Coming this fall –
The Cost of Care
How Four Nurses Put Patients First in a Profit-Driven System
From the New York Times bestselling author of The Shift, this richly drawn portrait of four nurses in four different sectors of our broken healthcare system reveals where solutions are actually possible--to make care about people rather than profits.
Theresa Brown worked as a oncology nurse for years before finally burning out, but instead of leaving the healthcare system behind entirely, she set out to find places where it's actually working. She embedded with nurses in four key areas of care that cover the human lifespan--a maternity center in Pittsburgh, a primary care facility in Portland, an elder care home in Denver, and hospice services in the midwest and in Connecticut--and came back with gripping, and often deeply moving, on-the-ground stories of patient-centered care. Taking us into the daily lives and the exhausting yet rewarding shifts of these four practitioners, Brown gives readers a rare window into what kinds of healthcare facilities are actually doing things well, taking care of patients, keeping things affordable, and supporting staff.
Even as the system feels like it's crumbling around us, Brown reveals scalable solutions and reminds us that there's still hope--all through the eyes of the people we know keep the whole thing running: nurses.
Early Praise for The Cost of Care
“Theresa Brown wades into the dysfunctional mess that is the American healthcare system, and, against all odds, diagnoses the possibility of hope. With a bracing combination of unsparing honesty and stubborn optimism, Brown uncovers models of humane and effective care that are hidden in plain sight. This book is both a reckoning and a revelation.”
—Danielle Ofri, MD, PhD, author of The Body Knows How to Die
“Compelling, eye-opening, and deeply necessary, The Cost of Care is both a searing indictment of the brutal financial machinery of American medicine, and a celebration of the extraordinary people keeping humanity alive within it. We need this book.”
—Angela Amar, Dean of Nursing at New York University
Theresa Brown
Nurse, Writer, and NY Times Bestselling Author of The Shift
Recent Columns & News
A Primer on Palliative Care
July 2026
I recently gave a palliative care ground rounds at the University of Pittsburgh, and I’m sharing the main points of my talk here because palliative care is such a good complement to oncology, especially for very ill patients. The theme of the talk was that palliative care clinicians “work in the gray,” or outside the black-and-white framework that is typical in the hospital. That is, if a patient comes in with a broken leg, their fracture will be repaired; a serious bacterial infection will be treated with IV antibiotics; a heart attack with a cardiac stent. But patients who have run out of curative treatments—as is true of many patients with metastatic disease—no longer have a clearly defined clinical course to follow. That is where palliative care comes in, talking with patients about managing their symptoms, helping them understand that no more clearly curative treatment options exist for their disease, and asking them how they want to spend their remaining time on earth.
Read More.
April is Workplace Violence Awareness Month, and I got attacked by a patient at work this April. I work in an outpatient clinic, and an elderly patient with severe cognitive impairment spit in my face when I first approached, and then clawed my left arm, leaving parallel, bleeding, four-inch scratches. The patient’s violent behavior, combined with cognitive impairment, made doing a complete exam impossible and left us unable to address the issue that brought the patient to the clinic in the first place. The only thing the patient’s visit accomplished was to leave me physically injured and psychically disturbed by what happened.
Why Nurses Are Soldiers for Compassion
April 2026
The way people and countries spend their money says a lot about their values. I’m not the first person to point out that the billions of dollars our president is spending on a war with Iran could be spent on healthcare instead. It’s a galling fact, and I’m going to reflect on it a bit in this column. Estimates put the cost of the Iran war at $1 billion for each day of fighting, and there is no end in sight.
Mentally juxtaposing the cuts to our healthcare budgets under Trump with the costs of the Iran War suggests a grim realization about our president’s intent. Wars destroy infrastructure, blow up buildings, and wound and kill people in large numbers, including, as we have learned, young children at school. Taking away people’s health insurance inadvertently hurts individual people who are ill, and in the worst-case scenario, will kill them if their illness is serious enough.
About Theresa
Theresa Brown, PhD, BSN, RN, is a nurse and writer who lives in Pittsburgh. Her third book —Healing: When a Nurse Becomes a Patient — was published April 2022 and is available wherever books are sold. It explores her diagnosis of and treatment for breast cancer in the context of her own nursing work. Her book, The Shift: One Nurse, Twelve Hours, Four Patients' Lives, was a New York Times Bestseller.
Theresa has been a frequent contributor to the New York Times and her writing has appeared on CNN.com, and in The American Journal of Nursing, The Journal of the American Medical Association, and the Pittsburgh Post-Gazette. Theresa has been a guest on MSNBC Live and NPR’s Fresh Air. Critical Care: A New Nurse Faces Death, Life, and Everything in Between is her first book. It chronicles her initial year of nursing and has been adopted as a textbook in Schools of Nursing across the country.
Theresa's BSN is from the University of Pittsburgh, and during what she calls her past life she received a PhD in English from the University of Chicago. She lectures nationally and internationally on issues related to nursing, health care, and end of life. Becoming a mom led Theresa to leave academia and pursue nursing. It is a career change she has never regretted.
Available Now
Healing: When a Nurse Becomes a Patient
As an oncology and hospice nurse, I thought I knew cancer—knew it. But when I was diagnosed with cancer myself, I realized I knew nothing at all about being a cancer patient: how terrifying having cancer is, and how lonely. Healing: When a Nurse Becomes a Patient traces the intersection of my nurse-self and my patient-self, from breast cancer diagnosis through treatment and after, when I return to work in home hospice. What did Theresa-the-nurse learn from Theresa-the-patient? That we want and need compassion from our health care. Medicine can cure, but healing requires more: thoughtfulness, listening, and a genuine and generous focus on every patient.
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Books by Theresa
