Quick Synopsis

In Cost of Living, Emily Maloney examines her experiences with the troubled U.S. health care system from both the perspective of a patient and a caregiver. In doing so, she examines what the health care system costs us – financially emotionally, physically, and spiritually.

Publisher’s Synopsis

The searing intimacy of Girl, Interrupted combined with the uncomfortable truths of The Empathy Exams in a collection of essays chronicling one woman’s experiences as both patient and caregiver, giving a unique perspective from both sides of the hospital bed.

What does it cost to live?

When we fall ill, our lives are itemized on a spreadsheet. A thousand dollars for a broken leg, a few hundred for a nasty cut while cooking dinner. Then there are the greater costs for even greater misfortunes. The car accidents, breast cancers, blood diseases, and dark depressions.

When Emily Maloney was nineteen she tried to kill herself. An act that would not only cost a great deal personally, but also financially, sending her down a dark spiral of misdiagnoses, years spent in and out of hospitals and doctor’s offices, and tens of thousands owed in medical debt. To work to pay off this crippling burden, Emily becomes an emergency room technician. Doing the grunt work in a hospital, and taking care of patients at their most vulnerable moments, chronicling these interactions in searingly beautiful, surprising ways.

Shocking and often slyly humorous, Cost of Living is a brilliant examination of just what exactly our troubled healthcare system asks us to pay, as well as a look at what goes on behind the scenes at our hospitals and in the minds of caregivers.

Book Review

When the publisher of Cost of Living offered me an advanced readers’ copy of the book, I was excited to dive in. I have a lot of experience with the U.S. health care system – both professional and personal. I was excited to see a non-academic book published that discusses the ridiculous cost of health care in this country. However, Cost of Living did not live up to my expectations.

I nearly abandoned the book after reading 30 percent. But I have terrible guilt and could not in good conscious DNF a book that I was gifted. So I put it aside for a few days hoping that maybe I was just in a poor mood and that was impacting my enjoyment. I think that was partially the problem as I did not struggle through finishing Cost of Living when I picked it back up.

I think essay collections are pretty hit or miss similar to short stories. Sometimes one essay/story shines much more than the rest or the collection as a whole is lackluster and not fully executed. I found the essays in Cost of Living suffered from a bit of this. Many essays I found boring or uninteresting. I do not know if this is because I have had very similar experiences to the author or if they were objectively not engaging. I think the best essay of the bunch was “Something for the Pain” which discussed medical pain management in the United States, the opioid epidemic, and how responses to the epidemic have impacted patients with chronic pain. The worst was “A Brief Inventory of My Drugs and Their Retail Price” that listed the 22 psychiatric medications the author has taken and her reactions to them. I could make a similar list, but why would anyone other than a medical professional want to read it? I think if the essay had been more substantive and better executed it could have shown those who have not had these experiences the challenge and failure of mental health care, particularly in the U.S.

As a whole, Cost of Living did not do anything for me. I feel like it failed to have a point or or a conclusive message convey. There was clearly a central theme to Cost of Living, but for me, it lacked a cohesiveness that would have made the essay collection compelling and to do what the synopsis promised.

While the essays are well-written, I did not find them or the writing compelling. Emily Maloney’s writing is very straight-forward and factual. I am used to writing like this, so I was unbothered and liked it. However, I do feel that she failed to convey emotion and hook readers.

Overall, Cost of Living was just an okay read for me. I did not learn anything new, but I do not think that will be true for most people who read it. I think it is a consequence of my experiences, personal and professional.