House of God

House of God #1

by Samuel Shem

„House of God“ ist eine bitterböse medizinische Satire. 1978 erschien das Buch, wurde in mehrere Sprachen übersetzt und millionenfach verkauft. Es gilt inzwischen als Kultbuch (nicht nur) der Mediziner. In der Tat ist das, wovon hier erzählt wird, harter Tobak - unappetitlich, zynisch, herzlos und nervenaufreibend bis zum Letzten. Mit dem Nebeneffekt, dass die Halbgötter in Weiß von ihrem Thron gestoßen werden.

Dr. Roy Basch absolviert im House of God sein erstes Praxisjahr. Wie alle Medizinstudenten glaubt er enthusiastisch daran, dass die erste Pflicht des Arztes die Hilfe für den Patienten ist. Dass der Alltag in einer modernen Klinik ganz andere Prioritäten setzt, muss er schnell und unbarmherzig lernen. Auf seinem Weg durch die einzelnen Stationen wird er mit „Gomers“ (Get out of my emergency room - Raus aus meiner Notaufnahme) und den 13 unumstößlichen, grotesken Regeln des Krankenhauses konfrontiert.

Es ist das Verdienst von Samuel Shem, alias Stephen J. Bergman, auf die Krise der modernen Medizin, ihre beängstigende Unmenschlichkeit aufmerksam gemacht zu haben. Der Professor für Psychiatrie hat mit „House of God“ bei seinem Erscheinen 1978 einen Skandal ausgelöst, wird aber heute ganz selbstverständlich gelesen. „Mount Misery“, mit den Erfahrungen von Roy Basch in der Psychiatrie, „Doctor Fine“ und „Orvilles Heimkehr“ sind weitere Bücher von Shem.

Unter der Regie von Norbert Schaeffer entstand eine unglaublich virtuose Inszenierung der Medizin-Satire. Ohne Erzähler wird der Hörer in rasendem Tempo von einer „irrsinnigen“ Momentaufnahme zur nächsten katapultiert. Unappetitliche, ekelerregende Geräusche wechseln sich mit makabren Gesprächen, leitmotivisch eingesetztem Geschrei von Gomers und dem Wahnsinn nahen, inneren Monologen ab. Brillant ist Ulrich Noethen als Roy. Die Zerrissenheit und Hilflosigkeit gegenüber den alptraumartigen Erlebnissen, denen er in „House of God“ ausgesetzt ist, bringt der Sprecher absolut überzeugend rüber. Ein Hörspiel, das es in sich hat, das die Nerven ganz schön strapaziert, das unterhält und gleichzeitig zum Nachdenken zwingt! Hörspiel, Spieldauer: ca. 125 Minuten, 2 CDs. Mit Booklet. Eine Produktion des MDR. -- culture.text

Genres: Medicine, Fiction, Medical, Humor, Classics, Contemporary, Book Club

488 pages, Paperback

First published January 1, 1978

About the author

Samuel Shem (b. 1944) is the pen name of the American psychiatrist Stephen Joseph Bergman. His main works are The House of God and Mount Misery, both fictional but close-to-real first-hand descriptions of the training of doctors in the United States.
Of Jewish descent, Bergman was a Rhodes Scholar at Balliol College, Oxford in 1966, and was tutored by Denis Noble FRS, cardiac physiologist and later head of the Oxford Cardiac Electrophysiology Group. In an address to Noble's retirement party at Balliol, he related that Noble's response to Bergman's attempt to become a writer was to ply him with copious sherry. He graduated from Harvard College and Harvard Medical School.
He was an intern at Beth Israel Hospital (subsequently renamed Beth Israel Deaconess Medical Center) ,which inspired the book The House of God.
As of 2017, Bergman is a member of the faculty of the New York University School of Medicine at NYU Langone Medical Center.
Shem's play Bill W. and Dr. Bob had an Off Broadway run at New World Stage in New York City. It ran for 132 performances and closed on June 10, 2007. The New York Times called it "an insightful new play."

Reviews

[Shelley · Rating 1 out of 5]

I don't usually review books I rate at 3 stars or lower, but this is an exception: I detest this book so much that I feel compelled to write something about it.

Make no mistake: I am a resident physician (and read this book during my internship year), so none of the horrible things that happen in the book faze me. I am also the last person to dislike a book because it is not "feel-good", or because it offers more questions than solutions (those are often the best books). However, I take issue with this book because, to me, it doesn't deliver what it promises. "The Classic Novel of Life and Death in an American Hospital:" for me, the only word true in that subtitle is "Novel."

The main character, a thin guise for the author himself, goes through internship. He is overworked, he is bitter, and he has sexy escapades with nurses and social workers while his fiance psychoanalyzes him. Okay, been there done that (minus the sexy escapades and fiance part). Let's see: then he rants against the evil of the medical training system and the futility of the medical care he delivers. Fine, now that the obvious stuff is out of the way, let's cut to the chase. Oh wait, now it's over.

But where are the other things? Where's the guilt, not just over how you think you mishandled a patient's care, but also over how you've not lived up to what others and what yourself expected of you and how you've neglected all friends and family? What about the oppressive sense of responsibility which you are initially overwhelmed with, frequently take for granted, sometimes make light of, often resent, and occasionally try to dodge? What about inevitable dehumanization that is not so much created by a villanous, uncaring system but is really a part of the job description? What about your transferences and countertransferences towards patients, your natural defense systems and how they sabotage your clinical judgement, making you even more guilty and defensive, your feeling of inadequacy that is only outweighed by your desire to be somehow normal again and part of the rest of humanity? These are things my colleagues and I deal with on a daily basis. This so-called "classic" doesn't address any of them except in the most perfunctory manner possible.

What it does do is rage against the residency system of his time. There have been immense changes since then; some may say the pendulum has even swung too much the other way. I cannot find much beyond that. The book is of historical interest in that regard, but given the depth of the emotional toil that is internship, I expected a lot, lot more out of the "classic novel".

It also doesn't help that the central character acts like a sociopath, and I don't think you can blame that solely on the system.

[Julianne · Rating 3 out of 5]

As I tell people: I liked the morals, not the story.

The message on why "the boys" didn't like the chief, how doing nothing is good medicine, and the difference between gomers and old folks are very pertinent to me and how I practice in healthcare. My favorite Laws include:

3. At a cardiac arrest, the first procedure is to take your own pulse.
4. The patient is the one with the disease
10. If you dont take a temperature you can't find a fever.
13. The delivery of medical care is to do as much nothing as possible.

Healthcare in the 21st century has gotten better at following the "less is (sometimes) more" idea, and the ethics of end-of-life care (beneficence and pt autonomy) are much better than that portrayed in the book--and yet the issues are still prominent today.

That being said: I couldn't keep track the different interns, making the story difficult to follow. I didn't find the characters terribly likeable. I totally skimmed over all the sex stuff (completely unnecessary IMHO and caused a break in the flow of the story).

And, as usual, I HATE the term "respirator". It's a ventilator, dag-nab it!

Summary, I like what Shem had to say, I didn't particularly like the way he said it.

[Efka · Rating 4 out of 5]

Apie šitą knyga būtų galima rašyti ir kalbėti daug: pradėti nuo to, kokios yra medicinos realijos lyginant su mūsų visų susidarytomis iliuzijomis, maitinamomis visokių grej anatomijų ir daktarų hausų ir baigti daktarų persidirbimais ir psichozėmis. Bet nieko panašaus daryti aš nenoriu. Nenoriu ne todėl, kad ši knyga būtų bloga, priešingai – nepaisant astronominio kiekio cinizmo, abejingumo ir paniekos, kurios visam pasauliui kupini šios knygos herojai, knyga tikrai nebloga bent jau tuo, kad priverčia susimąstyti ir pagalvoti apie žmonės, kurie diena po dienos, valanda po valandos kapstosi augliuose, pūliuose ir kraujyje ir kaip tai turėtų juos veikti psichologiškai, kurie yra mūsų laikų dievai, lemiantys kas gyvens, o kas mirs, ne todėl, kad neturėčiau minčių, bet todėl, kad po šitos knygos apėmęs jausmas yra toks, kaip įkišus rankas į puvėsių ir gleivių kupiną kupstą – pasąmoningai supranti, kad nieko baisaus ir kad tai tik paprasta organika, bet labiausiai vis tiek norisi tik daug kartų nusiplauti rankas muilu ir daugiau prie tos nekaltos organikos nebesiliesti. Ir tai yra tikrasis šios knygos veidas. Viena vertus ji sukrečianti, kita vertus perskaičius norisi tiesiog pamiršti ir daugiau apie ją nebegalvoti, nes kitaip net ir gražiausia diena tampa ne tokia gražia. Į daktarus daugiau niekada nebežiūrėsiu kaip į „tiesiog profesiją“, kaip ir visiškai nebestebina, kad būtent daktarai ir teisininkai laikomi dažniausiai prasigeriančiomis profesijomis. Einu paskaityt kokį sacharoze ir lengva erotika persmelktą romantinį niekaliuką šiokiam tokiam atsigavimui.

Nenuostabu, kad gydytojai taip iš tolo stebi skaudžiausias žmonių dramas. Tragedija ne ta, kad jie abejingi, o ta, kad jiems stinga jausmų gilumo.Dauguma žmonių gyvai reaguoja į savo kasdienį darbą, bet tik ne gydytojai. Neįtikėtinas paradoksas: daktaro specialybė neapsakomai nužmogina, bet kartu ją didžiai vertina visuomenė.

[Renee Godding · Rating 4 out of 5]

Rating: 4/5 stars

"Gomers Never die"
Neither will that quote...

Let me try to review this book in one sentence:

This book tells the truth, nothing but the truth, but NOT the full truth...

Sounds cryptic but if it is the best I can do. The House of God adresses grim and dark topics that are usually not spoken about in literature. It does not shy away from showing the “dark side” of medicine and truly, as both a patient aswell as a doctor to be, that is the type of book that will get my 5 star rating.

What it does, it does really well. At times it feels like satire, but honestly, so does the reality in hospitals sometimes. On top of that o found it very funny and it actually had me laughing out loud ik public at times (which rarely happens with a book). If that makes me a horrible person with a demented sense of humor: so be it. I rest in my fate.

However; I take half a star off for the missed opportunities this book had. If the author had described the actual emotional impact that the events must have had on the characters, it could have added such a layer of depht. Emotions like guilt, shame, feeling of wanting to prove your worth but failing at times are hinted at, but not explored. I get maybe this was not the story the author was going for: but I feel it could have really added a lot.

[Andy · Rating 2 out of 5]

I've avoided reading this for years. To be fair, I didn't even know about it until half way through med school and then I never had much desire to come home and 'read about the day job'. But, now I'm a GP and have been out of the hospital for approaching 2 years now I thought I'd give it a whirl.

Hmmm. It's about what I was expecting. Almost everyone who has reviewed it on here appears to be a doctor and the number of 'just like real life' comments astound me. I trained in the UK and work in NZ so I don't have any first hand knowledge of what it's like to work in the States but damn. I hope this is extremely dated compared to modern practice but it seems people still feel this is accurate. Really? Medicine really is a different kettle of fish in America in that case.

There are flashes of familiarity and a few incidents and feelings have a ring of truth (with a few things I suspect only doctors could really fully appreciate). But the sheer unpleasantness, disgust and lack of humanity is disturbing.

In all honesty, my first house year was probably one of the best of my life. Fun, busy, new, a great group of close knit friends; dancing, sex and drinking definitely played a role, plus there were long nights, weekend shifts and some stressful on calls. But there was none of the negativity portrayed here. Yeah, you deal with crap at times (literally and figuratively) but I just cannot relate to the majority of the feelings in the book. I really enjoyed my elderly care and old age psychiatric rotations and love working with older patients (one of the joys of life as a GP). There were no major train-wrecks in our first year (though I have seen the toll on other doctors over the years).

I think it's an ever lasting theme amongst the medical profession. 'You guys have it so much easier than I did when I was a junior'. I've heard that countless times, I've said it myself and I've heard older doctors tell me their mentors said exactly the same to them. By this standard, modern medicine should be a breeze. We still worked long hours and calls, still had to work hard with limited support and make tough decisions. I don't think many of us went in with our eyes so shut though. We were all fairly aware what life as a junior doctor would be.

The reviews comparing this to Catch 22 seem a little lazy. Perhaps as a historical (hopefully) depiction of the horrors of the American Health Care System it has some merits, but otherwise it just leaves a nasty taste in the mouth. Now I've read it I can put it aside but I'm not sure I'd recommend it and I would truly be concerned about med students reading this for tips.

[Patrick Henderson · Rating 5 out of 5]

I read this in college, then again my first year of medical school, then again my last year of medical school, then again during my internship, and I'm reading it once more now as a senior resident. Along with the television show Scrubs, it's the most accurate portrayal of American medicine that I'm familiar with. I gave it to my father and he called me saying that he wanted to go medical school. I gave it to my mother and she called me crying, asking if my job really is as bad as Shem makes it out to be.

I think when it first came out it must have been truly shocking. Though today, with so much of medicine being patient-directed (and not physician-directed), I think you could look as this as a quaint little black mark on American history -- like the old cartoon cigarette commercials, or the movie "Freaks".

Yeah but the thing is...a ton of this still rings true. The essence of medical care continues to be placement. Gomers still, without fail, go to ground. Any medical student who doesn't triple my time is worth his or her weight in gold.

There's a rumor that the Fat Man was fired from his position due to his indiscretions which were detailed in this book, which is a shame. I continue to learn from him even at this stage in my career.

[Elizabeth · Rating 4 out of 5]

Disclaimer: I did my internship and residency at the other hospital, "MBH," in Shem's classic novel about medical training, at the same time that he was busy observing his fellow house officers and higher ups at the House of God. So my take on this book is colored by immersion in the culture he parodies, and by the fact that one of his main characters bears strong resemblance to a medical school classmate who interned in Boston at Shem's hospital.
Fresh out of five years of medical training, I read this book back when it came out and found it laugh-out-loud funny because, like all caricatures, it is based in truth. It has just appeared in audio, and the view from a few decades down the road is a little bit different, but still entertaining (though I have to admit that the raunchy sex got a little boring). The exaggerations seem a little more exaggerated, and the truths more grounded in the realities of experience. There was a Fat Man in my training program - actually several of them- and I suspect everyone who has become a doctor knows a few. The Fat Man's rules all contain germs of truth. Shem was an astute observer of the human condition at a young age. Most of us were just trying to learn and survive, but he was taking notes.

[Hamad · Rating 3 out of 5]

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“It’s an incredible paradox that being a doctor is so degrading and yet is so valued by society”

Although this book has more than 2 million copies in print, I only heard about it two years ago when I was doing an elective in my internship. I heard it was funny with a very accurate depiction of things we go through as doctors. I wanted to read it ever since but there was something that made me keep putting it off. Maybe the fact that it was written in 1978 and the writing then rarely works for me. I was kind of right.

The book follows six interns as they join The House of God hospital and go through all different kind of stuff and trauma to reach the top. To be honest, only the main protagonist Roy Basch seemed to be distinct as we spend most of the time with him and the other 5 interns were kind of jumbled together.

There have been many improvements in the medical community since then, but it seems some things will never change as I personally have gone -and is going- through them too. The way interns are looked upon by the rest of the medical staff, the way different specialists handle things, and all the endless work and little appreciation are some of those things.

The writing did not bother me in terms of prose, but it was overly written and lengthy. The sexual stuff was also way over done and unnecessary. I think most of that is explained by the year it was written in hence my fears from the start.

“This is the basic human story. We are all on the same journey. Every one of us will suffer—there’s no way around it. The crucial question is not how to avoid suffering, it’s how we move through it.”

Summary: The story was okay for me, and I don’t regret reading it because it was recommended to me more than once by medical people. I just think the writing did not work for me but I kind of enjoyed some of the humor and the moral of the story. I won’t be reading book two because I think I got the idea from this one.

[India M. Clamp · Rating 4 out of 5]

Samuel Shem is the pen name for the author of this book. After reading a few lines of the lascivious tales within, it becomes obvious why a pseudonym was used. “The House of God” details the journey of Roy Bausch and 5 interns at one of the most prestigious teaching hospitals in the world. Contents are plenary, raw and tragic.

“ ...Get the job done, and since we're all in the ninety-ninth percentile of interns, at one of the best internships in the world, what you do turns out to be a terrific job—a superlative job. Don't forget that four out of every ten interns in America can't speak English.”
---Dr. Samuel Bergman, MD

A Senior Resident, called “The Fat Man” is the kind of genius who swears like a sailor and gets away with it because he is just “that good.” Rife with black humor and a candid delineation of what enduring an internship is really like. In a quotidian terror of learning by doing, we discover how “Ex Nihilo Nihil Fit” becomes a mantra.

Imagine at Beth Abraham Hospital nurses (akin to divine buxom cherubs) named: Molly, Angel and Hazel succor in ways that de-facto/de-jure rules do not seem to apply. “Buffing the chart,” inspires smiles like dollars coming from outcomes you would not wish on an enemy. Must read for any resident, intern or student of medicine! Buy, laugh and and most of all learn.

[Natalie Liogas · Rating 1 out of 5]

I'm not finishing this. I was told this book was full of insight into what life as a resident is like, but those tidbits of wisdom are scarce. It's less of a recollection of the life of a fresh medical school grad and more of a collection of immature and bizarre musings about women's bodies and vivid descriptions of the author's sexual fantasies. I hope the author sought help for his psychosexual dysfunctions :/

[Cecelia · Rating 4 out of 5]

I felt I should read this book, described as the "Catch-22 of medicine" before graduating from med school. It was scary how accurate most of it is, right down to the 'Laws' of the House of God quoted throughout. Remember, Age + BUN = Lasix dose. But well written and a good read, although I don't know how funny it will be to those outside the medical profession (probably still so to spouses).

[Amy Bruestle · Rating 2 out of 5]

First of all, let me say that i have never heard of this book. However, i won the sequel through a giveaway on goodreads in exchange for an honest review. Anyone who knows me knows that i must start from the beginning of a series! So i checked this book out from my local library and read it so I could read its sequel.

Honestly, if it weren’t for the fact that i wanted to make sure i didn’t miss out on any pertinent information that would be needed to understand or interpret parts of book 2, i would have stopped reading.

It was pretty boring. Also very strange wording. I don’t really know what to say to describe it.

[McGooglykins · Rating 5 out of 5]

When I was a nursing student, I was sitting at the nurses station and writing a rough draft of my patients notes for my supervising RN to read through before I put them in the file. One of the medical interns sat down next to me and asked me if I'd read The House of God. I thought he might have been trying to convince me to join some obscure religion. I hadn't, I warily told him so, and he threw his hands up in the air and said "You have to, you need to read it, it's real life put down on paper, and it will stop you going mad. Or make you feel better about going mad when you do get there. It certainly made me feel better about going mad. They tell us we should read it, but they never tell you nurses and that's a crime. So I'm telling you now. Have a good shift!". Then he bounced up out of his chair and disappeared to wherever doctors go when they're not making the place look messy and stealing the charts just before you need them.

It took me a while to track down this book, but now I have I can absolutely say that this intern was one hundred percent right. This book IS real life down on paper. Everything in it (with regards to patients, emotional turmoil, medical care, and bowel runs) is totally relate-able. It may be dated (all these references to the Nixon era make only the vaguest sense to anybody in my generation who is not American) but it is still relevant, and after my first year out, it was cathartic to read this book and see that it isn't just me. Other people before me have felt the same helplessness and cynicism and experienced the same highs and lows, regardless of when they started or whether they're medical or nursing or anything else.

And the Laws of the House of God? Are hilariously, wonderfully, absolutely true.

[Dr. Amanda · Rating 3 out of 5]

Slightly satirical and overly sexual book about being an intern doctor. Written back in the 70s so things are ~a bit~ better now (no more 36 hour shifts!) but many aspects still ring true.

[Chrisnaa · Rating 1 out of 5]

I hated The House of God. My one law after reading this is DO NOT TRUST ANYONE THIS INTO FREUD. Every single female in this book is described sexually, the main character just going around fantasising about women to the point I thought I was reading a prepubescent kid's diary. It was a poorly-written male fantasy. One main female character acts as a Freudian translator who tells us what each change in the narrative signifies according to Freud. She does not get any development, she is stagnant as the oh-so-understanding partner while the unsubtle authorial stand-in goes around having sex with everyone. It's ok though, Freud warned her about it. The other female character is villified because she is "frigid" and thus not willing to accompany interns on their journey of self-discovery.

The emotion of this book, the despair and fear and hopelessness, is hidden and gouged at by a rotating cast of characters and CAPITALISATIONS and M.A.T.I.C.D.W (more acronyms than I could deal with). It’s like someone took all the traits I hate about poorly-written discharge summaries and then let it ferment in a strangely pornographic greenhouse. And this is not to mention how awkward the sentence structures in this book are.

The elevation of this book to near-biblical proportions amongst the medical community is more a testament to how few books accurately capture the feel of burnout and the fear of being an intern, as opposed to a commentary on how well-written Shem's book is. The depiction of burnout does not need to be accompanied by sexism that was already dated on arrival or sentences that fear ever approaching beauty.

[Natalie · Rating 3 out of 5]

This was my second attempt at reading this book. My first, when I was still a medical student, ended a few chapters in, when I had to stop reading because I found the book far too cynical and depressing. Now, apparently, I'm jaded enough to enjoy it, though I know the reality isn't quite as awful as this book would have you believe.

Plenty of it, of course, hits right on target. The exhaustion of night shifts: that moment when you actually wish somebody would die because it means less work for you... it happens. The sense of losing touch with the outside world, of being unable to connect with anybody who hasn't lived your experience: that happens too, though not to quite such a dramatic extent as described in this book. It certainly can be hard to expalin that experience to someone who hasn't lived it. The isolation and uncertainty that comes after one error, and the lack of support or counselling by senior staff - now that can be all too common, and the story of the unfortunate Potts is a frightening example of just where that can lead.

I think one of my favourite reflection-of-reality moments was the way Roy seemed to feel, over and over again, that each new rotation was better than the last - excited with the change he'd think he had finally found a way to be human in medicine, before the inevitable disillusionment.

On the other hand, a lot of what occurs in this book simply wouldn't happen in the real world, or at least it wouldn't in a 2013 hospital in Australia. I'm not too sure if the differences are because the story takes place in the 1970s, or because it's the US, or a bit of both. For example, ordering invasive investigations that clearly aren't indicated just so the hospital makes money... doesn't happen here, though unnecessary investigations do get ordered for various other reasons. Also, interns being left alone to run the hospital - that doesn't happen either, of shouldn't anyway. Interns answer to registrars and registrars answer to consultants, and ultimately if something goes wrong, it's the consultant who'll have to explain it.

Anyway, I think this book is still a worthwhile read for anybody starting out in medicine - if only as a chance to reflect and appreciate how and why the way we practice medicine has changed. It's also, of course, darkly hilarious, and remains the source of many a medical in-joke (what's the first thing you should do at a cardiac arrest? Take your own pulse...)

[Elizabeth · Rating 4 out of 5]

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.

[Rosemary · Rating 3 out of 5]

Over the years, I've been told many times by many different people that I should read The House of God. These recommendations usually come with some variation on an explanation that the book is a thought provoking insight into the delivery of healthcare and/or medical education. I envisioned delving into an Atul Gawande-esque, cerebral discussion of the virtues and limitations of modern medicine. Instead, I found myself stifling gut wrenching laughter as I - initially - enjoyed this "fictionalized" memoir of a first year resident in the 1970s. This, while in the middle seat on a transatlantic flight, must have left the people next to me thinking they were stuck next to a madwoman for eight hours.

I thoroughly enjoyed the beginning of the novel, cherishing (and identifying with) the interns' horrors at their introduction to hospital wards and the stereotypes of their patients and the care they receive. The descriptions of the emotions that an overburdened, under supported intern can feel are things I can imagine or have experienced in some way. These depictions were raw and utterly honest. For that, I would recommend this book to any medical student or resident.

This exploration of the trials and challenges of medical training becomes consuming - to the protagonist and to the reader. I take most of the later part of the book with "a grain of salt" - recognizing this novel as the catharsis of a disillusioned resident who - notably - abandons his career path, takes time off of residency training, and ultimately returns to specialize in psychiatry.

For the gratuitous and extreme male chauvinism illustrated in The House of God, I find the book nearly unreadable. The protagonist's treatment of women is repugnant and offensive. His interactions with female colleagues and hospital staff constitute sexual harassment by any definition. Furthermore, the depiction of the protagonist's relationship with his girlfriend reads like an adulterers' fantasy of a self-sacrificing, subordinate female partner, which I find difficult to read. Ok, ok ... the book was written in the '70s and should be examined within its historical context, you say. In response, I'll point you to the author's afterword, written 25 years after the book was published. Nearly hidden in the author's self-congratulatory remarks are a few reflections on changes in medicine since the book's debut. He mentions that, "Another great advance is the status of women - now at least fifty percent of medical school students (in 1973 they were ten percent). As carriers of caring in our culture, women bring these qualities to the care of patients and relationships with peers," then quickly skips to applaud adoption of meditation and acupuncture as other great advances in the field. Hardly enough for me to come close to seeing past the frat-boy-like detailing of the protagonist's sexual exploits and abuse of nurses, social workers, and the solitary female resident so unflatteringly depicted in the novel.

[Shweta · Rating 1 out of 5]

if i didn’t have to read this for a class i wouldn’t have finished it. what a goddamn drag, if i worked with any of these bozos irl i would 🤬🤢😵😒 also why is every woman so sexy??? and so down to **** with these idiots??? what’s up with the constant objectification of women, except for the only female doctor who’s main problem is CLEARLY that she’s not sexy??? how come everyone is incapable except for our golden hero Dr Basch the Most Valuable Intern??? 🤮🤮🤮🤮 and gotta love Berry, the hottest, most understanding girlfriend in the world whose only characteristics are that she’s hot and knows psychotherapy 🥴 moving on from the stupid plot and characters, the actual writing itself made me want to die. i understood the whole “stream of consciousness” deal but reading some of those run-on sentences made my eyes glaze over. genuinely what the fuck was he even talking about. if i could give 0 stars i would

[Nara · Rating 2 out of 5]

There kinda just seemed to be...no plot?

[Emily · Rating 5 out of 5]

I read this during the first weeks of residency and couldn't have picked a better time to do so. What an excellent depiction of all that medical training is but shouldn't be.
Few thoughts:
1) Some of my Family Med colleagues thought House of God was abhorrent. I thought long and hard about this--and even about why it wasn't shocking to me. Here's the rub: it's satire y'all! All I can say is that if the anecdotes make you so uncomfortable, commit yourself to improving health care and medical education. We've come along way since the 1960s, but there's still a long way to go.
2) I liked House of God so much, I wanted to recommend it to my favorite fellow readers. But, I can't imagine that it would be fully understood by non-medical people. There are a few realistic and/or cynical few of you, however, that I think would really appreciate and enjoy it! (So if you're interested, we can always discuss afterwards.)
3) Lastly, the elephant in the room: my only real gripe about House of God is the excessive sexual situations. They just felt disproportionately over-the-top. Perhaps this is a reflection of the audience it was initially written for: primarily males, in the free-loving 1960s. Everything else in the novel had modern-day applicability, but the on-call threesomes, etc. must be less prevelent in the current era of "professionalism".

[Repix Pix · Rating 4 out of 5]

Reir, llorar, vomitar y temer el momento de tener que ir a un hospital.

[Milena · Rating 4 out of 5]

Prvi susret sa ovom knjigom pre 15 meseci (iskrena preporuka logoreične doktorke kojoj sam asistirala par nedelja) - zgrožena. Želudac se prevrće na seksizam, ejdžizam, patetične pokušaje humora, aroganciju novopečenih lekara, 70 strana pređeno kao po kazni i šlus. Ne mogu ja to.

Danas, sa neuporedivo više razumevanja, želuca ojačanog gutanjem osećaja nemoći, ubeđena da me malo šta više može iznenaditi u zdravstvenim ustanovama (... do sledećeg radnog dana), sedim i kikoćem se zbog istih paragrafa koji su me ranije užasavali. Jedna od onih - nije baš dobra knjiga, ali je neophodna knjiga.

[maura · Rating 3 out of 5]

this one is a little tricky for me. as a person who is surrounded by medicine, this story rang very true to the things that i have seen and felt about this culture. i enjoyed the gritty, unglorified nature of this story and fully recognize that, in the 70s especially, this story needed to be told.

however, while i felt the depictions of medicine felt very real and true, i really struggled with the portrayal of basically all of the female characters. they were almost all either hypersexualized or described as frigid.

the one female physician within the book is constantly criticized for making medicine into the only thing she has in her life, while there is no acknowledgement of the difficulties of being a female physician in the 70s. is it possible the reason she can't "do nothing" like her colleague, the fat man, suggests is because she has had to work twice as hard as her male counterparts to get to where is? i wanted to see more of her than just the frigid, control freak that roy perceives her as.

roy's partner, berry, is a clinical psychologist who's only function within the story is to be cheated on and then used as roy's own personal therapist.

all the nurses and orderlies are only ever used for sex from the male physicians.

and thats about all of the female characters. this book was definitely of its time, as evidenced by the depiction of the female characters or that a character is simple named "the fat man" and while i enjoyed the medical aspects of the book, there was definitely some room for improvement

[Klara · Rating 1 out of 5]

DNF at page 135.
I really tried to give this book a shot, but I just could not read one single page more of this book.
I absolutely despise this book, and it made me actually angry every time I tried to read it.
The characters are awful, have no remorse, guilt, doubt or depth whatsoever. I wasn’t rooting for anyone, and the actual story in the book was almost nonexistent. The book is filled with misogyny and gross sexualisation of literally every single female character.
I really thought this book would fit right into the type of book I would like: The medical topics, ethics, cynicism and not necessarily feel-good with likeable characters sounded right up my alley. It was recommended as a book which anyone in or interested in the medical field should read. But oh my god I have no idea why anyone would ever recommend this book. Please save yourself the money, time and anger and frustration. I wish I had never opened this book, and I would rate it lower if I could.

[Sarah · Rating 1 out of 5]

LOL one of the few DNF reviews for me here! I got through about 40 pages before I realized this book was Not For Me. I'm already pretty skeptical about reading books about med, they feel a little too close to homework for me than anything else, but I got a promising review from a friend that this book was one of the few he actually enjoyed and felt was realistic so I was like ok why not! Unfortunately, the writing style is too crass and striaght up like....depressing for me. I know when you get to residency you're so burnt out that you actually do start to hate the patients a little bit, but like woah were gonna start OUT with that??? Idk, if I'm gonna read a book about med, it either better be funny as hell or at least reflective. Like okkkkk we get it you HAAAATE old people!! Also all the weirdo gratuitous descriptions of sex......that's a BOOOOO from me. No one in the hospital is checking out nurses as like prizes to fuck, just straight up gross, man.

[Matt Scott · Rating 2 out of 5]

It has its bright spots, but this book does not deliver on its promises. Instead of a “timeless novel about life and death in an American hospital,” it is a dated and shallow story that is in desperate need of a modern spiritual successor. While some may dismiss its sexist, privileged, and even racist portrayal of its characters as a remnant of its time, this doesn’t mean that we should not strive for something better than this grim novel. Likewise, the inability of the author to explore the depth of emotion (good and bad) that accompanies patient care in favor of a satirical romp is at best tone deaf and at worst a subtle reassurance of the medical hierarchy these characters strive to fight against. The fact that this is still considered essential reading among training physicians reveals the desperate need for a stronger, more creative medical storytelling community.

[Lorelei · Rating 5 out of 5]

Oh my goodness, this was so good, and so painful! Funny and endearing enough to make up for all the horrible, and there is a lot of horrible. This is very true to modern medicine as I have experienced it. People constantly tell me that 'it's different now.' Sadly, not enough has changed, and what has changed hasn't changed enough. Regardless this is an incredible and a marvelous read. It breaks up well enough for reading on the bus, although at over 400 pages it is a little long for that. I would certainly recommend this to anyone with any interest in medicine, whether as a provider or as a customer.

[Pragya Maheshwari · Rating 4 out of 5]

Actually, I rate the book at 3.5 stars.
As true as the back cover read, the book is raunchy, troubling, hilarious and another personal addition, it's DEPRESSING.
Plot Outline: The story is narrated by Dr. Roy Basch, a student of BMS, about his life during the year of his internship at the House of God. The central characters are: his constant girlfriend Berry, his co-interns Potts and Chuck, senior the Fat Man, the hospital hierarchy including Jo, Fish and Leggo, the nursing staff at the hospital with a special mention of Molly (his part-time pass-time) and, of course, the patients.
A lot of things about the book actually troubled me, most of them rooting down to the Fat Man.
1. Refering to the old people as GOMERS (Get Out of My Emergency Room) as if they are pests or pathogens, for that matter.
2. That, the GOMERS don't die, hoe absurd is that.
3. AGE+BUN=Lasix dosage, common, who the hell does that.
4. The way the hospital nursing staff is looked upon.
5. GOMERS go to ground, (this one seriously made me feel pity of the patients)
6. And the worst of all, the Fat Man teaching the rubbish, nonsense, self framed laws to the new interns, PROCESSING a batch of POTENTIALLY LETHAL doctors.

But then there also are numerous bitter truths about life, about internship, about disease and about death. The deaths described are specially depressing, be it of Dr. Sangers, who bleed in Roy's lap to death, Saul the tailor begging Roy to let him die and Roy finally letting him die of cardiac hyperpolarisation, the Yellow Man, it was all too bad.
Pott's suicide brings as much relief as shock, the poor fellow ahd being dying everyday since the admission of the Yellow Man out of his inability to help him, save him.

Then, there are also some funny instances but they are largely overshadowed by the gloomy base plot.
Inspite of all this, on the whole, I liked the book. Despite the fact that it scares the hell out of me of the life in clinics and internship, I thank the author to have put up a blunt picture (even though largely exaggerated) of a doctor's life which seems all rosy, the whites don't really remain spotless.

Till the end of the story i had pegged the rating at 2.5 stars, largely coz it left me depressed. The rating however went a notch up after I read the afterword by the author. To know that I wasn't the only one to feel bad after reading the book for the first time, came as a relief. As the author puts it, that most people read the book thrice, first, before entering the clinics and describing the book as a highly exaggerated account (just like me), second when they are in the clinics and realise that it actually is true and third, when they are through this phase and look upon at it being actually true and that they have made through the phase.
This makes me optimistic about the fact that I might come to like this book more in the coming years and that I, too, shall pass this dreadful upcoming phase.

For those who are not into medicine as profession or study, the book might not be comprehensible enough for the extensive usage of medical lingo. Also, the fresh-into-med-school shouldn't read it, it's way too hard to handle.

[Vanessa Rogers · Rating 4 out of 5]

4.5 stars.

I'm really happy that I held onto this one to read as I prepared for my residency interviews. I found myself smiling often while I read it, either agreeing with the humour or grimacing from the honesty. Some parts of this I find exaggerated but the bulk of the trials of internship I actually do find believable. I can see why people out of the medical field often do not enjoy this book, but I definitely found much to relate to throughout. Medicine is not as neat and tidy as the public would like to believe.

I like to think that my clerkship has not been anywhere near this level of destructiveness but there are some similarities. The hours. The preceptors who expect you to give your life over to the hospital. The constant instructions to find balance without giving us the means to do so. The attitude of "I had to suffer and so will you too" attitude from our senior colleagues. ROR.

There were also a lot of differences. The sex - does anyone's modern clerkship look like this? Haha. Money hungry doctors - there are some, but honestly this doesn't work terribly well in Canada. Berry.

Read this book if you're in the burnout zone of a medical career. And then also if you're not, and you're not scared from losing faith in medicine.