The Cost of Hope: A Memoir [Deckle Edge] [Hardcover]

Amanda Bennett (Author)

Book Description

Release date: June 5, 2012

From Pulitzer Prize winner Amanda Bennett comes a moving, eye-opening, and beautifully written memoir—a love story of two unusual people, their complex marriage and deep devotion, and finally, Bennett’s quest to save her husband’s life.
 
When Wall Street Journal reporter Amanda Bennett meets the eccentric, infuriating, yet somehow irresistible Terence Bryan Foley while on assignment in China, the last thing she expects is to marry him. They are so different—classic and bohemian, bow ties and batik, quirky and sensible. But Terence is persistent. “You are going to be somebody,” he tells her. “You’re going to need somebody to take care of you.” Though initially as combative as their courtship, their marriage brings with it stormy passion, deep love and respect, two beloved children, and a life together over two decades. Then comes illness, and the fight to win a longer life for Terence.
 
The Cost of Hope chronicles the extraordinary measures Amanda and Terence take to preserve not only Terence’s life but also the life of their family. After his death, Bennett uses her skills as a veteran investigative reporter to determine the cost of their mission of hope. What she discovers raises important questions many people face, and vital issues about the intricacies of America’s healthcare system.
 
Rich in humor, insight, and candor, The Cost of Hope is an unforgettable memoir, an inspiring personal story that sheds light on one of the most important turning points in life.

Editorial Reviews

Review

“Equal parts marriage confessional and skilled investigative report. It’s the story of the sometimes amusing, sometimes baffling relationship and hectic but rewarding life she shared with [husband Terence] Foley for over two decades. It’s also the fascinating account of an illness—its origins, composition and progression—and of the cost (mental, physical and financial) of trying to treat it via the complicated, frustrating, outrageously expensive American healthcare system....[Bennett] vividly presents the startling price and the occasional payoffs of hope.”
--The New York Times Book Review
 
“Moving and intelligent…Like Joan Didion in The Year of Magical Thinking, Joyce Carol Oates in A Widow’s Tale, and Kay Redfield Jamison in Nothing Was the Same, Bennett finds, in her grief over her husband’s death, an opportunity to explore their fascinating and complex life together…. Foley is a larger-than-life character, and Bennett paints him vividly and affectionately. It doesn’t take long for the reader to fall in love with this guy and also with his wife, the warm and honest narrator of their story….A deeply felt memoir [to] savor.”
--The Boston Globe
 
“Poignant…Part love story, part expose of the absurdities of the American healthcare system, Bennett will open your eyes while filling them with tears.”
--Redbook
 
“Important, relevant, and riveting....The implicit message [of The Cost of Hope]...is that if this brilliant woman...can't figure out the health care system and its many dips and traps, then no one can.”
--Portland Oregonian
 
“[A] memoir squarely in the midst of our debate about the American health-care system and how broken it actually is…The Cost of Hope might be expected to come in under some vague heading like ‘Good and Good for You,’ but Bennett moves her book far beyond all that because she’s such a terrific writer....[The Cost of Hope] is a wonderful story about an engaging, even heroic, American family.”
--Carolyn See, Washington Post
 
“Both a memoir of a marriage and a sharp piece of investigative journalism....With The Cost of Hope she has not only memorialized [her husband] artfully, but turned his experience into a probing look at modern medicine and the choices it forces upon us.”
--Bookpage
 
 “[The Cost of Hope] illuminates the conundrum Americans face over the high cost of care—the fact that we will do almost anything to keep our loved ones alive because we can't bear to let them go.”
--Wall Street Journal
 
“Bennett is a skillful writer…[and her] candor is winning....[A] loving picture of a very human response to illness.”
--Philadelphia Inquirer
 
“A a love story about two ridiculously mismatched people; a portrait of a maddening, brilliant man; and an examination of our nearly unfathomable health care system…written with such honesty that when you open the book you feel like you're stepping right into their life.”
--Minneapolis Star-Tribune
 
“Must reading....[Bennett] carries off a high-wire act worthy of a novel, as she weaves together a hilarious retelling of the couples courtship [and] their cross-country lives together in the U.S. [with] a heart-tugging tale of their nine-year battle with Terence’s cancer. Along the way, Amanda dishes one of the most illuminating and digestible accounts I’ve read of why the U.S. health care system is an unfathomable mess. The book is an impressive feat and a darn good read, reflecting skills Amanda acquired during decades of reporting and editing, as well as her biting with, knack for just the right anecdote, and perfect ear for the incisive quote.”
-- Michael Waldholz, Forbes
 
“The hot-button issue of unregulated health-care costs underscores this engaging memoir of marriage and terminal illness….While retracing the path of [her husband’s] terminal prognosis, [Bennett] uncovered a flawed system of mismanaged lab information, astronomical insurance charges and conditional physician reimbursements. The author leaves readers with more questions than answers after dealing with an industry that sets prices “like a giant Chinese bazaar” yet facilitated her husband’s participation in experimental clinical trials….A moving, beautifully written chronicle of true love and a clarion call for health-care reform.”
--Kirkus Reviews (starred review)
 
“[An] affecting memoir….[Bennett’s] story of how to fight for any hope you can get when there seems to be none, provides touching and instructive wisdom for the millions affected by cancer.”
--Publishers Weekly

About the Author

Amanda Bennett is an executive editor at Bloomberg News, directing special projects and investigations, and was the co-chair of the Pulitzer Prize Board. She formerly served as editor of The Philadelphia Inquirer, editor of the Herald-Leader (Lexington, Kentucky), managing editor of The Oregonian (Portland, Oregon), and Atlanta bureau chief (among numerous other posts) at The Wall Street Journal. In 1997, Bennett shared the Pulitzer Prize for national reporting with her Journal colleagues, and in 2001 she led an Oregonian team to a Pulitzer for public service. Her previous books include In Memoriam (1997, with Terence B. Foley), The Man Who Stayed Behind (1993, with Sidney Rittenberg), and The Death of the Organization Man (1990).

See all Editorial Reviews

Product Details

• Hardcover: 240 pages
• Publisher: Random House; First Edition edition (June 5, 2012)
• Language: English
• ISBN-10: 140006984X
• ISBN-13: 978-1400069842
• Product Dimensions: 6.4 x 0.9 x 9.5 inches
• Shipping Weight: 15.5 ounces (View shipping rates and policies)
• Average Customer Review: 4.4 out of 5 stars  See all reviews (81 customer reviews)
• Amazon Best Sellers Rank: #124,263 in Books (See Top 100 in Books)

Most Helpful Customer Reviews

23 of 25 people found the following review helpful

5.0 out of 5 stars Poignant, bittersweet, funny, compelling...thought-provoking. May 8, 2012

By Barbara McArthur VINE™ VOICE

Format:Hardcover|Amazon Vine™ Review (What's this?)

A beautifully-written memoir - a story that will last in your memory long after the last page is turned. Amanda Bennett was married to one of the most unusual men - totally "out there" in everything he said, did, wore. He was a one of a kind character, larger than life and highly entertaining to read about! I laughed out loud at many of their verbal battles. This was definitely a "can't live with each other or without each other" kind of marriage. When the diagnosis of a terminal illness is delivered to Terrence, the energy of their warfare is focused on finding a way to save his life.

An exceptionally rare form of kidney cancer sends Amanda and Terrence on a quest for a cure. With determination, and unwavering hope - and a good insurance policy - they navigate the complex world of oncology with its many treatment choices, various specialists for various kinds of kidney cancer, interminable tests and clinical trials. Through it all, the bantering continues, along with Terrence's great sense of humor - and the great love they have for each other. Denial, confusion and frustration make decisions difficult.

Amanda raises some good questions about the cost of the treatments and experimental drugs. From the info that is sent out by our insurance companies (and in my case, Medicare), it's impossible to figure out how much things really cost - what the hospital is receiving, what Medicare is paying and why the amounts change fairly often for the same office visits and procedures. Her points about the cost of scans is illuminating - and, she's right. We hardly ever pay much attention to those charges - and we've never thought about shopping around for the best price on a scan.

Amanda questions whether or not they did the right thing in trying all the treatments, having all the tests, etc. Since I've been down this road myself (my son with a brain tumor), I feel that we all do what we think is best. It would be helpful to have a neutral party standing beside you to help you see your choices and the consequences of your decisions. When the chips are down, though, we'll do anything to try to save our loved one - and that's the way it should be, I think. The toughest thing, is what Amanda encounters - knowing when it's time to just opt for peace, comfort and letting go.

15 of 18 people found the following review helpful

4.0 out of 5 stars A Fascinating but Quirky Memoir May 4, 2012

By Karen Vaughan VINE™ VOICE

Format:Hardcover|Amazon Vine™ Review (What's this?)

Amanda Bennett has written an intricate book about her marriage, her husband and the costs of his death. Terrence Foley, dressed in a 3 piece suit and owl eyeglasses meets her at a sweatpants-casual dress party in 1980s Beijing, where they make up part of an isolated ex-pat community. He motions her over, finds she is reporting for the Wall Street Journal on Sino-Soviet relations, describes himself as a Fullbright scholar studying just that and they have a deep and intricate conversation. Only later, when she realizes she failed to get his name for an article, she meets him and he confesses that he works in soybeans, trying to improve soybeans and pork quality after the Cultural Revolution destroyed agriculture, and only wanted to attract her attention. She yells at him and storms off, setting a pattern. He proposes at their third meeting where they shared a cab and sat silently in front of his television screen watching movies (a rare commodity.) And they do marry, fighting regularly but convinced that they can't do without each other.

The first part of the book is the story of their marriage, moves, one son and an adopted daughter from China. However a "shadow" found when Terrence is having abdominal surgery becomes an unusual kidney cancer. The second part of the book happens because Bennett decided to investigate which cancer he died of: collecting duct cancer or papillary cancer. She estimates that he had 15 CAT scans, but bills show 67. The charges ranged from $3232 to $550. Insurance negotiates these bills, so two identical $3300 scans were reimbursed at $776 to $2587 from different insurers. Medicare would pay $251 but an uninsured patient would be charged $1657. Similarly his Avastin pills wholesale for $550 per dose, but was billed by the hospital at $20,000 a dose. It reminds her of the Beijing Chinese Silk Market where vendors offered fake Chanel bags for exorbitant $300 "bargains" (and some tourists were happy to pay that) while her daughter bargained the same purse down to $3.00. Hospitals ask as much as they can and hope some insurance companies won't bargain as hard.

The book is well-written, with quirky lists of Terrence's collections that describe his broad interests and states of mind. I opened the book in the evening and devoured it in one gulp. Bennett uses her journalists eye to pick up illustrative details and a reporter's ability to remember facts to show absurdities in a system of health care that costs much but does not deliver broadly. I highly recommend it.

10 of 12 people found the following review helpful

5.0 out of 5 stars The cost of not saying goodbye June 5, 2012

By Monica J. Kern VINE™ VOICE

Format:Hardcover|Amazon Vine™ Review (What's this?)

The genre of cancer memoirs is a crowded one. What makes this book stand out in the field, in my opinion, are two factors: (a) Amanda Bennett is a professional writer, and it shows in the prose of this book, which is exceptionally well written and a pleasure to read; and (b) it offers a forthright scrutiny of the financial aspects of modern health care for serious illnesses and the implications our current system has for the decisions we make in treatment and end-of-life decisions.

"The Cost of Hope" is more than just a story about Bennett's husband's illness, though; it is also a touching and entertaining story of Bennett's courtship and marriage to a remarkable man. Terence Foley was a Renaissance man in the best sense of the word, speaking multiple languages and accomplishing much in a number of varied careers. Their story is romantic, but not romanticized: Foley was overweight, given to fantastic stories (okay, outright fibbing) when it suited him, and the two of them fought often and loudly. But the love they share for each other and their children shines through the pages of the book, and it becomes clear to the readers that these are real people, with messy emotions and messy lives, not the perfect characters you meet in novels or movies.

The bulk of the memoir is devoted to describing how Bennett copes with the news of her husband's diagnosis, his treatment over the course of several years, and his ultimate relapse and death from a very rare form of kidney cancer. One of the unique features of this memoir is that Bennett is a journalist, and she turns her journalistic skills after her husband's death to interview the specialists involved in her husband's care, as well as undertaking a careful examination of the mysteries inherent in billing and insurance reimbursement policies. Several themes emerge: First, Bennett details a growing frustration with the fact that her husband's care was not well-integrated; different specialists and practitioners would make treatment decisions and prescribe medications apparently without knowing or taking into account what was being prescribed by other practitioners. Second, she describes vividly the huge variety, and seeming irrationality, in how services and drugs are billed. At one point, Foley is prescribed Avastin, an anti-cancer drug, that was initially billed at more than $20,000 per dose (!!), a cost that is later negotiated downward to about $6,000... which their insurance company paid for. Bennett concludes, "We shop carefully for shoes, for tires, for lightbulbs, lawnmowers, and toothpaste. It never occurs to us to shop for CAT scans."

The most poignant part of the book was toward the end, when Foley experiences his relapse and rapid deterioration. Although they know his situation is serious and prognosis bleak, there is always another medication to try or clinical trial to apply for. But, as Bennett acknowledges, these attempts to cure the disease or at the very least stave off death had the unfortunate consequence of preventing them from facing the end when it was imminent: "Is there anything I would have done differently? I am sad that Terence and I worked so hard to save him that we never gave ourselves time to say good-bye." And, in the final analysis, that was the greatest "cost" of hope, worse than the financial costs, because hoping means not admitting when it is time to say goodbye.