Unaccountable:

What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care

By Marty Makary

I was afraid to read this book. I put it off for a long time while I struggled with myself. On the one hand, I wanted to be informed. On the other, I was afraid that it would scare me away from ever going to the hospital ever again. As it turned out, that's not the case *wipes nervous sweat from brow*

Yes, there are plenty of horror stories in here. There are also stories of fantastic surgeons who have had phenomenal success. The problem is that patients aren't being given access to the information we need to make informed decisions about which hospital to go to or which surgeon to have perform our surgery. The most frustrating part about it is that hospitals have the information, they just refuse to let us see it. They keep it under lock and key. It's their most closely guarded secret. Thanks to the internet and digital systems hospitals can now track their 90-day readmission rate, as well as the number of deaths and complications from surgery.

Here's the really frightening thing: hospitals make money off of complications. The longer you have to stay in the hospital, the more money they make. So their motivation to discipline or get rid of surgeons with high complication rates doesn't really exist (other than, you know, actually being a decent human being, but I guess that gets sidelined when money is involved). So they don't do anything about it. They just keep raking in the big bucks. For obvious reasons, this is a huge burden on the individual patients, employers, and the government.

Makary is convinced that this is responsible for much of our current economic crisis. While most of us are getting worked up over government subsidized health care, Makary insists that basic accountability would lower complications, thereby significantly lowering health care costs. Along with this idea, Makary talks about the way hospitals will buy up the newest technology simply because it's cool. He describes one machine that hospitals have been buying up in droves that allows surgeons to perform remotely. However, while there are certain benefits to having robotic arms, rather than human arms, open up a person, there are also drawbacks. At least a couple people had horror stories of the machine getting in the way of the doctors performing CPR when a patient coded on the table. Despite these risks, and its limited benefits, Makary describes surgeons drooling over themselves at the prospect of using this new machine. He admits that, in the future, it might very well prove beneficial but, at this point, it's hardly a reason for hospitals to spend the millions on it that they are currently lining up to do.

As infuriating as it is that hospitals refuse to release basic information such as their complication and readmission rates, Makary provides the reader with hope. Obviously, you can always get a second opinion. You can ask the right questions, such as "How many surgeries of this type do you perform annually? And, as always, there's the handy dandy internet! No, not everything you see on the internet is true, but you can get first-hand accounts of people's experiences. One patient Makary mentioned used the internet to research hysterectomies. When her doctor refused to do one laparoscopically, she went to one who would because she had seen that other doctors were doing it and having success with less recovery time.

Wolf Hall

by Hilary Mantel

This book is awesome! I love the time period and had already read numerous books about it but I had never read one that told the story from a man's perspective. I had read fictional accounts by Anne Boleyn, Mary Boleyn, Mary Tudor, and Katherine of Aragon, but never an account from Henry or any of his advisors or courtiers. This book did not disappoint. It was just as exciting as the others but it showing a whole new level of intrigue. Like everyone else at court, Cromwell is busy manipulating the king for his own purposes. Unlike everyone else, Cromwell doesn't limit his focus to the king and the nobility. He's influencing everyone from the king to his local jailers who are naming their children after him. And he does it flawlessly. Eventually, he always gets what he wants, all the while making it all look so easy.

Mantel's writing style is a study in minimalist writing. I kind of had a love-hate relationship with it. On the one hand I marveled at her ability to clearly convey something to the reader without outright saying it. A perfect example is Cromwell's affair with his sister-in-law. She never directly tells us that they're sleeping together but, with just a handful of careful phrases, she makes it undoubtedly clear that that is exactly what is happening. It was truly marvelous.

My real problem was with her refusal to refer to Cromwell by name. It was always "he". This got to be frustrating during dialogue when I had to re-read scenes to try to decipher who said what. Eventually I learned that "he said" almost always referred to Cromwell speaking. Almost always.

On the other hand, Mantel's refusal to use his name gave him an air of mystery. This was another masterful accomplishment on Mantel's part because the story is basically told from Cromwell's first person limited POV. Her minimalist writing though, and a certain amount of amnesia on Cromwell's part, leave him largely a mysterious character, even to himself and, by extension, the reader.

One recurring question in the novel is whether Cromwell has killed a man. He seems to have a fuzzy memory of a man and a knife but that's about all he can remember. Yet there is a reference to him teaching the boys that work for him how to silently kill a man with one swift stab. Again, it's just one sentence but, in a roundabout way, Mantel tells the reader everything they want to know.

One of my favorite things about the book was the few times Cromwell realizes (or has someone point out to him) that people are afraid of him. This baffles him and I think both the fact that it is a recurring issue with the people in his life (including his own son) and his unfailing surprise, say volumes about Cromwell as a character. However, true to form, Mantel shows us all this with just a few sentences, leaving the rest of the book to discuss all the exciting things happening in and around the court of King Henry VIII.

The Orbs and the Gentleman

by Alison Ver Halen

Galadriel paced back and forth as she watched the sun rise higher in the sky. Where was he? It shouldn't have taken him this long. Her mind raced with all the things that could have gone wrong.

Finally, she heard hoof beats. She dove for cover behind a tree, in case in wasn't him.

The hoof beats got much quieter as they left the gravel road for the muddy earth, made soft by the recent spring rains. Then she heard his voice call out, softly, "Gala!"

She closed her eyes in a brief thanks as she released the breath she had been holding in.

"What took you so long?" she hissed as she emerged from behind her tree. "I've been waiting here since midnight!"

"I know, " he said as he dismounted. 'Forgive me. There was a change in the guards. Edward was not at his usual post and so I had to sneak out without being noticed. It wasn't easy, but I do not think my exit was marked."

He took a black felt bag from his belt and held it out to her. Galadriel snatched it from him then turned her back to him as she checked the bag's contents. Two perfectly spherical orbs looked back at her. They were a dark pink, or perhaps a light red, depending on how the light caught them. They seemed to almost glow from the darkness of the bag's bottom. Perfect.

She tucked the bag into her bodice. "And every thing else is in place?" she asked, scarlet skirts swirling as she turned abruptly back around to face him.

"It is."

"Excellent. Go and tell The Madame that we are ready."

He made a curt bow, remounted his horse, and took the road back south, the way he had come.

Galadriel waited until he was out of sight. The plan was for her to wait a few moments then follow him down the road towards the city.

But she had other plans.

Instead, she headed deeper into the woods. She would use the trees as cover to circle around to the back of the city where no on was expecting her to go. Except for one man. One man who would be very happy to get his orbs back.

Galadriel huffed and puffed her way through the gate. She had run all through the forest to get to The Gentleman as fast as she could. The delay of the orbs would surely reflect on her and, if there was one thing in the world she did not want, it was for The Gentleman to think ill of her.

She passed through the city's back gate with a nod to the guards. She slowed her pace and gave herself a chance to catch her breath as she made her way through the streets to the door she was looking for.

She lifted her hand to knock but the door swung open before she had a chance to make any sound.

"You have the orbs?" said a soft voice from the shadows beyond the door.

"I do."

The door swung wider to give Galadriel room to enter. She stepped in and, the moment she crossed the threshold, the door was closed behind her.

"Let's see them, then."

She pulled the back out of her bodice and held it before her.

He took it from her gently, almost reverently, and slowly opened the top to check its contents. He exhaled slowly, as if he hardly dared to breathe, as he looked into the bag.

"Do you think they'll meet with The Gentleman's approval?" asked Galadriel.

"Oh, yes," The Gentleman breathed, as he rolled the orbs about in his palm. "Yes, I am sure he will be quite pleased with these. Thank you, Gala."

Galadriel was too busy smiling in self-satisfaction to see the knife flash. It was only a moment. Then she was lying on the floor, her life gushing out of the gash in her throat.

Elite

by Anne Michelle

Oh my god, this book. I normally mean that in a good way. This time ... not so much.

Here's the thing: I am going to self-publish my novel and thereby enter the ranks of Indie authors (assuming I ever actually finish said novel but that's another matter entirely). With that in mind, I thought it would be a good idea to start stalking I mean following Indie authors online. So I downloaded a self-published book that one of my stalkees recommended.

Let me start with what I liked. The story was awesome! It was described as a YA sci-fi thriller, similar to "Ender's Game" but with a romantic element. That's pretty accurate so, in that sense, I was very happy to get exactly what I thought I was going to get. The characters were interesting and the relationships between them well-developed. There were a lot of action scenes and those were really intense and well-written. I loved those scenes! There were also moments that were genuinely heart-wrenching and for that, I applaud the author.

The problem with the book is the problem that so many people have complained of self-published books in general: they are not professional. First of all, the formatting was terrible. I read this on my kindle (which I love, btw) and the indentations at the beginning of paragraphs were sporadic at best and there were sections (most of the book, actually) in which the type was a faded gray rather than black. Other sections had black type. Note to self: do not use Smashwords!

Second of all, I doubt this book even had beta-readers look over it before it was published, much less a professional editor. The book was full of typos. I do mean full. The writing style was extremely amateurish. I felt like I was reading something written by a high-schoole (who knows? maybe I was). She seemed to deliberately avoid using "he said/she said" dialogue tags. I don't think she used it once. She always insisted on using the dreaded adverbs (argued back, asked, commanded, etc.) If she was deliberately avoiding the "he said/she said" dogma just for the sake of being rebellious, I can actually get behind that. I fought it myself for a long time, but I have slowly been coming over to the dark side recently. I think it's actually a testament to how good the author's dialogue is that I really wanted her to use "he said/she said". Every time she explained it to me I was all, "I know. It's obvious. Can we move on already?" Her dialogue spoke for itself (no pun intended) which is not always as easy as it looks.

And then there was the crying. Oh, good Lord, the crying! The main character is a seventeen-year-old boy and I am somehow supposed to believe that he is openly crying in front of his friends and brothers and not getting made fun of? Nope. Sorry. I do not believe that. Not for one second. A few tears when you think your brother is dead/dying is one thing. But sobbing (she used that word) in front of your friends just because you didn't get your way is another matter entirely. Even the girl cries too much. Overall, there was just way too much crying in this book. I know they're teenagers with raging hormones but seriously, get ahold of yourself.

Despite the above-mentioned drawbacks, I finished reading the book. Granted, it only took me three days but still, that's three days I could have spent reading a professionally edited book. It shows just how much I liked the story that I was willing to put up with all the bad writing to see how it ended. And yes, I was satisfied with the ending and, ultimately, glad that I read the book. If the author could just clean up her writing, I think she could produce some really stellar work. Best-seller quality. No joke.

Fingersmith

by Sarah Waters

I don't really know what to say about this book. I liked it. I definitely think I liked it. I'm just having a hard time processing it because it didn't turn out to be what I expected it to be.

The book is about a girl in mid-nineteenth century London who is recruited by a friend/thief to help him seduce and then rob an heiress. The plan is to lock the poor heiress up in a mental institution once they are married and the main character will then get a cut of the money. But things go horribly, horribly wrong and that's really all I can tell you. That's all I knew before going in and, should any of you choose to read the book, the last thing I would want to do is spoil it for you. That first major twist was such a huge "Oh, no you DIDN'T!" kind of moment that I wouldn't want to spoil it.

After that the book is full of twists and turns. No one is who you think they are. Everyone's motivations are different and mysterious and hidden. It's almost 550 pages and I read it in about a week because I couldn't put it down. I would definitely recommend it. The book is very well-written and brings nineteenth-century England to life without bogging the reader down with unnecessary details. The writing is just impeccable.

For what it's worth, I was very satisfied with the ending. That's really saying something because, for awhile, I wasn't sure the book could possibly come up with an ending that I would be satisfied with. But then Waters pleasantly surprised me and I was all "Yep, that's exactly where I wanted those characters to end up." *contented sigh*