Five Patients – by Michael Crichton (1970)

Michael Crichton is best known for his science-fiction and techno-thriller novels, but on occasion he veered off into non-fiction. In 1970 he wrote a book detailing the medical cases of five patients who were hospitalized at Massachusetts General Hospital while he was at Harvard Medical School. In it, he examined different aspects of hospital life: the non-stop atmosphere of the emergency room on any given day, the soaring cost of being hospitalized, deciding whether or not to operate, the introduction of technology into hospitals, and the way doctors interact with patients. About the time he published this book, Michael Crichton abandoned his medical career and devoted himself to being an author.

If you work in the medical field, the terminology in this book will be familiar to you. Unfortunately for me, much of the medical description was akin to a foreign language. There were parts of the book that I found very interesting, however, such as the section on hospital costs. He gave the example of John O’Connor, who was hospitalized for 31 days, yet only had a bill of $6,172.55! Mr Crichton went on to say:

“The single most important problem facing modern hospitals is cost… First, the cost of hospitalization has skyrocketed. The average MGH patient today pays per hour what the average patient paid per day in 1925. Even as recently as 1940, a private patient could have his room for $10.25 per day; by 1964, it cost $50.10 per day; by 1969, $72.00-$110.00 per day. This staggering increase is continuing at the rate of 6 to 8 per cent per year.”
(page 60)

Near the end of the book, the author gives the suggestion that hospitals should organize their patients into areas based on how ill they are:

“As they become healthier, they would be moved to new areas of the hospital, where they would be encouraged to be more self-sufficient, to wear their own clothes, to look after themselves, to go down to the cafeteria and get their own food, and so on. They would, at every point, be surrounded by patients of equal severity of illness.”
(page 221)

What a contrast between this 1970 view of hospitals and present day hospitals! Now you are lucky if you actually get to spend 24 hours in a hospital after having surgery. As soon as you are conscious, they try to get you on your feet. When you are able to stagger to the bathroom with help, they get out the discharge papers!

Sadly, the skyrocketing cost of medical care that Mr. Crichton describes continues its upward thrust. I would have to agree with the author when he says that we will need to transition to a national health care system as health care becomes impossible to afford.

The Little Bookstore Of Big Stone Gap – by Wendy Welch (2012)

Wendy and her husband Jack were tired of the big city and its fast-paced, high pressure jobs. So they set out to find another kind of life. They stumbled across an old 1903 Edwardian house in the Appalachian town of Big Stone Gap, and instantly knew it was the place of their dreams. Knowing next to nothing about running a small business, they moved into the upstairs, and turned the rest of the house into a second-hand bookstore. The first year was a roller coaster, as they made blunders as well as spectacular progress.

There were two main things I loved about this book:

First, Wendy’s observations about books and the people they are matched up with. Books, whether science fiction, cookbooks, westerns, or travel, fill a need in their lives. When you see a person find that book that makes their face light up, it makes you happy too.

Second, Wendy talks about everyone needing a third space, a place other than work or home, where someone knows you, and you can just be yourself and relax. Wendy and Jack’s bookstore became that third space for many people in town. By the end of the book, I found myself wishing that I was part of this wonderful little community.

(re-posted from April 9, 2014)