Little, Brown pre-empts 'The Poor Unfortunates'

Little, Brown has acquired The Poor Unfortunates: Stories from a Safety Net Hospital by Ricardo Nuila in a 48-hour pre-empt. 

The book is a US doctor’s report of hospital life, influenced by Chekhov’s writing. Senior commissioning editor Ailah Ahmed secured UK & Commonwealth rights in The Poor Unfortunates from Sophie Lambert at Conville and Walsh, on behalf of Anna Stein at ICM. Kathryn Belden at Scribner secured North American rights.

Inspired by Chekhov’s writing about his own work as a doctor caring for the poor, Nuila introduces readers to Ben Taub Hospital in Houston and the undocumented and poor people it serves within the larger chassis of the United States health care system.

The narrative uses the human body as a framework, with each chapter focusing on an organ, while first-hand accounts of Ben Taub patients are said to provide guideposts to show how bureaucratic structures and governmental regulations conflict with the moral duty of doctoring.

"Extraordinary stories" in the book include desperate patients manipulating their health in a bid to become eligible for emergency treatment, and patients who need dialysis three times a week and can only receive such treatment on emergency wards. Other obstacles to patient care include the semantics of citizenship status, Medicaid qualification and financial resources.

Ahmed said: "The Poor Unfortunates contains the most extraordinary stories of human survival in a complex medical system filled with bureaucracy and regulation. Ricardo Nuila is an accomplished storyteller and has a huge amount of empathy for his patients and their loved ones. This is a book about the dark and challenging times in ordinary lives, and the narratives of hope, triumph and trauma that accompany them."

Nuila, who works as an attending physician and teacher of Internal Medicine at Ben Taub, added: "It’s not only my hope, it’s also my patients’ hope that these stories can serve the health care systems that give care to the marginalized in our society. In Texas, the cracks are gaping, but there are cracks in all healthcare systems. Hopefully these stories can illuminate ways to fill in these cracks."

The Poor Unfortunates will be published in spring 2019.