House of God: The whole thing had a touch of magical realism


Review of House of God by Scott Alexander at Slate Star Codex

“This was a heck of a book.

On some level it was as predictable as I expected. It hit all of the Important Internship Tropes, like The Part Where Your Attendings Are Cruel, The Part Where Your Patient Dies Because Of Something You Did, The Part Where You Get Camaraderie With Other Interns, The Part Where You First Realize You Are Actually Slightly Competent At Like One Thing And It Is The Best Feeling In The Universe, The Part Where You Realize How Pointless 99% Of The Medical System Is, The Part Where You Have Sex With Hot Nurses, et cetera.

All I can say is that it was really well done. The whole thing had a touch of magical realism, which turns out to be exactly the right genre for a story about medicine. Real medicine is absolutely magical realist. It’s a series of bizarre occurrences just on the edge of plausibility happening to incredibly strange people for life-and-death stakes, day after day after day, all within the context of the weirdest and most byzantine bureaucracy known to humankind.

Just in the past week, for example, I had to deal with an aboulomaniac patient – one with a pathological inability to make up his mind. He came to my clinic for treatment, but as soon as he saw me, he decided he didn’t want treatment after all and left. The next day, he was back on my calendar – he’d decided he needed treatment after all – but when his appointment came around, he chanegd his mind and left again. This happened five times in five days. Every day he would phone in asking for an appointment. Every day I would give it to him. Every day he would leave a minute or two before it began. Unsure how to proceed, I sought out my attending. He ignored my questions, pulled me into a side office, took out his cell phone, and started playing me a video. It’s a scene from his musical, The Phantom Of The Psychiatric Unit, which he’s been forcing his interns to rehearse after rounds. I watched, horrified. It was weirdly good.

If I were to write a book about this kind of thing, people would criticize me for being unrealistic. The only way to get away with it is to pass it off as “a touch of magical realism”, and this The House of God does to excellent effect.”

Read the whole essay here.

Image: Kevin Sloan


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