator and city names.

Everyone should read this book

This book is so very important and explains a lot of the problems in healthcare and our society at large. My only criticism is the narrator's mispronunciation of some Ohio specific words. Still, I am recommending this book to everyone.

Great book from start to finish.

I love this book. It combines healthcare, health insurance, doctors , nurses, addiction, first responders,employment. It all flows together nicely in the book. Well written and great narration. I enjoyed this whole book from start to finish.

Must read

Well written, well read audible book. I learned much about the complexities of the health care system. Sadly, the author’s assumption that a single payer government run insurance plan as the panacea to solve all that is wrong, seems simplistic and naive. Systems like Kaiser Permanente, Imtermountain Health, and others show that integrated health care delivery systems which include insurance plans work to reduce cost and improve quality.
Still the book is a must read.

A facinating look at the failure if American health care

I started this book thinking I would learn about the struggles that have lead to the closures of so many rural hospitals. I did get that view, but I learned even more about hoe badly our healthcare system is failing the American public.

Excellent and thoughtful

I teach a course on the US health system for graduate students. After reading this book, I will be assigning portion services to my students. The analysis of both the health system in economic and personal terms is very valuable understand the pathology that is American healthcare.

The author points out the social determinant of health as the underlying problems of the American healthcare system. This analysis is spot on. Unless we can address issues of poverty, homelessness, drug addiction, and a host of other social problems, we will never truly address the health needs of our people.

The author has written a compelling story. It should be read by all Americans.

An accurate depiction of my hometown and rural America

I grew up 15 min out side Bryan, OH, the town featured in this book. I attended The First Baptist Church before it was sold and converted into Father John’s, restaurant noted many times. I’ve been to the Bryan hospital for treatment of the minor childhood accidents that required stitches or an X-ray. My family members trusted and were treated by many of the doctors mentioned in this book.

It was surreal how accurately Alexander depicted the town, it’s residents and their struggles. The central focus of this book is the town’s hospital and the US healthcare system, but the story was about the people of small town America.

I left the area for college in Cincinnati and have lived in Connecticut, New York City and Southern California for the past 15 years. I rarely return, except for holidays and the occasional wedding. Partly because the depressing reality described in this book makes it hard to face. But the area and its wonderful people grounded me in the reality of places like Bryan that the “coastal elites” I’ve been surrounded by can’t understand. I’ve always thought of Bryan as a microcosm of what’s been happening to the rural US in the past 30 years.

Being from this area, I also resonated with other books like Hillbilly Elegy, but I think The Hospital clearly paints the picture of the tragedy of what’s happening to the US in such human terms that I recommend to anyone interested in understanding the middle of America.

Everyone Should Read This Book

This book explains in great and interesting detail why we, the growing underclass, are getting screwed by the healthcare industry. It is also a reflection on how the healthcare industry and big business weave together to create an even more dire situation for all of us who are just trying to live a decent life.