David Ansell is an intense man. He believes accessibility to quality health care is a moral issue and he ties the inequities of the multi-tiered American system to racism and poverty. I found him a refreshing antidote to the conservative posturing that dominates the current discussions of health care reform. I didn’t expect his book to be about the need for a single-payer health care system but once it’s clear what has shaped Ansell’s thinking, you can see he could hardly have arrived at a different conclusion.

His recently released book, County: Life, Death and Politics at Chicago’s Public Hospital, is a memoir of the events that shaped him as a physician. He and a group of medical school friends at Syracuse University, swayed by the work of Quentin Young at Cook County Hospital, came there to do their residencies. They were idealistic and anxious to fundamentally change the way health care was delivered.

Ansell appeared at Oak Park’s Main Library on June 29 to read from the book and provided chilling stories of how inexperienced (and largely unsupervised) new doctors learned on the job. While they became uniquely knowledgeable because of those experiences and typically went on to lucrative positions elsewhere, some patients died while they learned their craft. Adequate patient care was further thwarted by a system that put political patronage before people and played brinksmanship with funding for supplies and medication. Filth, vermin and lack of access to such basics as sinks and soap further compromised patient safety. Desperately ill people suffered bone-chilling cold in the winter and suffocating heat in the summer.

And, frankly, very few of us gave a damn.

I met Ansell for coffee and found him passionate and articulate about the need for health care for all. After a long and distinguished career in internal medicine at three Chicago hospitals (Cook County, Mount Sinai and now Rush) Ansell still burns with the injustice of what happens to those with no medical insurance and who have the misfortune to be born poor, black or Hispanic in this city.

“The conditions at Cook County Hospital,” he writes, “were so appalling and the suffering of such magnitude that we often felt that if the outside world knew about it, there would be more outcry to end or improve it.” Later he adds, “We were practicing Third World medicine in Chicago, one of the largest cities in the U.S. I shudder to think how many patients I may have harmed or killed because we could not diagnose or treat them quickly enough — and this because they were County patients and lacked access to the most basic services.”

The book is well-written and engrossing. There are unsettling stories and depressing details about being a young doctor in the system but Ansell does not waste time on extraneous verbiage. He told me he went through the book and tried to make it as clear and straightforward as possible, and he has achieved that. But reader beware: high-octane words are used frequently, such as myriad, cacophony, raucous and obsidian. Many contemporary books use carefully edited prose, and I haven’t encountered so many polysyllabic words outside of a dictionary in a long time. It was refreshing.

Whether you agree or disagree with Ansell’s argument about health care, you’ll find his narrative riveting. He offers a compelling argument that the current system is broken beyond repair and needs to be replaced, that we cannot continue to support health and wellness only for the fortunate few.

For more information about the book and Dr. Ansell, visit www.countythebook.com.

David Ansell