Twelve Patients: Life and Death at Bellevue Hospital by Eric Manheimer, MD

Twelve Patients: Life and Death at Bellevue Hospital by Eric Manheimer, MD

Published July 2012 by Grand Central Publishing

Source: checked out from my local library 

Publisher's Summary:

Dr. Manheimer describes the plights of twelve very different patients--from dignitaries at the nearby UN, to supermax prisoners at Riker's Island, to illegal immigrants, and Wall Street tycoons. 

Manheimer was not only the medical director of the country's oldest public hospital for over 13 years, but he was also a patient. As the book unfolds, the narrator is diagnosed with cancer, and he is forced to wrestle with the end of his own life even as he struggles to save the lives of others.

My Thoughts:

Bellevue Hospital is the oldest public hospital in the United States and one of the largest, by number of beds. The hospital itself is 25 stories tall, has an attending physician staff of 1200 and a total staff of 5500. It's a "safety net" hospital, which means that it healthcare for people regardless of their ability to pay or insurance status. It handles over half a million patient visits a year. They handle the medical care of inmates from Riker's Island and for years provided long-term care for mentally ill persons. In other words, as the medical director of Bellevue for almost 15 years, Dr. Manheimer had his hands full. Certainly he was involved in every aspect of the hospital, right down to being one of its patients. 

Through twelve patients, Manheimer touches on not only a number of medical issues but the roles that politics, a broken health care system (including such a desperate need for money that hospitals feel forced into signing agreements with soft drink companies), and societal woes play in the care of patients. It's a  book about so much more than just medical diagnoses and treatments. Through these patients, Manheimer tackles immigration issues and the effect of trade agreements on immigration, the foster care system, the justice system, medical errors, drug addiction and its causes, mental illness, organ donations, end-of-life care, and medical ethics. 

Manheimer is clearly a man who cared very deeply about his employees and his patients, trying to make sure that every one of his patients received care that was based on the best decisions for each without prejudice. He spent a lot of time getting to know his patients, trying to get down to the reasons for their conditions that might effect treatment, and their families. He has a lot to say about society and the ways that we have failed ourselves when it comes to how we treat each other and how medical care it delivered. I learned a lot and, for the most part, agreed with Manheimer's assessments. Manheimer and his wife have led an interesting life outside of his medical practice that allowed him to connect on a more personal level with many of his patients, but I did, sometimes, feel like we got a little too much background on their experiences. 

There was one chapter that I had issues with - one where he addresses obesity. To be fair, he's not wrong that excess weight can cause a host of medical problems; but he seemed to be saying that it's a given that people who weigh more than the medical community says they should are all at risk. Further, he seemed to really be pushing surgery for those who have failed traditional diets. I have major issues with this approach, given the risks and psychological damage these surgeries can cause. 

On the other hand, the chapter about his own cancer is gripping. Having experienced cancer in my own house, I could relate to an extent, on the toll the treatments take on not only the patient but their families, as well. Manheimer confesses to having reached the point in his treatment and disease that he was ready to give up. His wife talked him into continuing. But Manheimer readily acknowledges that this is not necessarily the best choice for all patients. 

This is not an easy read but one well worth taking the time to read and consider. I'll be thinking about these patients for a long time.