Still recovering from the Great Recession, an Ohio hospital is losing money, making it vulnerable to big health systems seeking domination. As the CEO fights for the hospital's independence and local leaders address the town's problems, a 39-year-old diabetic literally fights for his limbs, and a 55-year-old contractor lies dying in the emergency room. With these and other stories, Brian Alexander strips away the issues of policy to reveal Americans' struggle for health against a system that's stacked against them, yet so fragile it collapses when the pandemic hits.

"A superb account of a small-town hospital whose first priority is delivering high-quality medical care…. Deeply insightful."—Kirkus Reviews (starred)