01/07/2022
Maloney's debut collection of essays is an intimate view of the United States health care system from her perspective as both a patient and a caregiver. She narrates her personal experiences as a patient in the U.S. mental health system, clearly depicting an aspect of health care that doesn't currently help people in need. Maloney paints a picture of the greed of some health care providers, who she says line their own pockets rather than help people who are in pain; the frequent burnout experienced by workers in high-stress environments; and what she calls the dangerous nature of training hospitals. Maloney's book also gives information about billing, insurance coding, debt collection, hospitals, pharmaceuticals, and mental health providers, in a way that will stimulate conversations about the flaws in the system. Maloney's behind-the-scenes look at health care and how the system works is in equal parts heart-wrenching, humorous, and infuriating; an important work for readers who have experienced health care in the United States or who seek to understand the industry. VERDICT Maloney's nontraditional health care memoir serves as a warning for those who've never had to stay in the hospital stay, and sends the message that there is work to be done.—Leah Fitzgerald
2021-11-16
Personal essays about the emotional and financial toll of the American health care system.
Debut author Maloney is candid about her experiences as both a patient and caregiver. In the title essay, she writes about regretting her suicide attempt, but she’s nearly as rueful about how her ignorance led her to seek treatment at a hospital that saddled her with an astronomical bill. Working as an emergency room technician, she’s alert to how every pill, shot, and scan adds to a patient’s burden. As a medical writer, she learned about pain management, a portion of the industry that pays her outsize fees in a discipline flooded with largesse despite OxyContin’s devastating impact. Clearly many things are economically out of whack here. But much like other recent memoirists—Jia Tolentino (Trick Mirror) and Anna Wiener (Uncanny Valley) come to mind—Maloney comes at these injustices not with fury but with a flatness that almost seems determined to avoid feeling at all. This can be effective when Maloney lets the facts do the work, as in her chilling description of her planned overdose: “I normally took 900 milligrams; two pills at 450 milligrams each. So I took all of them instead.” And it’s clear that abuses by various systems have given her plenty of motivation to put on masks: “I am careful to regulate what I say, how I say it, who I am, who I appear to be.” At times, the linguistic flatness reads as disengagement; it’s unclear, for instance, what her accounting of the costs of various medications in one essay is meant to say about herself, pharmaceutical pricing, or our tendency to overmedicate. Nonetheless, Maloney’s self-awareness is mostly engaging, and her resistance to big emotional gestures is understandable, particularly as a woman socialized “to say yes to everything….I am a string of yesses all the time, yes, yes, yes.”
Sharp personal essays light on lyricism but potently suffused with disillusionment.
A Best Book of 2022 - USA TODAY
Named one of the Chicago Public Library's "Best Books of 2022"
Shortlisted for the 2022 CHIRBy Awards
“Maloney’s essays . . . start with a question and work things out on the page. . . They notice everything and have nothing to prove. They don’t prematurely grasp at an ending. These qualities combine to elevate this collection far above the usual first-person essayistic fare. Her broad authority and the quality of the prose — astute, compassionate and lethally funny — are what make these essays remarkable.”
—Sarah Manguso, The New York Times
“Cost of Living is bracingly real, whether Maloney’s subject is herself or the medical field she knows as both patient and professional. The book is sure to haunt your imagination the next time you enter the labyrinthine health care system and face the expenses, financial and otherwise.”
—USA Today
“In Cost of Living, author Emily Maloney might make you laugh. At a minimum, she’ll open your eyes to some of the more dysfunctional aspects of the U.S. healthcare system…Wry and unflinching.”
—Forbes
“An analysis of health care, an analysis of soul, this book is both tender and bold.”
—Good Morning America
“A riveting new collection of essays about [Maloney’s] history with therapists, drugs they prescribed, her chaotic Illinois upbringing and the inevitable cost of health care.”
—The Chicago Tribune
“Cost of Living explores the financial, physical and psychic toll of trying to survive within a broken system. It's a complicated and intimate tale of the messy healthcare apparatus we're all at the mercy of.”
—Salon.com
“A fascinating new essay collection that considers what it means to give, and receive, care. It's a book that couldn't be more timely. This isn't just a thoughtful, compassionate book; it's also an essential one."
—Minneapolis Star Tribune
“Maloney artfully unpacks the fraught connection between money and health in her brilliant debut collection. Maloney is masterful at beginning in a place of skepticism and ending with empathy, all while weaving in her own fascinating story. Readers will be eager to see where she goes next.”
—Publishers Weekly (starred review)
“Sharp personal essays”
—Kirkus
“Maloney’s behind-the-scenes look at health care and how the system works is in equal parts heart-wrenching, humorous, and infuriating; an important work for readers who have experienced health care in the United States or who seek to understand the industry.”
—Library Journal
“I've never read anything like Emily Maloney's Cost of Living, a devastatingly precise, thoughtful accounting of what it costs to stay alive in capitalist America. In essays rife with vivid characters in unforgettable scenes and stitched through with vulnerability, Maloney offers a clear-eyed assessment of our disastrous medical system. From the years-long medical debt of surviving a suicide attempt to the deadly fate facing untreated pain patients, Maloney's writing indicts the system while honoring the humanity of those caught in it. Everyone with a mortal body should read this book. I hope it creates change.”
—Alex Marzano-Lesnevich, author of The Fact of a Body
“Emily Maloney has written a luminous book on one of the greatest shames in American society: our avaricious health-care system. In essays which humanize the subject through incredibly rich character detail, Maloney has offered a beating heart to every reader who feels. What we do with that heart is up to us. I hope everyone reads this.”
—Garrard Conley, New York Times bestselling author of Boy Erased
“A disturbing book – an indictment of a health-care system that burdens the already burdened with bills they can’t pay – but also, such an exhilarating read: lucid, mordant, and awake, awake, awake.”
—Joan Wickersham, author of The Suicide Index and The News from Spain
“Emily Maloney’s Cost of Living is a brilliant book, a staggering indictment of a brutal and arbitrary health-care system that shapes our days in ways so small it often goes right over our heads. On top of that, it’s gorgeously written—clear, exacting, rigorous, compassionate—in sentences that lift off the page like song.”
—Paul Lisicky, author of Later: My Life at the Edge of the World
“Emily Maloney writes from a vantage point completely unlike any other and takes us on a tour, both fascinating and harrowing, of the various costs of the health-care system: financial, physical, emotional, spiritual. Cost of Living is a desperately needed book that offers the reader an entirely new understanding of what it means to be sick and what it means to be healed. I love this book.”
—Kerry Egan, author of On Living
“In Cost of Living, Emily Maloney explores from many perspectives, and with deep empathy, intelligence, and humor the real suffering caused by medical debt and the underpayment of healthcare workers. Like Barbara Ehrenreich's Nickel and Dimed and Atul Gawande's Complications, Maloney's memoir is at once illuminating and alarming. It will leave readers asking: why has no one ever written a book like this before?”
—Suzanne Koven, MD, author of Letter to a Young Female Physician
“Emily Maloney’s deeply affecting and astute collection of essays are offered to the reader as a kind of gift to be savored. There is such melancholic richness throughout; each one must be unwrapped slowly and contemplated gently. Within each essay is a steady stream of rational sense-making and introspection, gracefully intertwined with all that is utterly incomprehensible about the medical industry, mental illness, and life itself.”
—Rana Awdish, MD, author of In Shock
