Those of you that like to see behind the veil of medical care in the U.S. will enjoy the new book by Dr. David Ansell: County: Life, Death, and Politics at Chicago’s Public Hospital.
Ansell began internship at Cook County Hospital in 1978. He stayed there seventeen years.
Along the way, he got involved in politics, fighting the good fight for the poor and disenfranchised of Chicago. He co-authored the landmark 1986 New England Journal of Medicine article understatedly titled “Transfers to a Public Hospital,” that led to the passage of EMTALA that same year.
[EMTALA is the law that was enacted to prevent "patient dumping," the practice of transferring patients from one emergency room to another (such as Cook County) because of a patient's lack of insurance.]
Dr. Ansell was responsible for another success: he helped establish a breast cancer screening program for women at Cook County. Prior to his work, it was believed by many that only specialized breast surgeons could implement such a screening program. Ansell fought medically and politically to achieve better access for poor and uninsured women, in addition to showing that disease screening could adequately be handled by frontline health personnel and not just specialists.
Part of what made the book so interesting for me was the recent history of Chicago and the stories of Ansell’s colleagues at County–many of whom I’ve been lucky to meet and learn from over the years:
There’s Quentin Young, social activist and physician who doctored to MLK and Jesse Jackson, among others. There’s husband and wife team Gordy Schiff and Mardge Cohen, who have inspired generations of Chicago medical students to put their progressive values out front when thinking about their profession. There’s also Renslow Sherer, a pioneer in developing AIDS treatment both at home and abroad, and someone I’ve been blessed to call a colleague for the last few years.
County is an excellent exploration of one doctor’s professional development over a lengthy career. Ansell, in an NPR radio interview, was asked about the poor conditions at the hospital. He likened it to working in the developing world. He and his colleagues were “Doctors within Borders,” as contrasted with the esteemed NGO that works globally in humanitarian disasters.
One thing Ansell didn’t touch on: He now is Chief Medical Officer at Rush, a major academic teaching hospital in Chicago. He made the leap from anti-establishment to major power player in the Chicago health stratosphere. I would have appreciated learning more of his mindset as he made this transition to leadership. I wonder, too, about reconciling values from his longhair days of picketing and demanding change to the more cloistered world of institutional change in the executive suite.
Maybe I’ll ask those questions diplomatically when I interview him.
[UPDATE: Abigail Zuger reviewed County in the NY Times. Link here.]