The House of God

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The House of God
Author Samuel Shem
Country United States
Language English
Genre(s) Satirical novel
Publisher
Publication date 1979
Media type Print (Hardback & Paperback)
ISBN ISBN 0-440-13368-8
Preceded by None
Followed by Mount Misery
This article is about the book The House of God. For religious uses of the term, see Place of worship.

The House of God is a novel by Samuel Shem (a pseudonym of the psychiatrist Stephen Bergman), published in 1978.

Contents

Dr. Roy Basch is a new intern in a hospital called the House of God, after completing his medical studies at the BMS ("Best Medical School"). He is poorly prepared for the grueling hours and the sudden responsibilities without much guidance from senior doctors. He survives the year (unlike a colleague, who commits suicide) due to various factors: his girlfriend Berry, various adulterous relationships with nurses (portrayed in great detail), and an enigmatic resident who goes by the name The Fat Man. The latter provides his patrons with wisdom such as the "Laws of the House of God" (which amount to 13 by the end of the book). The book finishes when it turns out that the psychiatry resident, Cohen, has managed to inspire almost the whole year's group of interns to pursue a career in psychiatry.

  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 14 GAUGE 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 book is very likely autobiographical, as the BMS is a thinly veiled Harvard Medical School (commonly called HMS), and The House of God representing the Beth Israel Hospital now a part of Beth Israel Deaconess Medical Center, one of the HMS-affiliated hospitals in Boston, Massachusetts.

It is very likely that some details have been exaggerated (such as an orgy in the resuscitation room), and towards the end of the book events take on a semi-hallucinogenic tone, both of which can be taken as a depiction of the effects of chronic stress and sleep deprivation. In any case, upon its appearance, many American doctors felt that "The House of God" resonated with their own experiences during their internship training.

Several of the terms developed in the book have found their way into the jargon of junior hospital staff:

  • To Turf (verb: to find any excuse to refer a patient to a different department or team)
  • To Bounce (verb: a turf that has returned to its first department)
  • Gomer (noun: Get Out of My Emergency Room - a patient who is frequently admitted with complicated but uninspiring and incurable conditions)
  • LOL in NAD (noun: Little Old Lady in No Apparent Distress - an elderly patient who following a minor fall or illness, would be better served by staying at home with good social support, rather than being admitted into a hospital with all the iatrogenic risks of modern medicine. A joke on 'NAD' abbreviation of 'No Abnormality Detected' used to record the absence of abnormal signs on examination).
  • Zebra (noun: a very unlikely diagnosis where a more common disease would be more likely to cause a patient's symptoms - from the common admonition that "if you hear hoofbeats, don't think of zebras").

In-jokes abound in the work. One of the principal characters is Eat My Dust Eddie, a doctor so-called because of the saying embroidered on his jacket. His name is often abbreviated as EMD, which is also the acronym of the feared terminal cardiac event electromechanical dissociation.

In 1984, a film was made out of the book but never released in theaters or on VHS/DVD.

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