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

Calling upon real experiences as a rookie physician, Audrey Young explains the heartfelt, busy, and noble lives of a Seattle hospital's staff and clientele in The House of Hope and Fear: Life in a Big City Hospital.

Part memoir, part love letter to the heroic staff with whom the author works, this book tells the story of Audrey Young’s first postgraduate job as a physician at Seattle’s county hospital, Harborview, which built its reputation on accepting patients who are turned away elsewhere. Centering in the “air traffic control” section of the hospital—where incoming patients are assigned to available beds and medical staff—this book is a close-up portrait of providers’ conscientious efforts to supply excellent care in a crowded and growing hospital, whose population is often indigent, uninsured, or both. Young’s writing style matches the urgent, fast pace of her duties, sometimes lingering with an especially captivating patient, but often rushing from room to room, from emergency to capacity crisis, or from musing on universal health care to answering her ever-present pager. The storytelling is unapologetically frank and includes incidents of maggot infestation, a long-neglected gangrenous toe, a number of other medical gross-outs, and plenty of sad tales. But here, too, are stories of recovery against the odds, unexpected gratitude, and the roller coaster of health and wellness in a pulsing emergency department.

Young does some additional research on programs that help to serve the underserved, such as a “wet house” that houses alcoholics without demanding their sobriety. She attends a drug rep’s dinner and hands her leftovers to a beggar on the street. She calls for social reform and means it—this is not empty rhetoric but rather her everyday mission. First, do no harm, but also: treat them all as she herself would want to be treated: with care, politeness, and compassion.