In the face of numerous votes in the House of Representative to repeal the Affordable Care Act (aka “Obamacare”), County: Life, Death, and Politics at Chicago’s Public Hospital provides a vigorous counterweight in the continuing national debate over health care in America.
Written by David A. Ansell, who currently practices at Rush University Medical Center and is also a member of the Board of Directors of the Cook County Health System, County was originally published in 2011 as a hardcover. The 2013 paperback version includes a new foreword by the author.
The author is a New York native who came to Chicago in the late 1970s as an intern and stayed. Drawing on his day-to-day experiences as a resident and attending physician during seventeen years at Cook County Hospital, Ansell deftly mixes his personal story into the overall public healthcare debate. Using Cook County Hospital as the perfect backdrop, Ansell illustrates the dysfunction of today’s healthcare system. With a steady eye, he outlines the appalling treatment of patients at Cook County Hospital: hours-long waits for fifteen minutes with a doctor, a complete lack of privacy or dignity, medication and basic medical equipment unavailable, months between follow-up visits, patients dying in the ER while awaiting care (one woman died of a burst appendix, a relatively simple condition to treat).
The author also touches on local politics without getting bogged down in minutia. A bit more about the politics and corruption of Chicago and Cook County would lend some much-needed color and context to the narrative, although it’s plausible that the author may believe politics is not his forte, and he may not have wanted to shift the focus away from the patients he cared for.
What politics Ansell does engage in highlight his battles with County Hospital bureaucracy and the inequities of the U.S. healthcare system. County forcefully sets before the reader’s eyes the hellish realities faced by the poor and uninsured while avoiding the trap of becoming a polemic. Ansell advocates for a single-payer health system, but he doesn’t use economic arguments, political expediency, or an overwhelming statistical assault. Instead, he relies on the ridiculousness of the County Hospital bureaucracy and his personal stories with his patients to make his case. Some of those stories are quite touching. County presents a specific point of view; it doesn’t pretend to be even-handed. No doubt others make a case for the other side.
The book is a quick read that, for the most part, follows a sensible chronological order (this breaks down at about Chapter 20, giving the book several denouements rather than one tidy conclusion). The author is a skilled writer who knows how to keep the reader engaged and interested. Unfortunately, Ansell sometimes falls into a bit of self-aggrandizement, conveying a sense of “I was in the front lines of protesting” that detracts from the book.
In addition, there are two minor errors that a Chicago-based author (and publisher) should know better than to make: pork bellies are traded at the Chicago Mercantile Exchange, not the Chicago Board of Trade, and the disgraced police detective is Jon Burge, not John Burge. The book’s editor should have caught those errors.
County is not a comprehensive history of Cook County Hospital; rather, it focuses on the author’s years there, from the 1970s to the 1990s. Many of the names mentioned throughout the book will not be familiar to those outside the medical community, but everyone has heard of and knows about Cook County Hospital. For readers who are interested in an insider’s look at the “Old Lady on Harrison Street,” County is a worthy read.
May 2013, Academy Chicago Publishers
$22.50, 256 pages, paperback
Learn more about County and author David Ansell.
—Reviewed by Stephen Isaacs