Drama

This week's reading offered further insight into the hierarchy of the hospital and the web of interactions within it. It dovetails nicely with the previous week's mention of the rigid structure in Shem's House of God, now moving more into the minds and the politics of major (and minor!) players in the hospital environment. Salamon's Hospital reveals a wealth of human emotion hidden in plain sight. Beneath the childish feuding, overblown egos, bad attitudes, bickering and belittling, and lack of respect lay generally good, caring people with exceedingly stressful jobs. Salamon found significant moral imperative even in the cold sterility of the administrative environment in.

It seems paradoxical that an institution burdened with such responsibility - the health and well-being of its patients - is plagued with so much and politicking and teen-esque drama. It could be that one phenomenon begets the other. From the top all the way down, all of the players in the hospital bear this responsibility to the patients. In general, and I'm making large generalizations here, I got the feeling that at the core of the matter these people were dedicated to the cause. But it's not all sunshine and butterflies trying to uphold that obligation to the patients, especially with some of the vitriolic stuff that comes out of people's mouths.

How does a hospital, comprised of this wide range of personalities set within a sprawling bureaucratic machine, best meet the needs of their patients? The Cancer Center at Maimonides is an interesting example. The community hospital lacks the resources and endowments of major academic powerhouses and must strike a balance between caring for the community and staying open. It means catering to a more affluent population to be able to provide top-notch care for the community - and trying not to 'lose its soul' in the process. Losing its soul, becoming out of touch... is medicine as a business a necessary evil, at least for community hospitals? Is it an evil? How does this relate to models of corporate hospital restructuring versus the philanthropic model?