In the little-discussed sister city to my hometown, located in a lesser-known republic on an obscure continent, the number of hospitals has become a problem. Not because there are too few, but because there are too many. So many, in fact, that nearly every building on every street is now owned and operated by the republic’s massive medical-industrial complex.
It was not always so. Like most cities, this one started with a single, modest hospital. When the city’s population surged to 100,000, two more hospitals were built — one in the east and one in the west, so as to stay just within the recommended beds-to-people ratio. And all was well for a while.
What city officials did not account for was the toll that the population boom would take on the water system. More and more people, especially new immigrants and tourists, became seriously ill from drinking (or bathing in) the city’s practically untreated water.
The mayor promised a quick solution. But mayors only have so much power in that lesser-known republic. The city council came to an intractable disagreement, at first on the methods and means to treat the water, and later as to whether the water should even be treated at all.
The one thing everyone could agree upon was that more hospital beds were needed for all those made sick by the tainted water. Twenty new hospitals were commissioned and built within a month, with plans to build 20 more in the following decade, in anticipation of continued population growth and ever-more-frequent hospitalizations.
And so black sludge continued to run from the faucets of our sister city. Residents adjusted to this new way of life: they boiled, they imported, they avoided. Newcomers and passers-through were advised to do the same. As a result, the number of hospitalizations due to poisoned water decreased over time instead of increasing as the city had expected.
This presented the city council with a new problem: The hospitals were not full enough. Imagine the embarrassment at having set up so many beds, at such great expense, and having practically all of them empty! But rather than repurposing the surplus hospitals, or halting construction on the new ones, elected officials passed ordinances mandating extended hospitalization in the case of serious illness or injury, whether it was warranted or not, and short hospital stays for even the most minor of scrapes and bruises. Paper cuts, for example, were rebranded “cellulose fiber lacerations,” and added to the schedule of wounds for which hospitalization was required.
In just a few weeks, the hospitals were so full that the city council commissioned another one hundred medical buildings to be constructed before the end of the year, with another one hundred planned for the following year. The city began using public properties adjacent to existing hospitals to increase bed capacity, so the parks, the schools, the clerk’s offices, the courthouses and even the jails were eventually part-whatever-they-already-were, part-hospital. Medical facilities spilled into the private sector as well, as churches became rehab services during the week, restaurants doubled as dialysis centers and so on.
This resulted in considerable confusion. To make matters worse, a noise ordinance to quell the incessant monitorial beeping, formerly heard on every street corner at all hours of the day and night, resulted in a total ban on windows for all medical facilities, so that one could not tell what was just another hospital and what was something else. This was nice for a while; if one is not sick, one would rather not have to see or hear or think about sick people.
But soon the creep of infirmaries affected more than just the sick or injured. By honest mistake, taxi drivers dropped people trying to go to a hair salon or the airport at one of the city’s three dozen ICUs. Those people were hooked to an IV until new arrangements could be made. Hospitalizing oneself eventually became the default response to every complication, medical or otherwise, because it was the only possible response. Residents would visit the emergency room to resolve tax liens, set up a new TV or sew a missing button on a jacket.
The most remarkable thing about the problem of too many hospitals is that it is no longer seen as a problem at all. After a generation or two, no one noticed anything strange about existing in a place where hospitalization was the go-to solution to every ailment, real or perceived, of any quality or duration. To the residents of our sister city, everything is and was always normal; nothing has ever been out of sorts. •
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