The House of God

The House of God is a book by Samuel Shem (a pseudonym of the psychiatrist Stephen Bergman), published in 1978. As it provides a very cynical view of medical training and hospital life, it made a substantial impact on public opinion, and has arguably been an instrument in reforming medical training in the 1980s.

Contents

1 Storyline

2 Context and impact

Storyline

Dr Roy Basch is a new intern in a hospital called the House of God, after completing his medical studies at the BMS ("Best Medical School"). He is poorly prepared for the grueling hours and the sudden responsibilities without much guidance from senior doctors. He survives the year (unlike a colleague, who commits suicide) due to various factors: his girlfriend Berry, various adulterous relationships with nurses (portrayed in great detail), and an enigmatic resident who goes by the name The Fat Man. The latter provides his patrons with wisdom such as the "Laws of the House of God" (which amount to 13 by the end of the book). The book finishes when it turns out that the psychiatry resident, Cohen, has managed to inspire almost the whole year's group of interns to pursue a career in psychiatry.

Context and impact

The book is very likely autobiographical, with the BMS being Harvard Medical School (commonly called HMS), and The House of God is quite likely Beth Israel Hospiital now a part of Beth Israel Deaconess Medical Center, one of the HMS-affiliated hospitals in Boston, Massachusetts.

It is very likely that some details have been exaggerated (such as an orgy in the resuscitation room), but upon its appearance, many American doctors felt that the story resonated with their own experiences during their internship training.

Several of the concepts developed in the book have found their way into the jargon of junior hospital staff:

Gomer (noun: Get Out of My Emergency Room - a patient who is frequently admitted with complicated but uninspiring and incurable conditions)
To Turf (verb: to find an excuse to refer a patient to a different department or team)
Zebra (noun: a very unlikely diagnosis where a more common disease would be more likely to cause a patient's symptoms)

Criticism

Criticisms leveled immediately against the work are the depersonification of patients, ageism, sexism and the account of euthanasia. The bleak mood was hardly considered representative of the noble art of medicine.

Miscellaneous

In 1979, a film was made out of the book.

In-jokes abound in the work. One of the principal characters is Eat My Dust Eddy, a doctor so-called because of the saying embroidered on his jacket. His name is often abbreviated as EMD, which is also an acronym of the feared medical emergency electromechanical dissociation .

Bibliography

Samuel Shem. The House of God. 1979. ISBN 0440133688.