The Most Important Book Of The Century
I just finished How to Stay Out of the Hospital by Lila Anastas, and I don’t think I’m overemphasizing the book’s value when I suggest it could be one of the most important books of the century, if not the most important book!
How to Stay Out of the Hospital is a blistering – but not off-balanced – critique of the medical community and society’s current role with it. The book concludes with the following mental model, which could have served equally well as a back-cover blurb: Primary prevention is avoiding the medical issue altogether, secondary prevention involves early detection of an affliction, and tertiary prevention is the fight against a full-blown medical malady. Doctors receive almost all of their training in tertiary prevention, and it’s also where they stand to make the most money, but also where your odds are the worst.
We are all indoctrinated from an early age that – not to worry – one simply checks in to the hospital to fix medical problems. However that concept is outrageous-to-loony once you consider the flaws in any human enterprise, not to mention the fact that it’s the most inefficient possible way to further your survival – akin to hoping the fire department can prevent your house from burning down. The scope of the inefficiency is hard to wrap your head around once you finish this book, but one of the most obvious problems with that medical model is that you are attempting to fix a medical problem by relocating to a building filled with sick people; in an environment necessarily filled with serious medications, invasive instruments, and highly consequential treatments; in a world where Murphy’s Law is free to prevail! It’s a very sharp environment. Sadly, shockingly, and even horrifically, this has led to a statistically non-trivial level of serious problems. And yes, sometimes those mishaps are fatal.
The book goes far beyond common-sense axioms (e.g. don’t smoke & don’t drink). It’s filled with all different types of gems and food for thought. Page 173 offers the following suggestion: “If [you know ahead of time that] you’re going to be a patient in a medical center hospital, avoid being admitted on or near July 1, because this is the traditional day when new interns and residents arrive at the hospital and begin training.” I knew teaching hospitals obviously admitted new trainees, and it does seem like summertime would be the most logical time for that to happen, but I would never have connected those two dots if I hadn’t read this book.
Do not overlook this book! You will not look at hospitals the same way ever again. With such little fanfare and publicity, it would seem strange for me to keep heaping on the superlatives, but the truth is that this book is easily a seminal work from a survival point of view, right up there with 98.6 Degrees.
The book was written in 1986, so it’s slightly dated, but very, very far from obsolete. Could the most important book of this century actually have been published in the previous century?
The postscript is that if you don’t believe incompetence or unintentional bureaucratic dysfunction could ever occur in a hospital, surely you believe in greed and malice, don’t you? Not long after this was originally published, a licensed doctor from my area was arrested, in what has now become a fairly notorious criminal case in this region. The allegations are so unbelievable, litigation experts are now buying radio ads seeking out anyone who was ever a patient of this one single doctor. You can search online for the details, but according to The Department of Justice, Dr. Jorge Zamora-Quezada “[gave] patients chemotherapy and toxic treatments they didn’t need, all to fund his ‘lavish’ and ‘opulent lifestyle’.”