Book Review: The House of God by Samuel Shem

Background Information: 

The House of God by Samuel Shem is a book that every healthcare professional should read and illustrates what every patient fears most. This satirical novel provides an illustration of the medical internship that all doctors experience. Published in 1978, this book remains a favorite among medical students, interns, residents, and physicians. It has sold over 2 million copies over the last 30 years and has been received with exuberant praise, as well as harsh criticism.

Samuel Shem is a pseudonym of the psychiatrist Stephen Bergman, who wrote the novel based on his real-life experiences during his internship year at Harvard Medical School’s Beth Israel Hospital in 1974. The author brings to life the inappropriate, yet hilarious behaviors that keep healthcare professionals from going insane, all the while maintaining a professional disposition in the presence of their patients.

Review: 

Having worked in a hospital, I can definitely see the correlation between the material presented in this book and working in healthcare. Some of the situations seem exaggerated, but I wouldn’t put anything out of the realm of possibility. Many reviewers of the novel who read it both before and after experiencing their internship year said they thought it was exaggerated too… that is, until they were an intern.

I loved this book from the very start and literally laughed out loud on multiple occasions. I think it should be required reading for all healthcare professionals but especially for medical students. There are loads of morbid humor and sexually explicit narrations that I’m sure many people would find offensive. However, medical professionals often experience more bizarre, revolting, and morbid situations than most people would ever believe. This book presents a side of healthcare that goes unnoticed by everyone except healthcare professionals and perhaps for good reason. If you work in healthcare and need a good laugh, read this book. If you’re thinking of going into healthcare (more specifically, if you’re going to medical school), this could be a great way to develop an understanding that medicine isn’t like you see on TV. Basically, it’s not always pretty!

I’ll have to read this one again before my internship year, as well as after I’ve experienced the life of an intern. I’ve seen several physicians say you have an entirely different appreciation for it once you’ve actually experienced the situations illustrated. If this book provides any insight to my future in medicine, one thing is for sure: it’s going to be an interesting ride!  In summary, I highly recommend this book.

A description in a single word: hilarious.

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2 responses

  1. May I send you a digital copy of my novel, Reluctant Intern, to read and possibly review on your blog?

    Description:

    Addison Wolfe never wanted to be a physician. He wants to be an astronaut. NASA turned down his application, forcing him to seek employment as a doctor. The problem with obtaining a physician’s license is the need to complete an internship to acquire one. Wolfe finds himself in an undesirable rotating internship in a very busy public hospital. Inexplicably, the Director of Medical Education seems to have developed an instantaneous dislike of him and the remainder of the internship class. Another mystery is why an attractive female physician expresses a romantic interest in him on the first day of internship.

    “The absolute worst time to go to a teaching hospital as a patient is the month of July. Recent medical school graduates, known as doctors, start their real training on July first. They don’t know anything. They don’t get any sleep. They are underpaid and overworked. Their stress is at catastrophic levels. Is it any wonder they make mistakes?” – Anonymous

    “In local news today,” the reporter said, “state and federal authorities are in the process of taking into custody the entire intern class at University Hospital in Jacksonville. Officials cited the number of deaths attributed to this class as the reason. It seems that wrong doses of medications, inappropriate surgeries, failure to diagnose lethal conditions, and other mistakes have led to hundreds of deaths….”

    “The overdose?” Wolfe asked.
    “Yes,” Dr. Rubel replied, “that will be her legal cause of death, of course. The real cause of death was the autopsy. Barbiturate overdose, followed by refrigeration outside and then here in pathology, slowed her metabolism down. She was actually alive when they started the autopsy. The flexing of her limbs when the saw touched her brain happened because of nerve conduction, brain to extremities. But it was too late; we cannot put her back together. A hard lesson for those poor boys to learn. You, too, gentlemen. It is also true for those who are clinically dead from exposure or drowning. Remember this: a patient is never dead until he is warm and dead. Don’t forget that!”

    The senior resident started his description, “EMS responded to a report of a cardiac arrest at 1:07 a.m. in Junior’s Topless Bar, on East Bay Street….”
    Figueroa again jumped to his feet. “What is this, a bad joke?” he asked. “Two EMTs walk into a bar…. Let’s be reasonable, guys. The most likely reason for needing a paramedic in a bar at 1 a.m. is a knifing or a gun shot wound, not a heart attack.”
    The autopsy and x-rays were condemning. The thirty-nine year old, black male had no history of heart disease. No medical history of any kind. He did have a bullet entrance wound to the back of his head with no exit, bullet still in his brain.

    The patient was a massively obese woman who complained of a headache. The intern knew only that she was complaining of a headache and had requested aspirin. Extremely busy, and assuming the nurse would let him know if it were not a good idea to give the patient aspirin, he quickly flipped to the order page and signed the order that had been written by the nurse. Figueroa asked the intern if he had talked with the patient. No. Had he examined the patient? No. Had he even skimmed the chart? He had not. He asked if he knew what allergies the patient had. The intern did not know. At the time he approved the order for aspirin, did he realize the patient was on warfarin, another clotting inhibitor? No. Did he know that aspirin also inhibited platelets and clot formation? Yes. Did he know the patient had a history of blood clots? No. Did he suppose that a blood clot in someone’s brain, or a ruptured berry aneurysm in the same area might cause headaches? Yes, he knew that. The autopsy pictures revealed stenosed carotid arteries, two small clots in the patient’s brain, and massive bleeding from a ruptured berry aneurysm.

    1. MedicalMinded | Reply

      I would be honored to read your novel and write a review on my blog. I always enjoy reading new medical novels. Please send at copy at your convenience and it will be next on my list.

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