Samuel Shem’s The House of God is one of the strangest and most unsettling books I have read in a long time. The title is completely misleading — whatever this is, it is not religious book. The House of God is kind of a Mash/Catch 22 look at a medical internship at a big city hospital. The humor is very dark, and generally at the expense of patients. Since I am on the patient side of things, as opposed to the doctor side of things, the picture painted by The House of God is disturbing enough to make me consider converting to Christian Science! There is a lot more to this book, but the overwhelming message is how much doctors can despise their patients. Sorry, but the somewhat thoughtful evolution at the end of the book doesn’t really overcome this bewildering theme. Perhaps this book is meant to be one big joke, but there is a morbid ring of truth to a lot of the interactions.
The book covers the internship year of Roy Basch, MD, a bewildered young doctor at a major urban hospital. Basch and his fellow interns are completely unprepared for their internships, and they get precious little on-the-job training. Their response is triggered by terror, immaturity and utter lack of sleep, and it isn’t good for patients. It is distinctly unpleasant to read about how they learn to loathe elderly patients who don’t die and other unfortunate patients who have the misfortune to cross their paths. There are some comforting words of wisdom from the Fat Man, a wonderfully drawn character, but let’s just say that dying at home seems like an excellent option. I did appreciate the another theme, which was to stop torturing elderly patients with painful, futile procedures.
This book was written in the 70’s, and medical schools’ training programs have allegedly improved, but that may be wishful thinking when most medical students seem to follow their classes on-line, instead of in the classroom. (DO training generally requires classroom attendance, I believe.) The other part of the book that is arguably dated is the pervasive sexism, except for Basch’s partner, who across as the only sane person in the book. The rest of the female characters are competent, yet randy, nurses and one senior resident who is treated with scorn by all. There are more women physicians today, but they have a tough time getting into the senior ranks of medicine.
So, I hope the author was largely being ironic, and I hope things have changed, but this is one sour, depressing and humiliating book from a patient’s point of view.