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The House of God : The Classic Novel of Life and Death in an American Hospital

The House of God : The Classic Novel of Life and Death in an American Hospital

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Rating: 5 stars
Summary: House Of God---House Of Truth
Review: The best book of it's kind to be written! Not only is it funny, but it is TOTALLY TRUE. Shem's portrayal of a year in the life of an intern is right on and especially timely now, in the days of managed care. Much too often decisions are made for other reasons than the patients' welfare. The trick,per Shem, is to work within the system without getting yourself booted out of it. The second trick is to take care of yourself while taking care of the patient. This is mandatory reading for both patients and health care providers. Take heart, though, the good Docs are out there, you just may have some trouble finding one.

Rating: 3 stars
Summary: Funny, but ...
Review: The HOUSE OF GOD was originally published in the 1970's when it was relatively more fashionable to throw eggs at anything that was "establishment". In this darkly humorous novel, the target is the U.S. medical profession - specifically, the training young physicians receive at the beginning of their careers.

We follow the education of Dr. Roy Basch during the year of his hospital internship in the HOUSE OF GOD after graduating from the Best Medical School. Almost immediately, he's introduced to the patient population that will be his nemesis - the Gomers (the acronym for Get Out of My Emergency Room). Gomers are geriatric, mentally disoriented, chronically ill, debilitated adults who get no better, yet never manage to die on their own. Dr. Roy can choose as a role model either the Fat Man or Jo, two second-year doctor-trainees ("residents"). The Fat Man's philosophy is to do nothing to treat the Gomers, while Jo will attempt every heroic procedure in the book. Paradoxically, Gomers get better, or at least remain stable, under the former regimen, but get worse and die under the latter. At the other end of the patient scale are those relatively young admissions that die tragically no matter what. After several months of experiencing this and exposure to the incompetence and/or mercenary greed of the private physicians on the hospital staff, Basch is sustained in this psychologically and professionally crushing environment only by the sex he has with Nurse Molly. Then, even that isn't enough, and Roy alienates his friends by becoming withdrawn, sarcastic, and obnoxious. Can our hero, all idealism now lost, be saved before he drops out or commits suicide?

Since the HOUSE OF GOD was authored by a physician, Samuel Shem, I give him the benefit of the doubt that his description of the dehumanizing experience that is a medical internship in a large, urban medical center is at least partly accurate. And, it is humorous, at least until the reader realizes that each one of us is a potential Gomer, at which point the plot becomes less cause for chuckles. God forbid that we should become victims of such medical malpractice as found within these pages.

The greatest failing of this novel in the year 2001 is that it's dated. In this age of AIDS, I would doubt that 'terns" are nowadays as promiscuous as depicted. And, since many physicians are now not much more than salaried drones for the HMOs, the egotism of the medical profession as a whole is not quite the balloon to be popped that it once was.

As an alternative to Shem's novel, I would recommend the 1971 cinematic black comedy THE HOSPITAL, starring George C. Scott, since it touches on much the same themes. Scott is at his very best, and the movie can be viewed more quickly than this book can be read. At 420 pages, the latter got a little tiresome.

Rating: 4 stars
Summary: Internship at its best
Review: The 'House of God' is an excellent attempt to let the reader understand what an internship in internal medicin is about. Many of the situations are realistically described using a colourful, often sensitive language. All the figures appearing in the story are very classical without being exagerated or unreal. The author talks about everything humans usually try not to see, not describing doctors as brave heroes nor as ignorant idiots, but as humans. Of course Shem did not mention all kinds of problems interns (or some interns) are confronted with during their internship: not every intern has a father who is dentist and who can send his son money to support his 'one-year-holiday'. Not every 'intern' is far from any materialistic problems. Dr.Basch in the 'House of God' has been lucky in the end because he had the tool to win this impressively horrible year: love and care from his girlfriend, who is 'the' real hero of the 'House of God'

Rating: 3 stars
Summary: realistic
Review: I am a physician who completed a residency in Psychiatry. We had to do four months of medicine in our first year. The book is incredibly accurate with regard to the anxieties and fears that an intern has. These are too numerous to mention here. I'll probably never read the book again as those memories are too painful and I never want to go through that cruelty again. Being an intern means losing yourself; your patients become your life. I only gave it three stars because some parts of the book seem like verbatim copies out of Joseph Heller's Catch 22. Otherwise 5 stars for authenticity.

Rating: 5 stars
Summary: DO Review
Review: Excellent read for any medical student or pre-med. It gets to the heart of medicine and explores a plethra of issues in residency. At times, it is very cynical. I cried because I was laughing and sad...sometimes simultaneously. Ironically, a Dr in the ED I work in quoted one of the rules...BUN+age= lasix dose....just a few days ago. While, it is depressing and honest, there is an uplifting aspect. As the god-like physicians develop, both young and old, we see how the stages and coping mechanisms help them mature into human doctors.

Rating: 1 stars
Summary: Don't buy it!!
Review: An awful book, I am sorry I wasted my money on this ... macho ... book. I surely hope the doctors I see weren't like this during their internship. Gomers indeed!! I net when Dr. Shem is eighty he will feel differently.

Rating: 4 stars
Summary: Very funny, insightful, though too long, phony ending
Review: This appears to be an elaborated autobiography of the author's internship experiences and a rationalization of his 'abandonment' of medicine for psychiatry.

There is much hilarious insight into 70's hospital life, with some fanciful sexism thrown in, presumably to keep things interesting, but which may have the opposite effect these days.

My one disappointment in the book is that the second half of the book rings quite false to me. I can understand the validity of the author's attraction for psychiatry, as a means to exploit his training without having to actually touch patients, but his portrayal of it as actually being more curative than medicine is quite a stretch, and sounds like quite the rationalization.

The portrayal of the hyper analytic Freudian girlfriend as the means to his recovery of Shem's humanity, strikes me as an over the top rationalization of his resignation to their marriage. She does not sound at all human in his characterization, and makes me wonder about the real-life counterpart to this character.

The one anecdote in the book that sounded to me like a true account of psychological healing was the mime show of Marcel Marceau. If this book is ever made into a movie, this would make a wonderfully touching scene. I have to believe it is based on an actual experience of the author's.

I noticed that some readers here seem to have been annoyed by the recurrent Irish cop characters, but I found them quite enjoyable figures, sort of Shakespearean characters who function as the observers of the story.

Overall, a fun read, and a valuable account of the reality of an important profession, occasionally marred by superfluous scenes. Given that, it's reputation as on a par with Catch-22 is quite deserved, in my opinion.

Laughter *is* the best medicine!

Rating: 5 stars
Summary: Dated, though realistic and insightful
Review: Having read the book as a medical student, some contents proved at best foreign, strange, and at times shocking...as a surgical intern in an urban level one trauma center, many of the poignant episodes regarding such items as "Gomers go to ground..." are now scarily relevant. For those medical students seeking a true, but frequently exaggerated view of the life of a house officer (medicine, surgery,OB/Gyn etc.), this text will satisfy. Though dated with respect to some issues such as harrassment, you will find that the characters still exist...they're just working twenty years later in places like Atlanta, New York, Miami, and Shreveport.

Rating: 5 stars
Summary: Ranks with Catch22 and Dr Strangelove
Review: Transcends mere medicine, describing how to survive in a corporate culture where the objects of one's work are designed to make one commit suicide. How to achieve by doing nothing. How to recognize and deal with ignorant and fanatic managers. How to recognize and learn from the rare wise mentors.

The book's 70's sexism falls a little flat these days, but deep down therapeutic laughter is still abundant in this book!

Rating: 4 stars
Summary: Hilarious and Slightly Disturbing
Review: Samuel Shem's wacky story of six brilliant interns is both laugh out loud funny, and poignant at the same time. Written in the seventies it almost became required reading for medical students, with many of them adopting the vocabulary used in the book. The constant high stress is sometimes only relieved by the erotic couplings of the nurses and interns, but the effects and demands of the hospital takes it's toll on each of the characters with very different results.The book definitely took some turns I didn't expect, and all in all I found this a really satisfying read.


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