HOSPITAL

A portrait of Maimonides Medical Center in Brooklyn, N.Y., that, like the hospital’s own emergency room, is overflowing and overextended.

Salamon (Rambam’s Ladder: A Meditation on Generosity and Why It Is Necessary to Give, 2003, etc.) was permitted to roam Maimonides from waiting room to executive office in 2005 and 2006. Armed with a tape recorder and notebook, she talked to the chairman of the board, doctors, nurses, social workers, patients and members of the community involved in the hospital’s affairs. Woven into her wide-ranging account of the financial, ethical, scientific and sociological factors that shape a big metropolitan hospital’s operations are dozens of revealing profiles (most notably of president and CEO Pam Brier); her front-of-the-book cast of characters lists nearly 70 names. Salamon calls Maimonides “a petri dish of the post 9/11 world,” an apt description for a hospital founded to serve a community of Orthodox Jews in a neighborhood rapidly filling with immigrants from all over the world. Cultural conflicts are ever-present, as are those caused by human ego and ambition. The author recounts racial and religious prejudices that affect patient care, personality clashes and turf wars between doctors. Patients come and go, live or die, and fights with insurance companies are won or lost. Adding color but cluttering up her canvas are myriad irrelevant details from the administrative and professional staff’s lives and social and professional relationships. Readers learn not only who said what to whom at a staff meeting, but who wore what to whose funeral. Excerpts from the author’s daily log also pad this meandering account. However, some frank and chatty e-mails from a new emergency-room resident, a Midwesterner trying to adjust to the big-city life and work in a huge urban hospital, provide a welcome additional perspective.

Ambitious, unwieldy and unfocused.