Book Review | The Hospital Always Wins, by Issa Ibrahim

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The Hospital Always Wins Cover

I didn’t know whether or not I would review this book, but decided to do so when I remembered a couple of y’all expressing interest when I mentioned it in a previous post.


Issa Ibrahim is institutionalized for a very specific reason: readers will find out the details later, but it’s not a spoiler to reveal that he’s murdered his mother. According to him, it was a marijuana-induced psychosis, i.e. the drugs were a deadly choice for someone with potential preexisting mental health issues.

Because of this, Issa Ibrahim spends some time on Rikers Island, wins an insanity plea, and gets transferred to Creedmoor  Hospital. Here, he stays nearly two decades, learning to live with his crime, and move toward a life beyond Creedmoor’s walls.

The Hospital Always Wins, perhaps a play on “the house always wins,”illustrates what an insanity plea really means. It’s an insider look at how the criminal justice system fails the mentally ill by placing them in facilities just as flawed as regular prisons. Ibraham describes both sexual relationships and assaults between patients and staff, as well as bureaucratic conspiracies to keep patients under lock down. It’s not pretty. In fact, on many occasions, it’s wholly disgusting.

Effectively disowned by his remaining family, Ibrahim immerses himself in his art. He’s commissioned by staff to illustrate tattoo designs and uses the money to increase his stockpile of art supplies. Art takes him far, and his art shows become one of few ways he’s allowed to leave the Creedmoor campus (escorted by male staff, of course).

Ibrahim’s artist statement: “My interest in the politics of race, mental illness, and popular culture informs my range of subject matter. I am telling a parallel narrative. My life as a psych patient, a flawed Superman, learning to navigate the many identities I had to assume in the system in order to survive various barriers to freedom, in addition to exposing the Everyman in the world at large. We are living in a comic strip, with plenty of super villains and heroes, love stories, cliffhangers, absurdist comedy and heartbreaking tragedy. With equal parts whimsy and warning, I use familiar icons in historical settings as reflections and metaphors for our own bankrupt culture.”

Ibrahim intersperses the recollection of his time at Creedmoor with memories of his mother, the most loving figure in his life. It’s an effective storytelling tactic, that builds to the crescendo– when he recounts exactly what happened the night of her death. It would be crass to end there, but Ibrahim also discusses how he begins to find closure.

The Hospital Always Wins is a purposefully cringe-inducing look behind a mental institution’s tightly closed doors. While Issa Ibrahim, for many reasons, is perhaps one of few who could tell this story, I found the people on the periphery a bit more interesting. I was personally turned off by what I interpreted as Ibrahim’s problematic relationship with women, with whom he seemed unable to build nonsexual bonds.

For those interested in Issa Ibrahim, I’m a much bigger advocate of his work elsewhere, including this article, and this appearance in an HBO documentary from several years back. In the recommended links, you’ll find engrossing details about his crime, diagnosis, and institutionalization. Heavy on the serious content and light on the schoolboy sexual details about him and the hospital staff.

I’d love to hear from some people who felt this book spoke to them. There is a discussion worth having about how mental health issues are handled in the criminal justice system, but this book missed a great opportunity to bring them to the fore.

Disclaimer: I was given this book in exchange for an honest review.

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12 Comments

  1. […] The Hospital Always Wins, by Issa Ibrahim […]

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  2. I have never read anything like this though I have watched series and movies that depict life in mental health institutions.One show that stands out is America Horror Story season 2.I am intrigued by this book.Thanks for the review.I will check it out.

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    1. This book is WILD. I mean, I wasn’t a super big fan of it, but it makes me want to delve deeper and find something I’ll like a bit more

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  3. I used to work on mental health, and many of the people I encountered didn’t have teeth because they were old enough to be from the era of people who routinely had all teeth removed for FEAR that they might bite. For a much happier read, I’ve got Lois Lenz, Lesbian Secretary up at Grab the Lapels, lol.

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    1. In what capacity were you working on mental health issues? I have many friends who work in various ways, and they have wild stories. I don’t know if I have the stomach or heart for it.

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      1. I was what is called a direct care worker. We worked in homes in which people with varying mental disabilities lived. Some homes would have 14 people living there who could help with chores, but couldn’t be completely left alone. One home had 6 people all in wheel chairs in varying states of cognition (ranging from mentality of a 1 year old to able to say a sentence or two). I was MOSTLY okay when I was doing it, but my tolerance level is way, way low now when I’m in similar situations. It wears away at you. I used to do this job full-time when I was in college, also full-time. Past tense me impresses present tense me.

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  4. I’d not heard of this book before but it sounds fascinating. I’m definitely going to add it to my wishlist. Thanks for sharing such a great review of the book.

    Liked by 1 person

    1. Thanks for reading! It’s definitely interesting subject matter.

      Liked by 1 person

  5. This sounds so interesting – thank you for such a thoughtful review! I will add this to my TBR.

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  6. This book sounds fascinating! My degree is in criminal justice and sociology, so we spent a lot of time learning about mental illness within the criminal justice system. Unfortunately this is a funding issues and that our government does not focus on mental illness as it should.

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    1. oh wow, that’s such an interesting subject to have a degree in!! I wish this book delved deeper into the real issues. That would have made it so much better to me.

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      1. It was both fascinating and horrifying degree to earn. The things I learned, I can’t unlearn. If we focused more on mental health issues and had more services offered to these individuals, poverty and crime within this population would drastically decrease. It all boils down to money.

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