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If you've watched a TV show with a hospital setting, you might have a notion - albeit exaggerated - of how the interactions between patients and doctors can create dramatic scenarios.

A new book written by a doctor-nurse couple says similar dramas are playing out in real life. It warns of how we should be concerned about the lack of quality care that patients can receive in hospitals.

"Hospital Battlefield: A Field Manual For Survival," written by Lynne and Joseph Golonka, explains that inside knowledge and a lot of questioning will go a long way toward improving health care in the U.S.

While being critical of hospitals - to the point of receiving their fair share of backlash from the medical establishment - the Golonkas are quick to stress that the power to make change begins with the patient.

"We want to stir up this closed-hospital system, not fight health care professionals," says Lynne, a registered nurse.

The real enemy, she says, is illness. The book gives practical advice to help patients avoid hospital errors and infections and ensure a quick and safe recovery.

The "going into battle" metaphor is not intended to pit patients against doctors and nurses in a war-like fashion, the authors explain. But it does convey the urgency of "survival" within an imperfect system.

Chapters titled "Securing Allies" and "Chain of Command" are not difficult to equate with possible traps and troubles in hospitals. But the self-help guide is also peppered with medical-themed cartoons for a tongue-in-cheek approach to some of the challenges patients face along the way.

Yet the issue itself is a serious one, and the authors say preparation must be made for potential hospitalization. Some questions and ideas raised include:

* What are the right questions to ask medical professionals? Specifically, to whom do you address the questions and how do you ask them?

* Why is it so important to demand accountability from hospitals?

* What is one of the major reasons health insurance medical directors deny claims?

Ultimately, the book presents a realistic view of hospital health care and cites a surprising 1999 study as the basis of its argument. As many as 98,000 die in hospitals each year as a result of serious medical errors, according to the Institute of Medicine.

The Golonkas say that progress to improve the hospital system has been slow, and therefore they urge patients and families to be ready for battle.

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