Customer Reviews

House of God

5 star:		(99)
4 star:		(38)
3 star:		(11)
2 star:		(12)
1 star:		(9)

 

 

There are all kinds of things I hate about this book. I hate remembering how long I would go without sleep and the psychic torture that an internship inflicts on you. I hated the depersonalization of patients. I hated the sexual escapades. Most of all, I hated having in print the real feelings of an intern who has been up for three days - praying on the way to the ER that that Nursing Home Gomer with 20 fatal diagnoses would have the decency to croak before you got there so you could get an extra five minutes of sleep or a stale doughnut before the cafeteria closed again.

Shem portrays masterfully the jumble of emotions of a typical intern. There is a superficial level of glossy brown-nosing that got you into med school in the first place. Buzz words like compassion, continuity of care and empathy are used with the teaching physicians and in meetings. Then there is a deeper level of survival where you would kill your mother for 5 minutes of sleep or being able to crap without the code blue pager going off. This level is usually not discussed or written about in many of the typical intern coming-of-age books out there. Not because it isn't true, but because it's uncomfortable and offensive to non-physicians. Shem is the master of this level of medical thinking. No one else even comes close. Shem approaches but doesn't quite get to an even more primal level - that of duty. This level is what keeps an intern from punching his residency directors or the arrogant surgeon who asks him "What is the difference between a sh*thead and a brown-noser" and then tells you the answer is depth perception.(True story) It's what makes you do your best when you know the patient is hopeless or even abusive as you try your best to save them from themselves or some disease.

The humor is black as night and the sex is soft-core porn, according to my nephew in medical school to whom I sent a copy of this book.

House of God has two profound themes. The first is a detailed description of medicine and medical training. This theme is presented with black humor, and some (but not as much as you think) exaggeration. I have read nothing that does this better. The second theme of the book is universal, however. It is the theme of Man vs. World and the World wins, but the Man is too maimed to know it.

The book still disturbs and haunts me because Shem puts in print graphically and eloquently some of the thoughts and occurences that we don't even admit to ourselves.

It's interesting to hear non-medical opinions on HOG. This book is actually not that humorous. I can see how it "seems" to be; with all the dark morbid humor and the LAWS. A colleage told me not to read this book until i had finished my 3rd year of MD-school. Why? Until you put yourself on the ward, this book doesn't mean much to you. I didn't believe him and read it at the end of my 2nd year. I read it again at the end of my 3rd year. It was like i was reading a different novel. There is no way to clearly describe the sensation of having 7 admissions on call...all gomers....trying desperatly to BUFF and TURF them.

This book is a must read for the doctor to be. The nonmedical world has to realise that what seems as perverse dark sick humor (gomers, turfing, not doing anything, the only good admission is a dead admission) is merely an attempt to survive the onslaught of internship. Balance fatigue with limited knowledge and throw in some unparralled responsibility and you get a taste of what it's like.

House of God does just that.

Oh.. and never ever.... go to a teaching hospital in July. :)

I have read this book three times: When I was a first year medical student I found it to be exaggerated. When I was in my intern year I found it to be an understatement. Reading it for the third time in the middle of my residency allowed me to have a more mature perspective of this book. I find it to have a striking resemblence to another classic: "Catch 22" by Joseph Heller. I will start by saying that both books are NOT great literature masterpieces . They do not stand in one line with Joyce, Amos Oz, Steinback or Hemmingway and as a work of art they therefore deserve , in my opoinion 2 or 3 stars of rating.They do share, however, a unique quality which is this: They both manage to capture in an astonishing accurracy, through sarcasm and absurd, all that is twisted, wrong and cruel in the systems they deal with. Being both a doctor and an IDF officer, I can testify from personal experience that both the military and the medical field have a lot in common , mainly that they both are a stressfull, wearing enviroments. Shem's accurate perception lead this book to being the sharpest description of this enviroment so far, just as "Catch 22" was in its times I therefore share the enthusiasm of the majority of the reviewers of this book, as much as I can identify with the ones who found it disappointing in the literary sense. It therfore gets a rating of 4.

To the lay-readers who find the book's images and points of view both horrifying and repulsive, I would say only this: As a street paramedic I fully empathize with any experienced doctor, nurse, P.A., or other medical practitioner, who happens to be a little "crispy around the edges." Medicine at any level of practice is often a mental beat-down, frequently unrewarding, and always tough. The "gallows-humor" that HOG depicts so graphically is a defense-mechanism for a lot of health-care workers. Myself included. You either succumb to its temptation, or you burn out. And in that case, you're no good to anyone, least of all your patients. If you read the book from a perspective outside the medical profession, please keep an open mind and you will love the book as much as we who are "in the know" do. And if that doesn't work, you could always try walking a mile in our shoes...

I read *The House of God* the year after I completed my own internship, while running a rural clinic (a la NORTHERN EXPOSURE, but back during the Carter Administration) and contending with the first onslaught of Managed Money (also known as Mangled Care).

It was strange. I recognized the unarguable truth of the Laws of the House of God, and knew the Fat Man and Jo (the Journal Club Maniac) and all the slurpers and sleazebags and "physician entrepreneurs" for whom I'd spent a year of my life doing scut while salvaging their patients. I couldn't stop laughing through the first half of the book, and then a curious thing happened.

The second half of the novel left me more and more depressed, remembering the bleakness and pain of that year, and summoning up the hard lessons I had learned -- and was still learning as a young physician in the first years of practice. It reminded me that no matter what I did, the slurpers and the self-righteous stuffed shirts in my profession were going to win. They were going to keep on degrading and destroying patients and their families, gorging on the increasing wealth being poured into "the health care industry," and beating the hell out of decent physicians who actually dared give a damn about the humanity of the people who come to us for treatment.

And now, nearly three decades later, the laughs are completely gone and the truth is beyond concealment. *The House of God* is a wonderful glimpse of life as a scutpuppy back in the '70s, yes -- but more than that, it's a prophetic anticipation of the destruction of what was once a pretty decent profession, working to achieve something more than a favorable return on investment.

The '70s weren't "the good old days" by any stretch of the imagination, but who could've believed back then that the 21st Century was going to be so godawfully much worse?

If you are wondering whether this book is a realistic portrayal of residency -- in my observation it is. I first read this book in 1978 while working in an emergency room. Coincidentally, I started working in the ER on July 1, just as the new residents were starting. At that time I was a nurse-paramedic, had just worked two years in the float-pool on the med-center floors (as well as part-time on an ambulance). I intended to eventually apply to medical school and wanted more ER experience, as I contemplated becoming an ER physician. I learned my niche as the residents learned theirs.

I felt somewhat like an anthropologist as I watched the residents go through the same things described in the book "The House of God." Many of the residents passed the book among themselves that year. And the next. And the next. On occasion, each resident said more-or-less, "Yeah, it's a documentary."

After the third year I stopped working in the ER -- it was fascinating work that never let-up, but it can be a burn-out job -- and I moved on to other things, never going to medical school, but marrying a doctor. For twenty years I have kept in touch with my old environment on its periphery. Many things have changed in medicine the past two decades, but some things remain essentially the same.

I presume that one of the things unchanged is that new copies of "The House of God" are still being passed around among the residents, year after year. Probably the stress and distress that the residents experience -- as well as the black comedy of daily dealing with the impossible and hopeless -- is as heartbreaking, invigorating, debilitating, and tragic as it ever was. Thank you Dr. Shem, for taking the time to write such an excellent and realistic book on that complicated and perplexing time of growth and change in medical doctor's lives.

As a medical professional (a nurse) I loved this book. The boyfriend (a 4th year medical student) and I both agree that this is as close as to the real world as anything else published. Medical people will love it for its dark and real-to-life humor. Lay people will hate it for the same reasons. If you have a significant other in the medical profession- read this book and you will only begin to understand our stories and our frustrations with our job. The boyfriend is giving it to his mom who has absolutely no idea what goes on in between the brick walls of a hospital to help her understand that we aren't calous about our work. When you DAILY work with others hovering over the edge between life an death, the strain can get to you if you can't laugh. And this book will make you laugh, even in its darkest hour.

There is a well-known phenomenon in health care called "reality shock." It occurs when an idealistic student practitioner emerges from the educational process, bright-eyed, scrubbed and shining, and learns what the hospital industry is REALLY like. The light at the end of the tunnel can be seen (according to the studies on this process) when the new professional regains a sense of humor. When I graduated from college with a nursing degree, I went to work for a huge west coast HMO that shall remain nameless; after a year on the wards I was ready to lay down in front of a bus. I was working nights, caring for 22 patients with one unlicensed assistant, facing 28-year-old geniuses with metastatic cancer, or middle-aged alcoholics who would disconnect their IV lines and watch the blood splash on the floor, or .. well you get the idea. Somebody gave me "House of God" before a weekend off. By the end of the book I was laughing and crying and rediscovering just why I'd gotten into this business to begin with. If you're a health care professional and haven't read this yet, READ IT! If you're a "frequent flyer" in the health-care system and can't figure out why caregivers laugh at things that are absolutely NOT funny to the Real World, this book will tell you. Send this book to your senators and representatives. Send a case to your insurance carrier's Utilization Review department. And thank god that our anonymous author had the guts to write the truth.

This is now a hallowed classic, yes it's dated (set in the 70s) but that doesn't stop the impact and the occasional period point (like the sexual promiscuity) is easily overlooked.

I met Shem (a pseudoname)in the 80s at a meeting (he's a psychiatrist from Boston) and although I'm sure other reviewers have met him as well, he was very much full of himself with us. Most of us were not impressed....especially since he was not open to any criticisms of either his book or the issues surrounding patient care failings of the American health care system.

That said, the book should be required reading for anyone serious about a medical career. But you should read better stuff as well....start with any poem or story by John Stone, William Carlos Williams' Doctor Stories, Richard Selzer's books (especially Letters To A Young Doctor), and Jay Katz' The Silent World of Doctor and Patient.

I read this as a first year med student, when everything to come was a great mystery. The world of the training institution (think large, urban teaching hospital here) comes alive in this book, and while it seemed to me at the time that much of it must have been "buffed" by the author to make it more interesting, it turns it out is pretty right on.
I hope it doesn't shatter the readers' confidence in their doctors; what comes accross as a lack of compassion amongst Interns & Residents is just a symptom of the duress of their training ordeal (and their lack of sleep). Happily, excellent skills are usually attained by the concentration of work done, and compassion, if flagging in a few, returns to most all not long after Residency ends.