BY ESTHER J. CEPEDA, Chicago Sun-Times Columnist
Make it the last book you read in 2011 or your first of 2012, but whatever you do, don’t miss out on County: Life, Death and Politics at Chicago’s Public Hospital.
Written by Dr. David Ansell, now vice president for clinical affairs and chief medical officer at Rush University Medical Center, County is a brutally frank, lovingly detailed account of one doctor’s mission to end health-care inequities in Chicago.
I was fortunate enough to stumble upon the book, published last June, as I cleared my office last week. I meant to read the first few lines to see if it was any good and ended up getting so swept up in the breathless narrative that pretty soon I was 10 pages in and didn’t want to stop.
Ansell arrived at Cook County Hospital in the spring of 1978. He and four fellow medical school graduates managed to haul their belongings to Chicago despite professional mentors’ warnings not to sink their careers into such a “simmering cauldron of conflict and third-world patient care.”
But, as Ansell writes, “We came to County Hospital eyes wide open because of its troubles and not in spite of them.” He and his fellow doctors-in-training healed the sick despite “an antiquated facility, inept management, underfunding and a corrupt political Machine.”
The young, idealistic doctor had gotten through medical school and his first most difficult years with a belief that access to health care is a fundamental human right, so he was dumbstruck by the role race played in Chicago’s health and well-being. When Ansell arrived at County, patients were routinely dumped there because other hospitals simply refused to care for them.
“The presence of the County Hospital allowed for the extraordinary exclusion of black patients from almost all other hospitals,” Ansell wrote. “This was a form of Jim Crowism as heinous as any practiced in the Deep South and enforced, not by law, but by the collective behavior of an entire city’s establishment.”
Ansell describes waiting rooms stuffed “as tight as a stockyard cattle car,” clinics that felt like mosh pits, brilliant doctors and tough-as-nails administrators who fought alongside staff and community activists for much-needed reforms.
We learn about the race, political and financial issues still shaping urban medical care through the stories of County’s long-suffering patients. As anyone who has endured the difficulties of receiving care at County’s replacement, John H. Stroger Jr. Hospital, can surmise, the book offers no happy ending.
“Back in those days we fought to keep the hospital open and get the new one built. We fought for patient rights, set up preventive programs and eventually did make things better, but we still have these very clear, race-based inequalities,” Ansell told me. “Here I am 33 years later and the health outcomes have actually gotten worse.
“The chance that a 16-year-old black kid on Chicago’s South Side will live to 65 is 50 percent, whereas 80 percent of white ones will,” Ansell said. “Half of the early deaths are because of heart disease and cancer, which could be prevented if they had access to organized preventive treatment.
“I see waiting lists [at Stroger Hospital] so long that they say you can go blind waiting for an eye doctor appointment. At other hospitals, you can get an appointment the next day.
“Ansell said he wants people to read this book so they can decide for themselves if this is how we, as a society, want to treat people. “This is not the America I signed up for,” he said. It is shocking — and necessary — to read about third-world patient care just a few miles from the Magnificent Mile.