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David A. Ansell heard it as he sped down a corridor in the old Cook County Hospital in Chicago, he barely broke stride.

County: Life, Death, and Politics at Chicago's Public Hospital

That was when the disheveled corpse on the floor roared to life, a lighted cigarette dangling from one hand, and requested with vigorous profanity that Dr. Ansell remove himself from the premises. Ansell did just that.


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  • This anecdote may help explain why some people who take jobs in large urban public hospitals escape as soon as possible, while others stay on forever, bound to these deeply flawed, impossibly colorful institutions with a devotion as passionate, as long-lasting and as illogical as the kind generally directed at flawed and colorful human beings. Superlatives flood these hospitals: They have the poorest and sickest patients; the longest-suffering, most inefficient and occasionally most corrupt administrations; the most disengaged nurses in the world, and the most dedicated; the cruelest and kindest doctors.

    These players stage a hundred Dickensian morality plays an hour, for a panorama that calls out to would-be writers and would-be reformers alike. Ansell is both, which makes his account of almost two decades at Cook County more than the usual collection of medical war stories. He arrived at the hospital as an intern in the late s, a low point for the hospital and medical residency training in general.

    Inside Chicago’s ‘Hellish’ Health Care | Chicago Book Review

    The hospital, built in , was bursting at the seams, a filthy, unventilated, mismanaged horror. Ansell and his peers added a few of their own. In a large review published in The New England Journal of Medicine, the Cook County group outlined the unnecessary deaths that resulted. Ansell subsequently testified before a Congressional committee on the subject, and a law made the practice illegal without substantial safeguards. Ansell and his colleagues grappled with administrators to loosen a hogtied budget and open one of the first breast cancer screening programs in the country, with suitably prompt appointments and follow-up.

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