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Book and Media Reviews
December 22 2010

The House of Hope and Fear: Life in a Big City Hospital

JAMA. 2010;304(24):2750-2751. doi:10.1001/jama.2010.1870

This book is by turns inspiring and remarkably enlightening. But most of all, it is exhausting. The “house” in The House of Hope and Fear is Seattle's Harborview Medical Center, where the author received her medical training and served as an attending physician for 6 years. In this account, Harborview is often on the verge of financial and organizational breakdown; its medical staff regularly work to the point of collapse; and indigent, terribly sick patients, despite the extraordinary care they receive, keep coming back, at least in part because they lack the financial and personal resources to obtain the ongoing care they require. It is a tribute to the author's evocative powers that her portrayals of an overstretched institution, a dedicated but drained medical staff, and impossibly sick patients left me both discouraged and exhausted.