The Hospital: Life, Death, and Dollars in a Small American Town

422 Pages·1·4.381 MB·English

by  Brian Alexander

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Table of Contents
About the Author
Copyright Page

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To the memory of Bruce Alexander, writer, who kept
waiting to see a doctor until his Medicare kicked in
A Note to Readers
In some cases, the names of people have been changed in
order to comply with applicable medical care privacy law, or
to protect anonymity. Those names marked by an asterisk
are fictitious. In several cases, minor details of scenes have
also been altered to avoid disclosing identities.
We have assembled the most enormous medical
establishment ever conceived, and people are
sicker than ever!
—Paddy Chayefsky, The Hospital, 1971
They’re all sick when they come in here. They’re
horribly unhealthy. If they were healthier I’d see a
lot fewer.
—Lori Bolton-Sell, chief probation officer, Williams
County, Ohio, 2019

Prologue
There was nothing special about that morning. It was just a
winter Monday—cold, but of course it would be cold, being
almost mid-February 2019. Nothing like twelve days before,
when Jim Watkins, the chief of the Williams County Health
Department, had taken a photo of his car’s instrument panel
to immortalize the reading of –15. A couple of sub-zero days
in midwinter weren’t unusual for this far northwest corner of
Ohio, but even the crusty old farmers agreed that fifteen
below was a little extreme.
At the Seasons coffee shop, talk about the “polar vortex”
had faded, and High Street and Main Street had been
plowed. Some side streets were still coated, but passable,
and piles of crunchy snow, turning grimy, took up a few
parking spaces in the CVS lot. The lawn of the county
courthouse in the Bryan town square was covered in white,
offsetting its extravagant Baroque/Romanesque mishmash
of red brick and sandstone. Long strands of Christmas lights
still swooped down from its peak. The main county roads
and the state routes were clear, too, so most people were
getting to work okay. Everybody kept an eye out for deer
leaping out of frozen cornfields—the roadsides were dotted
with the carcasses of struck deer this winter. Drivers
sometimes ended their commutes in the ER because of
them, or because they slid on the black ice that lay
camouflaged like land mines.
Phil Ennen slipped into his long, brown overcoat,
wrapped a scarf around his neck, and placed a rakishly
wide-brimmed fedora on his head to prepare for his own
commute—a walk of about 150 yards across Garver Park to
the hospital, where he was chief executive officer. He could
see the building out his front door. At night, watching TV or
lying in bed, he could hear emergency medical helicopters
arrive and take off from the hospital’s landing pad. Only
8,500 people lived in Bryan, and Ennen knew all of them, or
so it seemed, so he’d wonder who was strapped onto the
gurney and what had happened and how bad it must have
been to require flying the patient to Toledo or Fort Wayne.
He was fifty-five years old. He’d worked at the hospital
for thirty-two years. He called it “my shop,” as if he were a
cobbler making shoes. Ennen was protective to the point of
defensiveness about his shop.
The aesthetic critique was one example. The hospital
stood out in a town of late nineteenth- and early twentieth-
century architecture, especially since the 2009 rebuild. The
rectangular orange and green exterior cladding panels and
the intersections of the building’s wings created a
modernist, alien dissonance. A few residents had taken to
calling it “the Lego blocks place,” as in, “You goin’ over to
the Lego blocks place to get yerself checked out?”
What really got to him, though, was the “Band-Aid
station” crack. “That place is just a Band-Aid station,”
people would say, and Ennen would smile to cover his
seething.
He grew up in Bryan. Most knew him as one of the Ennen
brothers, Mary Helen and Jack’s kids. His father owned a
small manufacturing company up in the village of Pioneer
that made parts for Detroit’s cars. His mother worked at the
hospital he now ran. He met Mary, his wife, in the first grade
at St. Patrick Catholic School. She was the daughter of Jim
Ebersole, the barber who owned Mel and Jim’s Barber Shop
on the square.
So Ennen understood the small-town way of
simultaneously demanding community respect from
outsiders while internally scoffing at any homegrown
institution as second-rate. He steamed just the same.
Sometimes it felt like the town—even the whole county—
didn’t give a damn about the work he did on its behalf.
Running a small independent community hospital was never