The House of God: The Classic Novel of Life and Death in an American Hospital

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The House of God: The Classic Novel of Life and Death in an American Hospital

3.9 of 5 stars 3.90 · rating details · 3,665 ratings · 434 reviews

Now a classic! The hilariousnovel of the healing arts that reveals everything yourdoctor never wanted you to know. Six eager interns-- they saw themselves as modern saviors-to-be.They came from the top of their medical school classto the bottom of the hospital staff to serve ayear in the time-honored tradition, racing to answerthe flash of on-duty call lights and nubilenur...more

Paperback, 416 pages

Published July 1st 2003 by Dell (first published 1978)

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Dec 11, 2007 Cecelia rated it 4 of 5 stars

Shelves: medicine, humor, classics

I felt I should read this book, described as the "Catch-22 of medicine" before graduating from med school. It was scary how accurate most of it is, right down to the 'Laws' of the House of God quoted throughout. Remember, Age + BUN = Lasix dose. But well written and a good read, although I don't know how funny it will be to those outside the medical profession (probably still so to spouses).

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Aug 01, 2008 Julianne rated it 3 of 5 stars

Recommended to Julianne by: Joe D.

As I tell people: I liked the morals, not the story.

The message on why "the boys" didn't like the chief, how doing nothing is good medicine, and the difference between gomers and old folks are very pertinent to me and how I practice in healthcare. My favorite Laws include:

3. At a cardiac arrest, the first procedure is to take your own pulse.
4. The patient is the one with the disease
10. If you dont take a temperature you can't find a fever.
13. The delivery of medical care is to do as much nothing...more

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Dec 24, 2012 Elizabeth Holter rated it 4 of 5 stars

Disclaimer: I was did my internship and residency at the other hospital, "MBH," in Shem's classic novel about medical training, at the same time that he was busy observing his fellow house officers and higher ups at the House of God. So my take on this book is colored by immersion in the culture he parodies, and by the fact that one of his main characters bears strong resemblance to a medical school classmate who interned in Boston at Shem's hospital.
Fresh out of five years of medical training...more

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Oct 24, 2007 Elizabeth rated it 4 of 5 stars Recommends it for: anyone, but esp. med students, people interested in how hospitals work

Spoiler alert (esp. 3rd paragraph) Also, this book has some very *explicit* parts.

This novel follows an intern, Roy G. Basch, for his internship year at a prestigious hospital nicknamed the “House of God.” Roy must deal with sickness of the elderly, the death of the young, the competition of his peers, the lack of an outside life, and the tension with his superiors. Roy discovers providing medical care is nothing like what he was taught in medical school. Each of these stresses makes Roy withdra...more Spoiler alert (esp. 3rd paragraph) Also, this book has some very *explicit* parts.

This novel follows an intern, Roy G. Basch, for his internship year at a prestigious hospital nicknamed the “House of God.” Roy must deal with sickness of the elderly, the death of the young, the competition of his peers, the lack of an outside life, and the tension with his superiors. Roy discovers providing medical care is nothing like what he was taught in medical school. Each of these stresses makes Roy withdraw more and become more cynical. He eventually decides that medicine is not for him and takes a year off before going into psychiatry.
One of the most interesting parts of the book is the juxtaposition of the two most prominent residents, Fats and Jo. Jo is an over-achiever who truly believes that she can cure all her patients. She never gives up, trying every intervention possible. She will come in even on her nights off to check on her patients. Fats, on the hand, makes fun of ‘”gomers” or old people who are so sick that they will never get better. Gomers are often unresponsive, so it is easy for the medical staff to not think of them as humans. Fats teaches the interns the rules of the “House of God.” He is trying to teach them how to not be hurt by working at the hospital. Fats states that the best thing to do is nothing. Often actually providing medical care actually makes the patient worse. To the interns surprise, Fats is right. As a patient, one would think that Jo would be the “better” resident, both in terms of provision of care and bedside manner. However, Fats is the one the patients love, and he has better outcomes. Yet the hierarchy of the hospital thinks he is too unorthodox and discounts him. Fats’s approach reminds me of Norman Cousin’s homeostatic theories. Sometimes it is better to let the body heal itself. It is an indication that we really do not fully understand how our bodies operate, so we cannot always properly intervene.
The disrespect with which the interns treat the patients, especially the gomers could be unsettling. I wonder how true this feeling about patients is. Both The Doctor and Wit depict the medical staff as not caring about the patient and not bothering to learn names. Those doctors are only interested in the disease. However, in House of God, it goes a step further to actual derision. The book is trying to make the point that some defense mechanism is necessary to be able to survive the true sadness of the situation. This point is really driven home by the suicide of Potts, the one intern who did not give in to the cynicism and contempt of the others. He let everyone and everything knaw away at him. The book recognizes how morally reprehensible it is to make fun of the sick, as shown by Berry’s (Roy’s girlfriend) disgust at Roy’s jokes. What Roy had to learn (from Fats) is that these jokes are only acceptable in the company of other interns and residents on the unit. Fats understands the boundaries of protecting yourself and being callous. Roy, on the other hand, universally applies what he deems acceptable behavior. Eventually, Roy does learn how to become a less cynical doctor.
This book is appealing for a lay-person because it describes so much of the day-to-day workings of the hospital for interns. For example, Roy rotates through several different units and schedules, and the reader learns the benefits and detriments to each type of unit. It could be surprising what Roy ended up enjoying, like the ER and the MICU over the usual wards. The usual wards were full of patients who were not going to get better, whereas there was more change and excitement in the other areas. It would be hard to describe all the details that were interesting to me as a lay-person, but I enjoyed that the book was able to give me the perspective of a hospital intern.

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Sep 08, 2007 Patrick Henderson rated it 5 of 5 stars Recommends it for: ANYONE going into medicine in any capacity...and anyone attached to said people

Shelves: hilarious

I read this in college, then again my first year of medical school, then again my last year of medical school, then again during my internship, and I'm reading it once more now as a senior resident. Along with the television show Scrubs, it's the most accurate portrayal of American medicine that I'm familiar with. I gave it to my father and he called me saying that he wanted to go medical school. I gave it to my mother and she called me crying, asking if my job really is as bad as Shem makes it...more

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Jun 14, 2007 Hetal rated it 4 of 5 stars

This book paints such an caustic view of life as an intern, it's almost addictive. Like an episode of Jerry Springer, you sit, entranced by the character's downward spiral, unable to stop him, but knowing full well he is headed for a hard landing.

The character starts off a somewhat wide-eyed and innocent intern on his first day, a bit sarcastic, but otherwise a good person with a great girlfriend and normal and rational thoughts. As the book goes on, Shem paints such a detailed and realistic pic...more

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Mar 01, 2013 Marc rated it 4 of 5 stars

A brilliant, funny, explicitly erotic, brilliant and caring story about real life in medical residency training, written in 1978 by a survivor. A story of dissociation and regression in the face of an inhuman system, but it shows ways out. Got me to thinking about how detached or caring I am in my own life. A gem, which my doc friends tell me is both realistic about residency training, and still valid several decades after it was published. The author, whose non-pen name is Stephen Bergan, later...more

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Dec 29, 2012 Elizabeth Nesbit-comer rated it 4 of 5 stars

This book describes pretty well the frustrations and somtimes downright craziness of working with elderly patients who are really sick. (Gomers) I spent several years working with alzheimers patients and then hospice patients. I did some things during that time that I am ashamed of now
1.screaming at deaf ladies
2. hiding from patients just out of their eyesight.
3. gagging and cursing at unconscious patients while changing their diapers.
4. Falling asleep on the job while working a 24 hour sh...more

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Sep 26, 2009 Emily rated it 5 of 5 stars

Shelves: favorites

I read this during the first weeks of residency and couldn't have picked a better time to do so. What an excellent depiction of all that medical training is but shouldn't be.
Few thoughts:
1) Some of my Family Med colleagues thought House of God was abhorrent. I thought long and hard about this--and even about why it wasn't shocking to me. It's satire y'all! All I can say is that if the anecdotes make you so uncomfortable, commit yourself to improving health care and medical education. We've come...more

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Jul 14, 2009 George Litz rated it 4 of 5 stars

The House of God is a novel that follows the internship year of Dr. Roy Basch. Dr. Basch works in a hospital called the House of God and is mentored by his attending, affectionately known as The Fat Man. Samuel Shem, M.D., writes the novel and much of the slang jargon thrown around in hospitals today comes from this very book. Shem does a fantastic job of drawing the reader into the chaotic life of an intern weather you have some experience in this setting or none at all. He also illustrates we...more

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Jun 18, 2009 Audreesh rated it 5 of 5 stars

I read this book back in high school and I read it a second time after finishing residency and fellowship. It's definitely dated but still as good a memoir of internship I have read. Even though it is quite sexist and not incredibly well written, it still somehow manages to capture the essence of that intern year, the overwork, fatigue and emotional strain, how it can change an idealistic medical school grad who wants to treat and help patients into a burned out cynic. It also shows the moments...more

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Jul 03, 2012 Mark rated it 4 of 5 stars

a fictionalized memoir about an internal medicine internship of the beginning of the 70s, this book provides a wealth of information for anyone trying to understand the innards of the medical training process. written at the cusp of the psychological age, Shem delves into the trauma inherent in dealing with trauma, but with humor enough to avoid overwhelming a reader unprepared for the gore. much of the humor black, but it still carries the reader with a lightness through bowel treatments, incur...more

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Apr 01, 2013 Natalie rated it 3 of 5 stars

This was my second attempt at reading this book. My first, when I was still a medical student, ended a few chapters in, when I had to stop reading because I found the book far too cynical and depressing. Now, apparently, I'm jaded enough to enjoy it, though I know the reality isn't quite as awful as this book would have you believe.

Plenty of it, of course, hits right on target. The exhaustion of night shifts: that moment when you actually wish somebody would die because it means less work for yo...more This was my second attempt at reading this book. My first, when I was still a medical student, ended a few chapters in, when I had to stop reading because I found the book far too cynical and depressing. Now, apparently, I'm jaded enough to enjoy it, though I know the reality isn't quite as awful as this book would have you believe.

Plenty of it, of course, hits right on target. The exhaustion of night shifts: that moment when you actually wish somebody would die because it means less work for you... it happens. The sense of losing touch with the outside world, of being unable to connect with anybody who hasn't lived your experience: that happens too, though not to quite such a dramatic extent as described in this book. It certainly can be hard to expalin that experience to someone who hasn't lived it. The isolation and uncertainty that comes after one error, and the lack of support or counselling by senior staff - now that can be all too common, and the story of the unfortunate Potts is a frightening example of just where that can lead.

I think one of my favourite reflection-of-reality moments was the way Roy seemed to feel, over and over again, that each new rotation was better than the last - excited with the change he'd think he had finally found a way to be human in medicine, before the inevitable disillusionment.

On the other hand, a lot of what occurs in this book simply wouldn't happen in the real world, or at least it wouldn't in a 2013 hospital in Australia. I'm not too sure if the differences are because the story takes place in the 1970s, or because it's the US, or a bit of both. For example, ordering invasive investigations that clearly aren't indicated just so the hospital makes money... doesn't happen here, though unnecessary investigations do get ordered for various other reasons. Also, interns being left alone to run the hospital - that doesn't happen either, of shouldn't anyway. Interns answer to registrars and registrars answer to consultants, and ultimately if something goes wrong, it's the consultant who'll have to explain it.

Anyway, I think this book is still a worthwhile read for anybody starting out in medicine - if only as a chance to reflect and appreciate how and why the way we practice medicine has changed. It's also, of course, darkly hilarious, and remains the source of many a medical in-joke (what's the first thing you should do at a cardiac arrest? Take your own pulse...)(less)

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Jan 01, 2012 McGooglykins rated it 5 of 5 stars

When I was a nursing student, I was sitting at the nurses station and writing a rough draft of my patients notes for my supervising RN to read through before I put them in the file. One of the medical interns sat down next to me and asked me if I'd read The House of God. I thought he might have been trying to convince me to join some obscure religion. I hadn't, I warily told him so, and he threw his hands up in the air and said "You have to, you need to read it, it's real life put down on paper,...more

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Mar 16, 2013 Shelley rated it 1 of 5 stars Recommends it for: people who enjoy orgies in the callroom

Shelves: contemporary-lit, american

I don't usually review books I rate at 3 stars or lower, but this is an exception: I detest this book so much that I feel compelled to write something about it.

Make no mistake: I am a resident physician (and read this book during my internship year), so none of the horrible things that happen in the book faze me. I am also the last person to dislike a book because it is not "feel-good", or because it offers more questions than solutions (those are often the best books). However, I take issue wit...more I don't usually review books I rate at 3 stars or lower, but this is an exception: I detest this book so much that I feel compelled to write something about it.

Make no mistake: I am a resident physician (and read this book during my internship year), so none of the horrible things that happen in the book faze me. I am also the last person to dislike a book because it is not "feel-good", or because it offers more questions than solutions (those are often the best books). However, I take issue with this book because, to me, it doesn't deliver what it promises. "The Classic Novel of Life and Death in an American Hospital:" for me, the only word true in that subtitle is "Novel."

The main character, a thin guise for the author himself, goes through internship. He is overworked, he is bitter, and he has sexy escapades with nurses and social workers while his fiance psychoanalyzes him. Okay, been there done that (minus the sexy escapades and fiance part). Let's see: then he rants against the evil of the medical training system and the futility of the medical care he delivers. Fine, now that the obvious stuff is out of the way, let's cut to the chase. Oh wait, now it's over.

But where are the other things? Where's the guilt, not just over how you think you mishandled a patient's care, but also over how you've not lived up to what others and what yourself expected of you and how you've neglected all friends and family? What about the oppressive sense of responsibility which we are initially overwhelmed with, frequently take for granted, sometimes make light of, often resents, and occasionally try to dodge? What about inevitable dehumanization that is not so much created by a villanous, uncaring system but is really a part of the job description? What about your transferences and countertransferences towards patients, your natural defense systems and how they sabotage your clinical judgement, making you even more guilty and defensive, your feeling of inadequacy that is only outweighed by your desire to be somehow normal again and part of the rest of humanity? These are things my colleagues and I deal with on a daily basis. This so-called "classic" doesn't address any of them except in the most perfunctory manner possible.

What it does do is rage against the residency system of his time. There have been immense changes since then; some may say the pendulum has even swung too much the other way. I cannot find much beyond that. The book is of historical interest in that regard, but given the depth of the emotional toil that is internship, I expected a lot, lot more out of the "classic novel".

It also doesn't help that the central character acts like a sociopath, and I don't think you can blame that solely on the system.(less)

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Sep 03, 2011 Nicole rated it 5 of 5 stars

I first read this years and years ago and have subsequently re-read it many times. My first encounter was way before my own entry into medical school and forays onto the hospital wards. I still find portions of it hilarious and right on the money though there are elements that are a bit dated, as I reflect on it in the 21st century. But the essentials still ring true - medicine is a hard field to be in day in and day out and you struggle to do what is right for your patients while not completely...more

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May 05, 2012 Aditi rated it 3 of 5 stars

This novel is ubiquitous in the Medical field, even today. Gomer. Horses not Zebras. Take your own pulse. These are quoted and referenced so often that I knew I just had to read it.
Many people say that you should wait until internship onwards to read it due to it's ridiculously high level of cynicism; I would postulate that nobody ever wants to become as cynical as the characters in this novel, and as such there's no real ideal time to read it. A word of warning though - do read it with a menta...more

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Oct 30, 2009 Andina rated it 4 of 5 stars · review of another edition

You would ask yourself, if it's trully the reality of the modern medicine? Idealists would suffer..
The helper-souls don't have any place anymore in this modern capitalist machine-like medicine world.

I didn't really notice, that this book is "the classical" of anglo-american residents and medical students. Till I got to the clinic, and mostly some of ambitious residents would ask me, "Did you read House of God?"

I began reading it with no expectations, and I had to say, I did get the shivers.
If...more

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Mar 03, 2013 Rachel Skye rated it 4 of 5 stars

Shelves: 2013read, favorites, on-the-shelf, school-assigned

I really liked this book. I dont normally sway towards liking assigned readings for classes, but I became extremely attached to this book. I read it for my Literature and Medicine class (comparative world literature) and I was sucked in. You get extremely involved with the characters.

Roy was a likable protagonist. He had his ups and downs, just like all characters. I think thats what made the reader like him so much. He was conflicted about life and death situations, and being a new intern, who...more

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Jul 30, 2011 Ross Mckinney rated it 5 of 5 stars

I teach this book in the Fourth Year Medical Humanities seminar. It's full of surprising insights about how medical training dehumanizes physicians, so I can use it as a cautionary tale. It's also representative of an era in medical care that is passing swiftly, but I can use the story as an illustration of the background training of the physicians who are currently my students' teachers. My generation went through the gauntlet of residency described in the House of God (although sex life in ped...more

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Jan 25, 2013 Fellini rated it 3 of 5 stars · review of another edition

Shelves: kindle

Врачебная проза как она есть: в меру циничная, изобилующая медицинскими подробностями (впрочем примечания изрядно облегчают понимание), со своеобразным юмором. Сложный год из жизни интерна, впервые встретившегося с настоящими больными и с удивлением обнаружившего, что практика значительно отличается от теории. Что условная "клятва Гиппократа" повсеместно заменяется принципом "латать и спихивать". Что работа врача - это кровь, гной и дерьмо, а вовсе не святой долг; хотя одно другому не мешает =)...more

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Oct 11, 2009 Wendy rated it 5 of 5 stars

"...the one truly great American Medical Invention: the creation of a foolproof system that took sincere energetic guys and with little effort turned them into dull, grandiose docs who could live with the horror of disease and the deceit of "cure", who could "go with" the public's fantasy of the right to perfect health devoid of even the deterioration of age..." Thus writes Roy Basch, MD, our narrator, upon concluding his internship at one of American's top hospitals. This book, written in 1978,...more

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Nov 12, 2012 Jennifer Cason rated it 3 of 5 stars · review of another edition

I read this one a pretty long time ago. Still, I recall some very memorable moments. Many were disturbing and some were cathartic (especially if you also work in a hospital). Becoming privy to the insider terms used among young residents like "LOL in NAD" (little old lady in no apparent distress), is amusing on one level, but upsetting on another. There is a palpable lack of empathy from the characters (doctors) in the book. They exist in a dark, overworked, oversexed, narcissistic bubble that w...more

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Oct 22, 2012 Jia Wei rated it 2 of 5 stars

"With the delivery of medical care this swiftly revolving door, with every doc on the planet frantic to BUFF and TURF elsewhere, these people had gotten expert at finding a static center and hanging on. These people didn't give a damn about their diseases or 'cures''; what they wanted was what anyone wanted: the hand in their hand, the sense that their doctor could care." -chapter 12

Put simply, this was an extremely quotable and thought provoking book: poignant at times, and humorous at others....more

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Mar 10, 2009 Steph rated it 3 of 5 stars

If you are currently headed off to medical school while reading this book, be prepared for one hell of a trip down the first intern year and for some serious re-consideration into why you have chosen the path that you have. Having read previous reviews on other sites, I would wholeheartedly agree that this book will come across to the reader in different forms if read before medical school, during clinical rotations, and during the intern year. While reading the novel, I noticed myself starting...more

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Jan 30, 2013 Lisasiegel rated it 4 of 5 stars

Having spent so much time the last few years in emergency Rooms and hospital rooms with my parents, at best I have become ambivalent about the power of medical care, and at worst, I feel like I've seen behind the curtain and found there was no Wizard of Oz. Recommended to me by a med student, this book shows the underbelly of medical care, but also the humanity that remains within the walls. From the elderly patients long gone but clinging to life to the tragic young lives that can't be saved. I...more

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Feb 11, 2010 Michael rated it 5 of 5 stars · review of another edition

I read this the first time when I was in college - for whatever reason, it is the kind of book that I happily read again every couple of years. Shem wrote several other books, but I stopped with Mt. Misery, the follow-up to House of God, which was a much more ponderous book to read.

Apparently in more recent years, House of God has been given as required reading for some medical schools since it is considered an accurate portrayal of some aspects of medical education (if overdone in some respects...more

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Dec 21, 2009 Mark rated it 4 of 5 stars

I enjoyed this peak behind the curtain of the life of a medical doctor intern. It is at once hilarious and completely disturbing. The characters explode many myths about who doctors are and what goes on in a hospital, though in doing so I found even greater empathy and respect for them as human beings. The writing is generally quite good. Certain passages are particularly elegant and poignant, while a few veer unnecessarily into unreadable stream of consciousness. The book includes a strong crit...more

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Feb 14, 2013 Laura rated it 3 of 5 stars

Samuel Shem's fictional account of the life of a hospital intern is reminiscent of Scott Turow's One L, Joseph Heller's Catch 22, and Ken Kesey's One Flew Over the Cuckoo's Nest. His humor has a bit too much edge to it to be really funny - I found myself worrying that I might end up in that hospital, even as I laughed at "the Fat Man's" rules and the descriptions of both the patient care rituals and the sex lives of the doctors. Shem is inclined to wax philosophical on too many occasions, moving...more

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Jan 23, 2012 Nancy rated it 3 of 5 stars

Shelves: classics-canon, medical, reviewed

It is the first of July, and Roy Basch, an intern at the House of God hospital is scared. It's his, and his colleagues' (The Runt, Potts, Chuck, and Hooper) first day of work as doctors. The book follows all of these doctors, and the nurses, patients, and assorted other characters that they come into contact with for the next year. Author Samuel Shem writes in the afterword that the book is vaguely autobiographical, and I don't doubt it. I liked this book and found it interesting, although I thi...more

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