The House of God

by Samuel Shem

The House of God is a book to relieve you of these illusions; it does for medical training what Catch-22 did for the military life—displays it as farce, a melee of blunderers laboring to murky purpose under corrupt and platitudinous superiors. In a sense The House of God is more outrageous than Catch-22, since the military has long attracted (indeed, has forcibly drafted) detractors and satirists, whereas medical practitioners as represented in fiction are generally benign, often heroic, and at worst of drolly dubious efficacy, like the enthusiastic magus Hofrat Behrens of Thomas Mann’s The Magic Mountain.

In the prevailing morbid milieu, spurts of lust arrive from a world as remote as the world of Basch’s father’s letters, with their serenely illogical conjunctions. Sexual activity between female nurse and male doctor figures here as mutual relief, as a refuge for both classes of caregiver from the circumambient illness and death, from everything distasteful and pathetic and futile and repulsive about the flesh.

I struggle to rest and cannot. Like a missile my mind homes to my hospital, the House of God, and I think of how I and the other interns handled sex. Without love, amidst the gomers and the old ones dying and the dying young, we had savaged the women of the House. From the most tender nursing-school novitiate through the hard-eyed head nurses of the Emergency Room, and even, in pidgin Spanish, to the bangled and whistling Hispanic ones in Housekeeping and Maintenance—we had savaged them for our needs. I think back to the Runt, who had moved from two-dimensional magazine sex into a spine-tingling sexual adventure with a voracious nurse named Angel—Angel, who never ever did, the whole long year, to anyone’s knowledge, string together a complete sentence made of real words. And I know now that the sex in the House of God had been sad and sick and cynical and sick, for like all our doings in the House, it had been done without love, for all of us had become deaf to the murmurs of love.

And despite the Fat Man and the policemen, what had happened in the House of God had been fierce, and I had been hurt, bad. For before the House of God, I had loved old people. Now they were no longer old people, they were gomers, and I did not, I could not love them anymore. I struggle to rest, and cannot, and I struggle to love, and cannot for I’m all leached out, like a man’s shirt washed too many times.

Alcohol helped in the House of God, and I think of my best friend, Chuck, the black intern from Memphis, who never was without a pint of Jack Daniel’s in his black bag for those extra-bitter times when he was hurt extra bad by the gomers or the slurping House academics, like the Chief Resident or the Chief of Medicine himself, who were always looking at Chuck as illiterate and underprivileged when in fact he was literate and privileged and a better doc than anyone else in the whole place. And in my drunkenness I think that what happened to Chuck in the House was too sad, for he had been happy and funny and now he was sad and glum, broken by them and going around with the same half-angry, half-crushed look in his eyes that I’d noticed Nixon had had yesterday on our French TV, as he stood on the steps of the helicopter on the White House lawn after his resignation, giving a pathetically inappropriate V-for-defeat sign before the doors closed over him, the Filipinos rolled in the red carpet, and Jerry Ford, looking more flabbergasted than awed, put his arm around his wife and walked slowly back to the presidency.

We came here to serve God, And also to get rich. —Bernal Diaz del Castillo, History of the Conquest of Mexico

The House medical hierarchy was a pyramid—a lot at the bottom and one at the top. Given the mentality required to climb it, it was more like an ice-cream cone—you had to lick your way up. From constant application of tongue to next uppermost ass, those few toward the top were all tongue. A mapping of each sensory cortex would show a homunculus with a mammoth tongue overlapping an enormous portion of brain. The nice thing about the ice-cream cone was that from the bottom, you got a clear view of the slurping going on. There they were, the Slurpers, greedy optimistic kids in an ice-cream parlor in July, tonguing and tonguing and tonguing away. It was quite a sight.