“House of God” in New York Times: Still a seminal, groundbreaking satire on medicine

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Howard Markel  writes for The New York Times:

“It was a raunchy, troubling and hilarious novel that turned into a cult phenomenon devoured by a legion of medical students, interns, residents and doctors. It introduced characters like “Fat Man” — the all-knowing but crude senior resident — and medical slang like Gomer, for Get Out of My Emergency Room.

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.

SHEM631-1Written by a psychiatrist, Stephen Bergman, under the pseudonym Samuel Shem, M.D., the novel is based on his grueling, often dehumanizing experiences as an intern at Harvard Medical School’s Beth Israel Hospital in 1974. More than two million copies have been sold, and the book has been continuously in print since its 1978 publication. A recent edition (Delta Trade Paperbacks, 2003) features an introduction by John Updike, who ranks the book alongside Joseph Heller’s famed military satire, “Catch-22.”

Over the years, it has served as a required guidebook for medical neophytes and a clarion call for the old guard to make striking changes in the way we train young physicians.

When the novel first appeared, many doctors were hesitant to admit they had heard of it, let alone were willing to discuss it. Several prominent physicians denigrated it as scandalous and without merit. And based on such scabrous reviews, hundreds of thousands of medical students eagerly read it, first laughing at how the protagonist, Dr. Roy Basch, and his fellow interns survive a year of being on call every third night and working 100-plus-hour weeks, and then shuddering when thinking about their coming internships.

“I got a lot of flak for this book,” Dr. Bergman recalled in a telephone interview. “Older doctors attacked it and me, students would ask me to speak and deans would cancel me.”

Stories of doctors learning the ropes have been a theme in American popular culture for decades.

What makes “The House of God” singularly compelling is its brutally honest portrayal of the absurd tragedies and occasional triumphs of hospital life; the once-common abuse of young physicians by their superiors; and the anger and frustration these interns directed at themselves and patients.”

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