Cooked: An Inner City Nursing Memoir

American Journal of Nursing Book of the Year Award, 2005

"Cooked should be required reading in every Introduction to Nursing course."
Dr. Linda Simunuk, Nursing Professor.

Click Here to Jump Down to Book Reviews

To order individual signed books, books for your class, or to book a talk, email carolkarels@gmail.com.

Book Description In May 1971, Look magazine featured a story entitled "Chicago's Cook County Hospital: A Terrible Place." The article provided an inside look at the largest public hospital in the country, one located on Chicago's dangerous gang-controlled and drug-infested west side. Months later, Carol Karels and seventy other nursing students began their nurse's training there, despite newspaper articles that warned that the hospital might close any day. 'The County,' as it was called by the multitudes who sought health care treatment there, has weathered massive layoffs, doctors and nurses strikes, budget slashing, and public relations nightmares. Chicago's counterpart to the Statue of Liberty, 'the County' welcomed the sick, desperate, and destitute multitudes who were turned away elsewhere. Burn victims, abused children, Skid Row drunks with TB, gunshot victims, nursing home rejects, drug overdoses, and those with complex medical conditions all found refuge on County's massive wards. Metal beds, separated only by green curtains, lined the walls of these wards. Patients shared a common bathroom (at one end of the ward) and TV (at the other end of the ward). The nurse's station was often a full block away from the last bed. Call lights were unheard of-patients shouted if they needed help.

Within weeks after starting nursing school, Ms. Karels began work on one of the busiest emergency wards in the hospital. Each night she assisted the overworked nurses and doctors by washing the vermin-infested bodies of the homeless, applying leather restraints to those who were confused and violent, shaking those with drug overdoses to keep them alert, translating street English for foreign doctors, and racing around the hospital to find medications and emergency equipment. Most who trained at Cook County Hospital, the hospital on which television's hit "ER" is loosely based on, describe it as a city unto itself. While the patients were housed on wards, the staff lived and ate right across the street in sexually segregated dormitories--male doctors in one, female nurses in the other. Social life consisted of Friday teas in the nurse's residence, local frat parties and Saturday night dances in the doctor's dormitory.

County was also a hotbed of political activity with staff members representing every imaginable political ideology. In the years before Medicare, Medicaid, legalized abortions, and managed healthcare, County's idealistic nurses and doctors were among the first in the nation to go on strike for better working conditions, and the first to go to jail for their convictions. The struggle for change, complicated by a massive internal bureaucracy, internal corruption, and city politics, is also documented.

Cooked chronicles the day-to-day challenges faced by committed caregivers and shows how stress and exhaustion often leads to indifference, callousness, tragic mistakes, and burnout. The memoir also shows how humor on the wards helps both caretakers and patients maintain their sanity.

The book also explores the culture of the Mexican immigrant on Chicago's near south side. Feeling shut out of the Chicago's public health care system because of language barriers, the Hispanic community resorted to forming their own community health clinic run by a street gang called 'the Brown Berets.' Ms. Karels shares memories of her Wednesday evenings at the clinic, which survived until organized violence took precedence over community healthcare.

Cooked is filled with stories about the compassion, caregiving, dedication, and chaos that took place on County's huge wards and in the surrounding neighborhoods. In Cooked the medical novice will get an inside look inside the country's largest public hospital while those with a medical background will nod their heads in recognition and encourage their children to read about a bygone era of institutional, yet excellent, medical care.

---

Book Reviews

Journal of Nursing Law
"Cooked will appeal to a wide array of readers-students, non-nurses, and nurses with varying backgrounds…Every nursing school library in the US and throughout the world should carry this book. Each chapter is fascinating and highly readable. The author provides the reader with an armchair view of the various hospital wards at Cook County Hospital. Numerous vignettes depicting patients, and the care they received from doctors, nurses and auxiliary staff provide the reader with a vicarious feel for the unique dynamics in the relation-ship between the underserved population, mostly minorities, served by Cook County Hospital during the early 70s."

Nursing Education Perspectives
"Set in Chicago, her story underscores the commitment many have made to the nursing profession while bringing to the forefront the turbulence of an era marked by political and medical activism. She shows us nurses at their best, true patient advocates with great collegial relationships." Dr. Michael Moran, Preservation Chicago

"This book is fantastic! It is inspiring and moving…as well as being an important historical document."

Nursing Spectrum Magazine
"This is a memoir about a hospital disrupted by chaos and held together by dedicated health care workers. Karels both honors these individuals and critiques the health care and political environments in which they practiced. Cooked is a reflection on how far we've come and a tribute to the efforts of those who struggled to provide adequate health care under the most trying circumstances."

AORN Journal
"This book reads like a novel. The author takes readers not only back in time but-for those who never darkened the doors of a huge, urban teaching hospital-to a strange place. Her descriptions of the sights, sounds, and smells are so good that readers can get lost in this foreign environment."

American Association for the History of Nursing Bulletin
"This delightful little book chronicles the journey into the world of nursing. She brings to life the day-to-day rigors of a student nurse, while facing the challenges in this large institution with a variety of colorful characters. This is a stunning read with few limitations. Seasoned nurses will love this book and younger nurses can experience a world before their time. The reader is left wanting more."

NurseZone.com
"The main character in her book is really 'The County', the hospital on which the television show ER is loosely based. For years, The County has had a reputation as a hospital "war zone" whose staff draws respect from peers who work in more civil environments. The County was the last-chance refuge for hundreds of patients turned away from other hospitals because of race or poverty."