Title: And Then There Was Swine Flu
Subtitle: The Diary of a Hospital Manager
Author: Acklima Akbar
Publisher: Toplink Publishing , LLC
Pages: 302
Genre: Fiction
Reviewed by: Jake Bishop

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Acklima Akbar has recreated a week in the life of a harried hospital administrator via an hour-by-hour diary which details one potential catastrophe after another.  The author knows her terrain well.  She, like the protagonist in this semi-autobiographical but fictionalized account, was a trained nurse who rose to become a Clinical Service Manager in a United Kingdom hospital. Therefore her chronicle rings with credibility as she takes readers through the gauntlet of situations encountered daily by an experienced health services professional who is as savvy in dealing with people as she is skilled in dealing with challenges.

Many people acquire knowledge through intense study.  The medical profession particularly demands it. But knowledge is not wisdom. Wisdom is acquired through experience, however experience alone does not make one wise.  Wisdom also requires an inherent aptitude for insight, and that’s something Akbar exhibits page after page as her heroine juggles a plethora of process and people-oriented problems.  The struggles are many.  There are too many patients and not enough beds – often brought about by inefficiencies in discharging patients that no longer require hospital care.  There are individuals who have risen to managerial roles who don’t know the first thing about managing.  There are doctors who blame nurses for scheduling problems the doctors actually create.  There are nurses who lose sight of the reason they became nurses in the first place. There are physicians that assume bluster and intimidation will get more done than understanding and cooperation. There are individuals who spend more time debating what should be done than actually doing it.  And there are meetings – countless, mind-numbing, time-wasting meetings.  Drop all of the aforementioned on top of an impending crisis such as Swine Flu, and you’ll have some idea of what you’re in for in this engaging roman à clef; a fictitious novel based on fact having a key towards a solution.

A tart sense of humor runs throughout Akbar’s reportage.  The use of the diary format allows readers to know what the author’s main character is thinking as well as doing.  More often than not she’s realizing the inherent irony and frequent absurdity of the situations doctors, nurses, and administrators get themselves into.   Of course, the dramatization of such inanities in a place as important as a hospital raises the ridiculousness factor exponentially.  That’s why television and movies have mined gold from such situations for years.  Perhaps none more so than in Paddy Chayefsky’s 1971 film, The Hospital.   Akbar’s book is not quite as outrageous, but it is filled with mirth, mayhem, and potential misadventure, especially when you consider… And Then There Was Swine Flu.