Review: Examination of a sick system | Book reviews and short stories


“Cost of Living: Essays” by Emily Maloney; Henry Holt and Co., 240 pages, $27.99.

America is in the midst of a health care crisis, and it’s even worse than you probably realize.

Not only are hospitals overwhelmed with COVID-19 patients, healthcare workers are leaving their jobs in alarming numbers. And those who are lucky enough to find a cure for their disease are often faced with bills they cannot pay; Americans currently have $140 billion in medical debt.

Emily Maloney intimately understands the nation’s medical crisis. She worked as an emergency room technician, but also has extensive experience as a patient – ​​she was treated for a mental illness following a suicide attempt, but later discovered that her illness had no cause. all its roots in psychiatry.

Maloney writes about her experiences in ‘Cost of Living’, a fascinating new collection of essays that examines what it means to give and receive care. This is a book that could not be more current.

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In the title essay, Maloney writes about acquiring a huge medical debt after a suicide attempt landed her in the hospital. “That debt was the cost of living,” she writes. “I couldn’t imagine the amount of money I had spent – ​​the debt I had incurred – trying to end my life. Suicide should be cheaper, I remember thinking.”

It was only later that she discovered that her illness was due to vitamin deficiency, hypothyroidism and a developmental disorder. At that time, she had taken 26 different prescription medications.

She writes about these drugs in “A Brief Inventory of My Drugs and Their Retail Price”, an astonishing essay that takes the form of a kind of pharmacological litany. There’s Zyprexa, $400 a month, which made him feel “under water,” and Wellbutrin, $80 a month (“When I stopped taking it, everything appeared shiny, hard and intensely beautiful.”) The effect of the list is almost hypnotic; it’s an amazing essay that highlights the cost of trying to feel better in a country dedicated to capitalism.

There’s not an essay in “Cost of Living” that’s less than captivating, thanks in large part to Maloney’s exceptional prose. In “In Telemetry”, she describes trying to explain her insomnia to a psychiatrist: “Everything seemed too bright and brittle. My speech was loud and tense – I had too many syllables and not enough breath to say them.” And in “For Pain,” she writes of a teenage girl injured in a traffic accident: “The pain, like anything else, was not constant, but close: it chased the edge, lapped the shore.

Maloney is a careful writer; although her book clearly explains what it is like to be both patient and caregiver in a broken medical system, it never becomes didactic. She lets readers fill in the blanks, asking them to put themselves in the shoes of those whose lives have been turned upside down by the disease. It’s not just a thoughtful and compassionate book; it is also essential.

Michael Schaub is a board member of the National Book Critics Circle. He lives in Texas.

Alycia R. Lindley