Customer Review

Reviewed in the United States on September 10, 2020
This is an extraordinary book. One that needs to be read. Discussed. And acted upon. Part illness memoir, part cultural manifesto. But what distinguishes it from prior memoirs or manifestos that consider the experience of being ill in America is its deep resonance with our present politico-cultural moment, when the fraying fabric of our two-century plus experiment in republican democracy is at risk of being irreparably torn asunder.

Most illness memoirs – be they about depression, cancer, heart disease, the invisible wounds of war, or any other malady that disrupts and perhaps inexorably alters one’s life course, and in turn, the courses of our loved ones as well – focus predominantly on a single patient’s experience -- be those experiences positive or negative, the treatment heroic or horrific, and the meaning of the experience illustrative, either in some exemplary or admonitory fashion. Despite different authors, different maladies, different experiences, and different outcomes, the narrative arcs of such memoirs typically follow a similar trajectory – eliciting along the way tears of joy, tears of sadness; faith in or contempt for how medicine is practiced in the United States today; and cause us to think, “There but for the grace of G-d ...”

Synder’s analysis casts aside these time-worn conventions and the myriad cliches endemic to the genre. What he offers in its place is a radical reconceptualization of how we might think about the experience of a patient, not just with a personal malady that requires the type of interventions that only a hospital setting can provide, but more tellingly what it means to experience that personal malady within the broader and, and perhaps more terrifying context of a simultaneous and increasingly lethal cultural malady as well. That is to say, the experience of being ill in a society that is itself sick and suffering. And because of that sickness and suffering, not only our health, the health of our loved ones, the health of those less fortunate than ourselves but also our freedom and their freedom is at risk. Lest anyone doubt this analysis, consider just one fact. When Synder first fell ill in December 2019, there was not yet a single diagnosed case of Covid-19 in the world (as the first known case would only be established later in the month). But since then, the virus has taken the lives of approximately 200,000 Americans, the vast majority of whom, had they resided in virtually any other advanced industrialized nation would still be here with us to day.

So while ostensibly a book about a man who goes from one hospital to another to another. Each time being subjected to innumerable errors, mistaken diagnoses, communication lapses, failures to follow protocols, mindless adherence to protocols, counterproductive duplicative procedures, and most frighteningly, a realistic possibility of losing his life, leaving his wife a widow, his children fatherless, all because of a failure to diagnose and treat what had begun as little more than a mere infection. But shocking as it, and while it could easily stand on its own, this harrowing tale is not what the book is about. Not at all.

Synder’s near death experience is not so much a cautionary tale but an extended metaphor – one that suggests, just as no one can really be free until everyone is free, so too, no one can be taken care of until everyone is taken care of. That what, at first blush, we might consider little more than single person’s experience in a life-threatening situation (that should never have become a life-threatening) is not merely a cautionary tale, a warning, or even a call to arms to get our healthcare house in order. But something much bigger. Much more alarming. That we ignore not only at our own peril, but at the peril of our nation and culture.

Synder’s experience, he readily acknowledges, is just one of thousands of similar episodes that take place each and every day in hospitals across the United States (and elsewhere, he concedes). The product, on the one hand, of commercial medicine inexorably marching in goose-step to its logical extreme – where profits not patients – are the driving force, indeed, to mix metaphors, the raison d'être of the healthcare business. Where patients are widgets to be processed. Not people to be cared for.

But medicine is just one of several symptoms that comprise our national malady. A malady that steals our freedoms. That make our lives more risky, more chaotic, more uncertain, more anxious than they need to be given the productive capacity of advanced industrialized societies to provide for these basic necessities that are considered the birth right of virtually every child born in the West and much of the Far East today. A malady that confuses rights, to which we are entitled, with privileges and benefits that our employers may, or is increasingly the case, may not, provide. Health insurance, not a right. Paid parental leave, not a right. Safe, high quality childcare, not a right. Paid vacation, not a right. Affordable public transportation, not a right. Affordable (or free) post-secondary education, not a right. A viable pension after a lifetime of work, not a right. Absent such rights, we are not free. Absent such freedom, we live in an increasingly chaotic and unsettled world whose soil offers fertile ground for unfreedom. For autocracy. For fascism.
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