In Keepers, noted medical ethicist and patients’ rights advocate Sholom Glouberman draws on a series of interviews with workers at various types of “total” institutions—nursing homes, prisons, hospitals for children with severe disabilities, psychiatric hospitals, and long-stay hospitals—to paint a vivid picture of life within the walls of such facilities. Those interviewed tell of their struggles to deal with bureaucracy, insufficient resources, burn-out, sexism, prejudice, and the patients and prisoners themselves, while at the same time trying to adequately respond to the needs of the “kept.” Each chapter opens with a brief section by Dr. Glouberman that puts the interview in context. The result is a rare and fascinating look behind the closed doors of total institutions. This edition of Keepers is a revised version of the first edition published in 1990. Reviews and Endorsements: “Recommended for anyone who has ever paused to consider the brutalising effects of some of our sealed-door ‘caring’ worlds.” —Paul Sayer, Nursing Standard “In the tradition of Studs Terkel.” —Andrew Rutherford, Criminal Justice and the Pursuit of Decency “Dr. Glouberman has done us a good turn in making us look at the contemporary version of the Inferno.” —Times Literary Supplement “Powerful … a strong re-indictment of our outmoded methods of long-term care.” —Health Services Journal From the Preface by the Author: “The short stories in this book are based on experiences that I had some years ago—they are derived from actual meetings with people who worked in total institutions. I visited a cross section of long-stay institutions in many towns and provinces across the country, including everything from maximum security prisons to hospitals for children with severe disabilities. I taped long interviews with about 60 people who worked in them. Although the interviews were carefully transcribed, they were relentlessly edited to try to capture how people were affected by their work in institutional settings. These prisons, nursing homes, and institutions for the severely disabled contained not only the people who lived in them, but also the workers who came there every day. I tried to reveal the character of the workers and the impact of the institutions on their lives by selecting from the situations they described and also by carefully choosing from the words they used. The stories are my constructions based on the tapes. I spent months editing and rewriting them. The genre has recently come into prominence—an amalgam of fact and fiction. In this case, I wanted to shake our understanding of these long-stay environments and the workers in them by creating a more intimate understanding of their work and lives.” About the Author: Dr. Sholom Glouberman is Philosopher in Residence at Baycrest Health Sciences, founder of Patients Canada and author of A Patient’s History of Medicine. His doctorate in Philosophy is from Cornell. He’s been an adjunct professor at Toronto, McGill and York Universities. His start in healthcare was by being a family caregiver for his dying father in Montreal. He wrote Keepers: Inside Stories from Total Institutions, a book about workers in long term care facilities that sparked an increased interest in healthcare. Among his other early efforts was participation in a multi-scenario strategic planning exercise for Ottawa-Carleton and as chief planner for a major addition to the then Royal Victoria Hospital in Montreal. For six years he was a Fellow of the King’s Fund in London England where he designed what remains the Fund’s premier leadership development program. At the Fund he had the chance to observe the ongoing professional struggles in the NHS and to participate in rethinking how healthcare is delivered in London. Although continuing to commute to England, he returned to Canada to take up his role at Baycrest, to direct training programs in patient centred care at Sunnybrook and to teach at the University of Toronto. He went on to lead research in health policy for the Canadian Policy Research Networks and direct a Masters Program in health management at McGill. He’s been a health system adviser to many organizations and individuals in Canada and the UK. In 2005 Sholom had major surgery, became a patient and wrote My Operation, a graphic example of the disparity between patients’ experience and institutional concerns. He founded Patients Canada in 2007. His most recent book is A Patient’s History of Medicine. Read more at sholomglouberman.net |