We welcome your reviews of books that • were published within the past three years • do not advocate for a political party or politician • do address issues supported by the League, and • intrigued you enough that you want to share them. Please submit your review at any time to Margan and Thad Zajdowicz (Margan.Zajdowicz [at] gmail.com).
Our Malady
Lessons in Liberty from a Hospital Diary
By Timothy Snyder
I hope the name Timothy Snyder rings a bell. In 2017, we reviewed another of his books, On Tyranny, which contains twenty pithy lessons about avoiding authoritarian government. It seemed such a pertinent book then that I kept it on my bedside table for months as a talisman against the dangers it anticipated. Sadly, my talismanic hopes were dashed and the hot breath of tyranny swept over our land anyway.
In December 2019, this same Yale historian ran head-on into another of our serious problems: health care. On December 3, Snyder was in Munich giving a lecture. He also had appendicitis, which was missed by the German physicians. To sum up a long and painful story, his burst appendix was finally addressed appropriately in the United States, but a metastatic lesion in his liver was overlooked until he lay close to death in the emergency room at Yale New Haven Hospital on December 29. Even in the ER at Yale, his septic shock was not taken seriously until someone finally noticed the baseball-sized abscess in his liver that was showering bacteria into his bloodstream. As an infectious disease physician, I was horrified by this story—unforgivable on so many levels. Our Malady emerged from Snyder’s experiences as a howl of rage at how we provide medical care in this country.
Snyder distills his thoughts down to four simple lessons. The first is that health care is a human right: “Part of our malady is that there is nothing in our country, not even life and not even death, where we take the proposition that ‘all men are created equal’ seriously. If health care were available to everyone, we would be not only healthier physically but also healthier mentally. Our lives would be less anxious and lonely because we would not be thinking that our survival depended on our relative economic and social position. We would be profoundly more free.”
His second message is that renewal begins with children. Snyder references the well-known fact that our country does poorly with child- and maternal care. “The beginning of life in this country is frightening and uncertain. Care of expectant mothers is wildly uneven and grossly inadequate.” He contrasts, with bitterness, the delivery and postpartum/neonatal care afforded to his family upon the arrival of his first child in Austria with the care his wife and second child received in the United States. Noting “how children are treated when they are very young profoundly affects how they will live the rest of their lives,” Snyder wonders why Americans resist seriously investing in early childhood.
The third message is that the truth will set us free. Snyder alludes to the handling of the pandemic in the first two months of 2020 and the attempts to downplay and minimize it: “The time lost in stupefaction and mendacity … could never be regained.” He is correct. We are now into the tenth month of the pandemic, facing a surge that promises to be worse that any we have yet seen.
Snyder’s last lesson is that doctors should be in charge. This is about medicine, healing, and health care. It’s not about making money. The sooner we reject the idea that health care exists primarily to make money, the faster our health will improve.
Snyder was the victim of unfortunate events and bad medical care. The health care system he encountered was not working to make him better. He barely escaped with his life. He is an articulate and angry man who has turned that anger into a well-developed and cogent analysis of the system that victimized him.
—Margan Zajdowicz, MD, MPH, Healthcare Committee Co-chair
