Man's 4th Best Hospital

I had always wanted to be the one at the end of the ambulance ride. Now I figured that even if I might have my usual trouble working in big hierarchical systems, I would never doubt my competence in, and caring about, what I at best called healing. And with Fats again? Driving into Man s 4th Best, I mused on a kind of medical heaven.

I parked in a six-story lot and got lost. I had been here often during med school, but everything had changed. On the crest of a hill, the glorious Art Deco Pink Building and garden and the 1816 neoclassic granite Blue Building were darkened by skyscrapers. I forgot the building name and asked Information for the office of hospital president Jared Krashinsky.

Oh, that s your Twitter Building. She handed me a map, as complex as linguine.

A whispering rocket ride to floor 40 and out. Staggered by the sheets of morning sunlight backlighting a panorama of sea and threads of bleached clouds and then nothing but magical realism blue. The meeting was in the dimly lit, hushed board room, leather and chrome. On a giant bright screen was a slide. As my eyes adjusted, I saw, at a square glass table as big and blocky as my Prius, the Fat Man in a florid and horrific Hawaiian shirt. Beside him was Humbo, a young, compact Hispanic guy in a short white doctor coat. And then what he d called his A Team from the House of God: Eat My Dust Eddie, Chuck, Hyper Hooper, the Runt, and Gath, an Alabama cracker who d been a surgical resident. A nurse, Angel Jones, the Runt s wife, sat beside him. I hadn t seen most of them for many years. Also, a woman doctor, I guessed from India. I slipped into a seat. Panting, wiping off sweat. Way late.

Jared Tristram Krashinsky, of the Lithuanian Krashinskys, Man s 4th Best president and titan of industry, stood at a lit screen in dim light, a power suit reading a PowerPoint:

this slide shows Core Concept One: Mobile Self-Management. Notice the two-headed arrow. I manage up, and I manage down. Man s Best

Samuel Shem is a novelist, playwright, and a member of the faculty of the New York University School of Medicine at NYU Langone Medical Center. His novels include The House of God, Mount Misery, Fine, and The Spirit of the Place. He is coauthor with his wife, Janet Surrey, of the hit Off-Broadway play Bill W. and Dr. Bob, the story of the founding of Alcoholics Anonymous (winner of the 2007 Performing Arts Award of the National Council on Alcoholism and Drug Dependence), and We Have to Talk: Healing Dialogues Between Men and Women.

Praise for Man's 4th Best Hospital

"Darkly funny." TIME Magazine's New Books You Should Read in November

"Shem has done it again. . . .So timely and relevant. You will get a little pissed-off, double over in laughter and even cry a little." Sanjay Gupta, MD

Samuel Shem has challenged generations of doctors in his writing to think deeply about why they chose medicine. His novels illuminate the humanistic core of clinical care, and serve as a bulwark against a system increasingly characterized by avarice and anonymity. Jerome Groopman, MD, author of How Doctors Think

If you want to know why the doctor spends all visit looking at a computer instead of you, and if you want to know how the doctor feels about it, this is the book for you: a mordantly funny tour through modern medicine with a powerful prescription for how to change.  Bill McKibben, bestselling author of The End of Nature and Radio Free Vermont

As he did in The House of God, Samuel Shem provides a bitter, caustic and overdue update on the cold and bureaucratic world that awaits the sick and the dying if they are lucky enough to be able to afford it. Arthur Caplan, professor of Bioethics at New York University Langone Medical Center

Oh my god! This book is brilliant enough to start a revolution. Dedicated nurses, doctors, and all haters of Electronic Medical Records unite! Together we must heed the Fat Man's call to put the human back in health care. " Theresa Brown, RN, author of the New York Times bestseller The Shift: One Nurse, Twelve Hours, Four Patients' Lives

"Filled with unforgettable characters and the shocking reality of the many rackets running through the medical industry, this sobering yet hilarious satire manages to offer a glimmer of hope for putting humans back into health care. Booklist (starred review)