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

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<a href="http://www.goodreads.com/book/show/401876.The_House_of_God_The_Classic_Novel_of_Life_and_Death_in_an_American_Hospital?utm_medium=api&amp;utm_source=blog_review" style="float: left; padding-right: 20px"><img alt="The House of God: The Classic Novel of Life and Death in an American Hospital" border="0" src="http://photo.goodreads.com/books/1174446711m/401876.jpg" /></a> <a href="http://www.goodreads.com/book/show/401876.The_House_of_God_The_Classic_Novel_of_Life_and_Death_in_an_American_Hospital?utm_medium=api&utm_source=blog_review">The House of God: The Classic Novel of Life and Death in an American Hospital</a> by <a href="http://www.goodreads.com/author/show/2735.Samuel_Shem">Samuel Shem</a> 
 <a href="http://www.goodreads.com/review/show/8198683?utm_medium=api&utm_source=blog_review"><h3>My review</h3></a>
 rating: 4 of 5 stars 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.
 
 
 <a href="http://www.goodreads.com/review/list/571596?utm_medium=api&utm_source=blog_review">View all my reviews.</a>

Elizabeth's review
rating:

recommended for: anyone, but esp. med students, people interested in how hospitals work
status: Read in October, 2005

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 o...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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