Houston Doctor’s New Book Shuns the Healer Hero Narrative to Tell Patient Stories — Ben Taub Is The People’s Hospital

In his debut nonfiction book, The People’s Hospital: Hope and Peril in American Medicine, Houston Dr. Ricardo Nuila unconventionally shuns positioning the doctor-storyteller as the hero of the story. When writing his first book, he never thought to cast doctors as the “healer heroes” we have become familiar with in books, movies and TV.

“I did not want the case of the hero doctor. I resist that idea,” Nuila asserts.

Instead, a hospital takes the starring role. The People’s Hospital is about Houston’s Ben Taub Hospital, the publicly-funded, safety net hospital nestled within the largest medical center in the world. While any heroes of the book are certainly those who work at Ben Taub, the narrative focuses on five patients who sought life-saving and life-sustaining care. 

The People’s Hospital begins with relatable accounts of those seeking treatment from the U.S. health care system. Some of these patients have insurance. Some find themselves under-insured. Some inhabit that in-between world where they earn too much money for medical assistance but not enough for insurance that covers treatment. Their fraught journeys eventually land them in the Harris County Health System at Ben Taub in the heart of the Texas Medical Center.

But perhaps the most epic patient story Nuila tells in The People’s Hospital is that of the U.S. healthcare system as a whole. Depicting it as a sort of ailing chimera with its parts haphazardly assembled over time, Nuila dubs it “Medicine Inc.” Though not the hero nor the villain, Nuila recounts Medicine Inc.’s own journey into existence and gives us his empathetic diagnosis. He examines how health care arrived at its current state and how we might change.

Nuila always thought of himself as a writer as much as a doctor. He’s covered medical and medicine-adjacent subjects for The New York Times and The New Yorker. But the Houston writing community knows this doctor from his fiction, writing workshops, readings and serving on the Inprint Advisory Board.

The People’s Hospital Is No Mere Medical Memoir

Along the way, Nuila sutures into the narrative – rather reluctantly – his own doctor-story.

“I really did not want this to be a medical memoir,” he tells PaperCity. “I didn’t think that my story out of the context of what this system is or what it does to patients is something that I wanted to write about or is that interesting.”

But when Nuila omitted his own story in early drafts, the book lost context. He realized The People’s Hospital needed his perspective from his years as a hospitalist at Ben Taub.

“My initial thought was to just write the patients’ stories and that would be enough,” he says. “But situating it and contextualizing it was a challenge. One of my biggest epiphanies was just where I fit into all this.”

Even in the final version, the first “I” in the book doesn’t arrive until page eight.

“I think that my story is interesting in the context that I found a place in healthcare where I really like to work and that’s the bigger story I wanted to tell,” Nuila says. “I did not want this to be a book about me. I was resisting that.

“I think that allowing myself to use my story in service of something different, that’s the mental hurdle I had to leap through.”

Patients Take Center Stage

With an effective but unusual narrative structure, we meet the five patients in The People’s Hospital before Nuila encounters them during his rounds. While their illnesses and ailments become part of their identity – a high risk pregnancy, a rare genetic disorder, cancer, liver failure – storyteller Nuila depicts them as real humans in all their heroic strengths and weaknesses.

“I didn’t have ideas and then selected patients according to that. It was more that there was some sort of gravitational pull that I felt towards them,” Nuila explains when asked how he chose these particular patients. He wanted to tell the twists and turns of their stories.

“I extracted the idea, kind of clarified the ideas of their stories,” Nuila says. “A lot of it had to do with the rapport I built with each of them. Part of it was just how dramatic their stories were. The writer in me identified the drama in it or the surprise.” 

Nuila also reflected on how the personal stories of patients became part of the hospital’s history.

“Some of the characters defy the preconceptions that I think are out there about a public hospital,” he says. That thought easily describes The People’s Hospital, as it defies our expectations of who the real protagonists are in our stories of health, illness, dying and living.

Through his research, Nuila gives us the history of Ben Taub and also tells the history of Medicine Inc.’s conception. Along with those five patients and occasionally himself, Nuila introduces an array of historical celebrity guests, from Florence Nightingale to fellow writer-doctor Anton Chekhov.

Doctor Nuila and the Power of a Family Affair

Nuila’s father, a prominent Houston OB-GYN, also makes an appearance. His account shows the transition that many private practice doctors made from practicing medicine as a vocation to becoming doctor-businesspeople.

“I could see that my dad was not unlike other doctors in his behavior,” Nuila says. “As much as he’s an individual to me, he also espoused mentalities that a lot of physicians have had.”

While The People’s Hospital portrays his father as an excellent doctor, Nuila does not shy away from the philosophical differences between father and son related to the politics and economics of U.S. medicine.

“Allowing myself to use my family’s story to say, you know, I think there are a lot of people who think the way he does,” Nuila notes. “I know that in the personal portion of the narrative that there was a foil aspect to it, but it wasn’t like I selected him as good foil.

“It just happened in the depiction of it to map out like that.”

Nuila will read from The People’s Hospital at the San Antonio Book Festival on April 15, Rice University’s Baker Institute on April 17 and the TMC Library on April 21.