The Cost of Care

From the New York Times bestselling author of The Shift, this richly drawn portrait of four nurses in four different sectors of our broken healthcare system reveals where solutions are actually possible—to make care about people rather than profits.

Theresa Brown worked as a oncology nurse for years before finally burning out, but instead of leaving the healthcare system behind entirely, she set out to find places where it’s actually working. She embedded with nurses in four key areas of care that cover the human lifespan—a maternity center in Pittsburgh, a primary care facility in Portland, an elder care home in Denver, and hospice services in the midwest and in Connecticut—and came back with gripping, and often deeply moving, on-the-ground stories of patient-centered care. Taking us into the daily lives and the exhausting yet rewarding shifts of these four practitioners, Brown gives readers a rare window into what kinds of healthcare facilities are actually doing things well, taking care of patients, keeping things affordable, and supporting staff.

Even as the system feels like it’s crumbling around us, Brown reveals scalable solutions and reminds us that there’s still hope—all through the eyes of the people we know keep the whole thing running: nurses.

• "Theresa Brown captures what every nurse knows but rarely sees reflected on the page: even in a healthcare system that often feels impossible, there are people quietly changing lives every single day. The Cost of Care is compassionate, honest, and deeply hopeful without ever looking away from the system’s flaws... a reminder of why so many of us chose this profession in the first place." 
  Hadley Vlahos, RN, New York Times-bestselling author of The In-Between
• “As an antidote to burnout from a busy nursing career in the profiteering US health care system, Theresa Brown sought out islands of caring for real world patients. Like an anthropologist, she brings us into four places providing great care. A magnificent insider account that everyone should read.” 
  Eric Manheimer, MD, author of Twelve Patients: Life and Death at Bellevue Hospital
•  "In a world where much of what we hear about our medical system is negative, The Cost of Care balances those real-life challenges with inspiring stories of how health care can be done right." 
  Damon Tweedy, MD, New York Times-bestselling author of Black Man in a White Coat
• “[Brown] seamlessly blends memoir, on the ground reporting, and health policy, making complex systemic problems accessible without sacrificing nuance. It’s a deeply humane portrait of what American medicine can become when compassion—not profit—guides care.”
  
  
   
  Publishers Weekly, *STARRED REVIEW*
• “Read this brilliant book to imagine a better future. Theresa Brown’s deep and powerful reporting on nurses illuminates exactly how our broken health care system could instead be humane, functional and even beautiful. Brown vividly brings to life the evidence-based, human-centered care that nurses provide and shows how much hope, promise, and practicality can be found in that practice. Brown's argument is a big one: A different world is possible when care is centered.” 
  Sarah DiGregorio, author of Taking Care
• "Theresa Brown wades into the dysfunctional mess that is the American healthcare system, and, against all odds, diagnoses the possibility of hope. With a bracing combination of unsparing honesty and stubborn optimism, Brown uncovers models of humane and effective care that are hidden in plain sight. This book is both a reckoning and a revelation.” 
  Danielle Ofri, MD, PhD, author of The Body Knows How to Die
• “Compelling, eye-opening, and deeply necessary, The Cost of Care is both a searing indictment of the brutal financial machinery of American medicine, and a celebration of the extraordinary people keeping humanity alive within it. We need this book.”  
  Angela Amar, Dean of Nursing at New York University
• “Reading this book is a salve for those broken-hearted by how American healthcare has changed, and for the nurses and doctors who feel swallowed up by a profit-driven system that does not seem to serve anybody. Creating deeply compassionate, personally fulfilling healthcare is possible, and the stories within this book inspire a call to action for us all.” 
  Mary Fariba Afsari, MD, author of Labor