A deeply insightful and disheartening portrait of America’s diseased health care system.



A superb account of a small-town hospital whose first priority is delivering high-quality medical care. Sadly, in today’s brutally competitive free market, that means it’s barely surviving.

In this eye-opening investigative study, journalist Alexander takes us to Bryan, Ohio, which has mostly recovered from the 2008 recession and possesses a surprisingly good hospital for its size (pop. 8,000). The author offers vivid portraits of a dozen individuals, including the hospital’s CEO, Phil Ennen, and readers will receive an expert education in his duties. Delivering care is one, but the business side is difficult. If rival medical centers steal business, customers don’t pay, or income doesn’t match expenses, his hospital will fail. Small hospitals have two strikes against them: Suppliers charge them more, and insurance companies pay them less (big medical systems negotiate for higher reimbursement; small ones have no clout). The free market extols efficiency above all. Once part of a larger system, Bryan’s hospital would see its staff trimmed, unprofitable services eliminated, and specialists moved to bigger cities. With less to offer, the hospital would become a drag on larger facilities; if it continued down that path, it would eventually close, a process that is playing out across the U.S. As of 2020, the hospital is hanging on and may even survive the pandemic, which is proving equally disastrous to rival hospitals. However, the future looks grim. Like all hospitals, Bryan’s depends heavily on government money, especially Medicare and Medicaid, but it’s not adequate, and this is unlikely to change in the near future. Like many states, Ohio has been cutting taxes and social services since the Reagan years, producing stagnant wages and declining health but only scattered calls for reform—certainly not in Bryan, where “a local politician could blame problems associated with a…business on the fact the owner was ‘not of American extraction’ and know he wouldn’t hear any disapproval.”

A deeply insightful and disheartening portrait of America’s diseased health care system.

Pub Date: March 9, 2021

ISBN: 978-1-250-23735-4

Page Count: 320

Publisher: St. Martin's

Review Posted Online: Nov. 24, 2020

Kirkus Reviews Issue: Dec. 15, 2020

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A handful of pearls amid a pile of empty oyster shells.


Bestselling author Haig offers a book’s worth of apothegms to serve as guides to issues ranging from disquietude to self-acceptance.

Like many collections of this sort—terse snippets of advice, from the everyday to the cosmic—some parts will hit home with surprising insight, some will feel like old hat, and others will come across as disposable or incomprehensible. Years ago, Haig experienced an extended period of suicidal depression, so he comes at many of these topics—pain, hope, self-worth, contentment—from a hard-won perspective. This makes some of the material worthy of a second look, even when it feels runic or contrary to experience. The author’s words are instigations, hopeful first steps toward illumination. Most chapters are only a few sentences long, the longest running for three pages. Much is left unsaid and left up to readers to dissect. On being lost, Haig recounts an episode with his father when they got turned around in a forest in France. His father said to him, “If we keep going in a straight line we’ll get out of here.” He was correct, a bit of wisdom Haig turned to during his depression when he focused on moving forward: “It is important to remember the bottom of the valley never has the clearest view. And that sometimes all you need to do in order to rise up again is to keep moving forward.” Many aphorisms sound right, if hardly groundbreaking—e.g., a quick route to happiness is making someone else happy; “No is a good word. It keeps you sane. In an age of overload, no is really yes. It is yes to having space you need to live”; “External events are neutral. They only gain positive or negative value the moment they enter our mind.” Haig’s fans may enjoy this one, but others should take a pass.

A handful of pearls amid a pile of empty oyster shells.

Pub Date: July 6, 2021

ISBN: 978-0-14-313666-8

Page Count: 272

Publisher: Penguin Life

Review Posted Online: May 19, 2021

Kirkus Reviews Issue: June 1, 2021

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Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...


A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.

The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.

Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.

Pub Date: Nov. 1, 2011

ISBN: 978-0-374-27563-1

Page Count: 512

Publisher: Farrar, Straus and Giroux

Review Posted Online: Sept. 4, 2011

Kirkus Reviews Issue: Sept. 15, 2011

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