The House of God by Samuel Shem

THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.

This sentence is one of the laws of “The House of God”. Well, actually it isn’t just one of the laws’, it’s the last, the thirteenth law and also my favorite one. In this “not just one” law the whole book is summarized. As I already mentioned this law the thirteenth and last one, so you’ll be probably wondering what the other ones would be, well those would be the following :

The laws of The House of God:

  1. GOMERS DON’T DIE.
  2. GOMERS GO TO GROUND
  3. AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE.
  4. THE PATIENT IS THE ONE WITH THE DISEASE.
  5. PLACEMENT COMES FIRST.
  6. THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14G NEEDLE AND A GOOD STRONG ARM.
  7. AGE + BUN= LASIX DOSE.
  8. THEY CAN ALWAYS HURT YOU MORE.
  9. THE ONLY GOOD ADMISSION IS A DEAD ADMISSION.
  10. IF YOU DON’T TAKE A TEMPERATURE, YOU CAN’T FIND A FEVER.
  11. SHOW ME A BMS (Best Medical Student, a student at the Best Medical School) WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET.
  12. IF THE RADIOLOGY RESIDENT AND THE MEDICAL STUDENT BOTH SEE A LESION ON THE CHEST X-RAY, THERE CAN BE NO LESION THERE.
  13. THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.

The House of God is the name of the hospital founded by the Israeli people who lived in America, but whose children weren’t able to get good internships in good hospitals because of the huge amount of discrimination. The book has been called one of the most important American medical novels by “The Lancet”, the British medical journal. It’s been translated into thirty languages and it has sold over two million copies. It has been turned into a film as well.

Stephen Bergman alias Samuel Shem

The book is written by Stephen Bergman in 1978 but he released the book under the pen-name Samuel Shem. The reason for this was that he’s a psychiatrist and he was afraid to lose his patients when they would find out about “The House of God”, but of course every patient found out and they really liked it. He chose the name “Samuel Shem” because “Shem” was one of Noah’s sons and “Samuel” was a prophet.

Nowadays he’s a professor of psychiatry at Harvard Medical School.

Once I told a friend of mine that I was thinking about studying medicine, the next time we saw each other she brought me this book and told me to read it. She also told me it was that kind of book that you’d find either really funny or really annoying. I started to read it and I immediately noticed that she was right.

The book starts at the end of the story with the main character, Roy Basch, reflecting back on his year of internship.

For the first semester he’s classified with Chuck and Potts. They’re in the care of the Fat man, who teaches them how to survive in The House of God, that the goal is to get rid of your patients by “turfing” (transferring) them to other departments, that there’re three kind of patients: The GOMERS (Get Out of My Emergency Room), who are very old and demented and who’ll never ever die; the mediocre old ones, admitted by a personal physician to evade elderly care payment or to avoid the change of a malpractice litigation and the young ones. The young ones always have incurable and fatal diseases.

As a result of all the hassles in The House of God he gets infected with “The doctors disease” in which he has a total lack of emotion. Fortunately he has an amazing psychologist girlfriend and some great friends, who help him to recover. Thereafter he decides to enter psychiatry, so he will finally be able to help people.

What stuck with me the most was that it was a very strange book:

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 few of the slurping going on. There they were, the Slurpers, greedy optimistic in an ice-cream parlor in July, tonguing and tonguing and tonguing away. It was quite a sight.”

Yes.

That strange.

And it keeps going on like that for like the whole book. I really enjoyed reading this book, sometimes I was laughing out loud and I saw people looking at me, but I didn’t care at all. The only thing I wanted to do was keep reading. Besides that it’s a really funny book, well if you have the same kind of humor as they have in “Monty Python”. Though it can be really sad now and then. I was almost crying at the part that a young nice patient died of cancer. But I also think that Samuel Shem wanted to show us something about the hierarchy, the people who do the real work are on the bottom, they’re underpaid and undervalued. The few at the top only give the orders and get too much money with making other people to work for them.

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