HOUSE OF GOD BOOK
The House of God is a satirical novel by Samuel Shem published in The novel follows a The Fat Man provides his interns with wisdom such as his own " Laws of the House of God" (which amount to 13 by the end of the book). One of. The House of God book. Read reviews from the world's largest community for readers. The hilarious novel of the healing arts that reveals everything y. Called “The House of God,” the book was drawn from real life, and 30 years after its initial publication, it is still part of the medical conversation.
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By turns heartbreaking, hilarious, and utterly human, The House of God is a The House of God and millions of other books are available for instant access. By turns heartbreaking, hilarious, and utterly human, The House of God is a mesmerizing and provocative novel about Roy earn your way to a free book!. House Of God by Samuel Shem, , available at Book Depository with free delivery worldwide.
None of it really bothered me, though.
I was secure in the understanding that all I had done was tell the truth about medical training. I took this pseudonym because I was just starting my psychiatric practice and wanted to protect my patients from knowing that their therapist had written such an irreverent novel. They all found out, and didn't care -- but "Shem" had arrived, and refused to depart. I also felt that real writers had no place in going out and publicizing their novels.
I refused all invitations. And then one day I got a letter forwarded from my publisher, which included the line: "I'm on call in a V. Hospital in Tulsa, and if weren't for your book I'd kill myself.
And so I began what has turned out to be a year odyssey of speaking out, around the world, about resisting the inhumanity of medical training. The title of my talk is almost always the same: "Staying Human in Health Care. And any good connection is mutual. I base a lot of my talks on what I've learned from The House of God.
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About how I've come to see it, and all my novels, as a "fiction of resistance," a way of resisting the injustices of a system. It wasn't until years into my journey that I realized the importance of the fact that I and my fellow interns were products of the s.
We grew up in that unique lost period of American history -- beginning with FDR and ending with Reagan -- when we learned that if we saw an injustice, and got together and took action, we could bring about change. During my college years, we helped put the Civil Rights laws on the books and ended the Vietnam War.
When we entered our internships we were a generation idealistic young docs.
We soon were caught in the clash between the received wisdom of the medical system, and the call of the human heart. Our patients, and we, were being treated inhumanely. As Chuck the intern put it: "How can we care for our patients, man, if nobody cares for us?
The novel can be read as a model of nonviolent resistance. Big hospitals, like all large hierarchies, are "power-over" systems. The pressure comes down on the ones at the bottom, and they become isolated. Not only do they get isolated from each other, but each gets isolated from his or her authentic experience of the system itself. You start to think "I'm crazy," instead of "This is crazy. The crucial question is how to find mutuality -- or "power-with" -- in a "power-over" system.
Historically, the only threat to the dominant group -- whether of race, gender, class, sexual preference, ethnicity -- is the quality of the connection among the subordinate group.
This applies not only in medicine, but in any of your significant relationships. If you are connected, you can talk about anything, and deal with anything; if you're not connected, you can't talk about anything, or deal with anything.
Isolation is deadly, connection heals. One of the worries in how the new generation of doctors practice medicine is their use of computers.
If you have a laptop or smart phone between you and your patient, you are much less likely to create a good, mutual connection. You will miss the subtle signs of the history, of the person.
With a screen between you, there is no chance for mutuality, and the connection has qualities of distance, coolness, rank, authority, and even disinterest. The "smart" digital appendages can make you, in human-connection terms, a "dumb" doctor. Law 15 : Learn empathy.
Put yourself in the other person's shoes, feelingly. When you find someone who shows empathy, follow, watch, and learn. Law 16 : Speak up.
If you see a wrong in the medical system, speak out and up. It is not only important to call attention the wrongs in the system, it is essential for your survival as a human being.
Law 17 : Learn your trade, in the world. Nobody knows. Maybe they get past it. The worst.
The laws in the House of God
They left, and I turned back to Rokitansky. Shame swept over me. My stomach churned. Rokitansky, are you crying? Someone once said that the point of art is to be more real than reality. The House Of God is way more real than reality. Reality wishes it could be anywhere close to as real as The House of God. This is a world where young people — the kid just out of school, the blushing new mother — die.
Even normal old people — your grandmother, your grandpa — can die. But the most decrepit, demented people, the ones for whom every moment of artificially-prolonged life is a gratuitous misery and you pray at every moment that God will just let them find some peace — somehow they never die. The Fat Man is right. The magical realism of House of God describes the reality of medical professionals infinitely better than the rational world of hospital mortality statistics.
Surely some treatment must get done somewhere? But where? It becomes a legend, The Place Where Treatment Happens, hidden in some far-off hospital wing accessible only to the pure-hearted. This sort of Kafkaesque picture is how medical care feels, and the genius of The House of God is that it accentuates the reality just a little bit until its fictional world is almost as magical-realist as the real one. Given the stress of the dementia work-up, every organ system crumpled: in a domino progression the injection of radioactive dye for her brain scan shut down her kidneys, and the dye study of her kidneys overloaded her heart, and the medication for her heart made her vomit, which altered her electrolyte balance in a life-threatening way, which increased her dementia and shut down her bowel, which made her eligible for the bowel run, the cleanout for which dehydrated her and really shut down her tormented kidneys, which led to infection, the need for dialysis, and big-time complications of these big-time diseases.
She and I both became exhausted, and she became very sick. Like the Yellow Man, she went through a phase of convulsing like a hooked tuna, and then went through a phase that was even more awesome, lying in bed deathly still, perhaps dying. I felt sad, for by this time, I liked her.
I began to spend a good deal of time sitting with Anna, thinking. I told him. Jo decided to go all-out on her dementia, right? Do nothing with Anna, and hide it from Jo.
Nothing to it. Basch uses hook and crook to prevent his patients from getting any treatment. This is so reminiscent of the bizarre incentive systems in real hospitals that it hurts.
But as the year goes on, everyone gets more and more frazzled. One intern has a mental breakdown. Basch runs through all sorts of interesting forms of neurosis.
Finally, the end of the year approaches, the original crop of interns thinned-out but triumphant — and then they realize they have to do the whole thing again next year as residents, which is maybe a little less grueling but still in the same ballpark. So they decide, en masse, to go into psychiatry, well-known to be a rare non-terrible residency.
House of God does a weird form of figure-ground inversion. An example of what I mean, taken from politics: some people think of government as another name for the things we do together, like providing food to the hungry, or ensuring that old people have the health care they need.
But this is viewed as a weird disease of the body politic, something that can be abstracted away as noise in the system. And then there are other people who think of government as a giant pork-distribution system, where obviously representatives and bureaucrats, incentivized in every way to support the forces that provide them with campaign funding and personal prestige, will take those incentives.
And House of God does this to medicine. Doctors use certain assumptions, like: 1. The patient wants to get better, but there are scientific limits that usually make this impossible 2. Medical treatment makes people healthier 3. Treatment is determined by medical need and expertise But in House of God, the assumptions get inverted: 1.
The patient wants to just die peacefully, but there are bureaucratic limits that usually make this impossible 2. Medical treatment makes people sicker 3. Sometimes people mistakenly receive unnecessary treatment that causes complications.
House of God goes the whole way and does a full figure-ground inversion. The outliers become the norm; good care becomes the rare deviation. Real medicine looks at least as much like the bizarro-world of House of God as it does the world of the popular imagination where doctors are always wise, diagnoses always correct, and patients always grateful. Insulin helps diabetes. Antibiotics help sepsis. Surgery helps appendicitis. What is going on? And the answer has to be somewhere in the bizarro-world of House of God.
Everyone agrees this is part of the story. House of God is a brilliant book in that it refactors perception to place it in the foreground. There is as much genuine human goodness and compassion in this book as there is in any rousing speech by a medical school dean.
I talked to my father about House of God, and I told him a few parts that seemed unrealistic. I looked into it more, and ended up appreciating the work on a whole new level. The Jungle is famous for launching a whole new era of safety regulations. House of God has a place beside them in the pantheon of books that have changed the world.
House Of God
This is some nth-level meta-humor: the reader probably mistook it for real advice because it meshes so seamlessly with all of the other madness and horror, yet most of the other madness and horror in the book is easily recognizable by practicing doctors as a real part of the medical system.
Now hospitals are safer and falls are comparatively rare. I am so serious about this. How did people become aware of this kind of thing?
How did the movement against it start? A lot of it seems to be because of House of God. Everyone in medicine knew about this sort of thing. But House of God made it common knowledge. People were scared to speak up.
A Book Doctors Can’t Close
Everyone thought that maybe they were just a uniquely bad person, or their hospital a uniquely bad institution. House of God shaped medicine because it was the first thing to say what everybody was experiencing. Shem writes an afterword where he talks about the reaction to the book.Also, with my wife, co-wrote the play Bill W and Dr.
An example of what I mean, taken from politics: some people think of government as another name for the things we do together, like providing food to the hungry, or ensuring that old people have the health care they need.
High grades in the pocket! At a point toward the end of the novel, the fraught protagonist has to make a choice. They left, and I turned back to Rokitansky. During this time, as they say, life happened. I refused all invitations.
Shem writes an afterword where he talks about the reaction to the book.