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Our Malady
Cover of Our Malady
Our Malady
Lessons in Liberty from a Hospital Diary
NEW YORK TIMES BESTSELLER
  • From the author of the #1 New York Times bestseller On Tyranny comes an impassioned condemnation of America's coronavirus response and an urgent call to rethink health and freedom.
    On December 29, 2019, historian Timothy Snyder fell gravely ill. Unable to stand, barely able to think, he waited for hours in an emergency room before being correctly diagnosed and rushed into surgery. Over the next few days, as he clung to life and the first light of a new year came through his window, he found himself reflecting on the fragility of health, not recognized in America as a human right but without which all rights and freedoms have no meaning.
    And that was before the pandemic. We have since watched American hospitals, long understaffed and undersupplied, buckling under waves of coronavirus patients. The federal government made matters worse through willful ignorance, misinformation, and profiteering. Our system of commercial medicine failed the ultimate test, and thousands of Americans died.
    In this eye-opening cri de coeur, Snyder traces the societal forces that led us here and outlines the lessons we must learn to survive. In examining some of the darkest moments of recent history and of his own life, Snyder finds glimmers of hope and principles that could lead us out of our current malaise. Only by enshrining healthcare as a human right, elevating the authority of doctors and medical knowledge, and planning for our children's future can we create an America where everyone is truly free.
  • NEW YORK TIMES BESTSELLER
  • From the author of the #1 New York Times bestseller On Tyranny comes an impassioned condemnation of America's coronavirus response and an urgent call to rethink health and freedom.
    On December 29, 2019, historian Timothy Snyder fell gravely ill. Unable to stand, barely able to think, he waited for hours in an emergency room before being correctly diagnosed and rushed into surgery. Over the next few days, as he clung to life and the first light of a new year came through his window, he found himself reflecting on the fragility of health, not recognized in America as a human right but without which all rights and freedoms have no meaning.
    And that was before the pandemic. We have since watched American hospitals, long understaffed and undersupplied, buckling under waves of coronavirus patients. The federal government made matters worse through willful ignorance, misinformation, and profiteering. Our system of commercial medicine failed the ultimate test, and thousands of Americans died.
    In this eye-opening cri de coeur, Snyder traces the societal forces that led us here and outlines the lessons we must learn to survive. In examining some of the darkest moments of recent history and of his own life, Snyder finds glimmers of hope and principles that could lead us out of our current malaise. Only by enshrining healthcare as a human right, elevating the authority of doctors and medical knowledge, and planning for our children's future can we create an America where everyone is truly free.
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    Excerpts-
    • From the book Prologue

      Solitude and Solidarity

      When I was admitted to the emergency room at midnight, I used the word malaise to describe my condition to the doctor. My head ached, my hands and feet tingled, I was coughing, and I could barely move. Every so often I was seized by tremors. The day that had just begun, December 29th, 2019, could have been my last. I had an abscess the size of a baseball in my liver, and the infection had spilled into my blood. I did not know this at the time, but I knew that something was deeply wrong. Malaise, of course, means weakness and weariness, a sense that nothing works and nothing can be done.

      Malaise is what we feel when we have a malady. Malaise and malady are good old words, from French and Latin, used in English for hundreds of years; in American Revolutionary times they meant both illness and tyranny. After the Boston Massacre, a letter from prominent Bostonians called for an end to "the national and colonial malady." The Founding Fathers wrote of malaise and malady when discussing their own health and that of the republic they founded.

      This book is about a malady—not my own, though mine helped me to see it, but our common American one: "our public malady," to borrow James Madison's phrase. Our malady is physical illness and the political evil that surrounds it. We are ill in a way that costs us freedom, and unfree in a way that costs us health. Our politics are too much about the curse of pain and too little about the blessings of liberty.

      When I got sick at the end of last year, freedom was on my mind. As a historian, I had spent twenty years writing about the atrocities of the twentieth century, such as ethnic cleansing, the Nazi Holocaust, and Soviet terror. Recently I have been thinking and speaking about how history defends against tyranny in the present and safeguards freedom for the future. The last time I was able to stand before an audience, I was giving a lecture about how America could become a free country. I hurt that evening, but I did my job, and then I went to the hospital. What followed has helped me to think more deeply about freedom, and about America.

      When I stood before the lectern in Munich on December 3rd, 2019, I had appendicitis. That condition was overlooked by German doctors. My appendix burst, and my liver became infected. This was neglected by American doctors. That is how I ended up in an emergency room in New Haven, Connecticut, on December 29th, bacteria racing through my bloodstream, still thinking about freedom. In five hospitals over three months, between December 2019 and March 2020, I took notes and made sketches. It was easy to grasp that freedom and health were connected when my will could not move my body, or when my body was attached to bags and tubes.

      ***

      When I look at the pages of my hospital journals, stained by saline, alcohol, and blood, I see that the New Haven sections, from the last days of the year, concern the powerful emotions that rescued me when I was near death. An intense rage and a gentle empathy sustained me, and provoked me to think anew about liberty. The first words I wrote in New Haven were "only rage lonely rage." I have felt nothing cleaner and more intense than rage amidst deathly illness. It came to me in the hospital at night, giving me a torch that ignited amidst kinds of darkness I hadn't before known.

      On December 29th, after seventeen hours in the emergency room, I had an operation on my liver. Lying on my back in a hospital bed in the early morning hours of December 30th, tubes in my arms and chest, I couldn't ball my fists, but I imagined that I was balling my...
    About the Author-
    • Timothy Snyder is the Levin Professor of History at Yale University and the author of The Road to Unfreedom, On Tyranny, Black Earth, and Bloodlands. His work has received the Hannah Arendt Prize, the Leipzig Book Prize for European Understanding, and an award in literature from the American Academy of Arts and Letters. He lives in New Haven, Connecticut.
    Reviews-
    • Publisher's Weekly

      July 27, 2020
      Historian Snyder (The Road to Unfreedom) frames this searing critique of the American health-care system around his own recent medical emergency. After a series of medical mistakes related to an appendectomy, Snyder nearly died before undergoing surgery for a severe liver infection in December 2019. Doctors treating the appendicitis had seen a lesion in his liver but did nothing to treat it; a different set of doctors botched a spinal tap and missed clear indications of a liver problem in Snyder’s medical records. These were not isolated mistakes, according to Snyder, but symptoms of a systemic failure in which doctors and nurses are not given enough time to meet with patients and truly assess their needs, and are encouraged to prescribe medication rather than get to the root of the problem. Snyder also contrasts his wife’s medical care during pregnancies in Vienna and the U.S., and sketches the Trump administration’s inadequate response to the Covid-19 pandemic. According to Snyder, the present state of health care violates America’s founding principles: “Freedom is impossible when we are too ill to conceive of happiness and too weak to pursue it.” Though he doesn’t offer much in the way of specific solutions, Snyder draws valuable context and insight out of his harrowing personal experience. The result is a troubling portrait of a system in which the patient is the last priority.

    • Kirkus

      August 1, 2020
      The award-winning Yale historian launches a broadside against the American health care system. "The day that had just begun, December 29, 2019, could have been my last." So writes Snyder about his hospitalization and subsequent poor treatment over the next few months, experiences that left him enraged at the state of health care in America. "In five hospitals over three months," the author found himself with a front-row seat to the beginnings of the coronavirus pandemic. He took detailed notes during his time as a patient, and he clearly shows a health care system far more interested in profits than health, a system that follows the dictates of computers and algorithms rather than any one-to-one relationship between doctor and patient. Snyder delivers a scathing critique of this "grotesque" and "ludicrous" system as well as a government response to the pandemic that he dismisses as "magical thinking." Indeed, the Trump administration's "unwillingness to test did not mean that we were healthy, only that we were ignorant," and the "focus on a foreign source of 'fault' meant that no one here was to blame. When no one bears responsibility, no one has to do anything." The author meticulously documents the health problems he suffered--among many others, a burst appendix, tremors, and "an abscess the size of a baseball in my liver"--seemingly all of which were ignored or misdiagnosed by doctors. Snyder compares the impersonalized, economy-driven care he received in American hospitals with the far more nurturing treatment he and his wife had experienced during a childbirth in Austria, a procedure that was both "intimate and inexpensive." Ultimately, writes the author, "our botching of a pandemic is the latest symptom of our malady, of a politics that deals out pain and death rather than security and health, profit for a few rather than prosperity for the many." An impassioned indictment of a broken system and its enablers and necessary reading as the pandemic intensifies.

      COPYRIGHT(2020) Kirkus Reviews, ALL RIGHTS RESERVED.

    • Library Journal

      September 1, 2020

      The malady discussed here is one that Snyder (history, Yale Univ.; On Tyranny) says permeates our society. From the end of 2019 until March 2020, the author found himself intimately involved with the U.S. health care system when his appendix burst following a missed diagnosis, leading to an overlooked abscessed liver and septicemia; it brought him to the brink of death. Once able, he began journaling his experiences, feelings, and conclusions about how we care for one another. He emerged from his personal battle directly into the new world of COVID-19. With this lens, the author describes what he sees as clear evidence of disparity in health care accessibility in the United States, in which the highest spending in the world produces poor results compared with other developed countries. He argues for health care as a human right, and asserts it is not recognized as such in this country. Advocating for a universal system with medical professionals rather than insurance companies in charge, he believes, would allow patients more freedom in their health care choices. VERDICT Snyder writes with passion and clarity, using personal observations, historical references, and case studies to raise the call for reforming the current health care system; stating that without changes, true freedom remains elusive for many.--Richard Maxwell, Porter Adventist Hosp. Lib., Denver

      Copyright 2020 Library Journal, LLC Used with permission.

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