DNF @ 27%

I hear too many irreverent opinions from misogynistic white doctors who seem to disregard human life in my regular day-to-day to continue reading this

“Neįtikimas paradoksas: daktaro specialybė neapsakomai nužmogina, bet kartu ją taip didžiai vertina visuomenė.”

Su šia knyga mano istorija labai įdomi. Ją bandžiau skaityti jau trečią kartą ir pagaliau įveikiau!

This was my 2nd time reading it: the first was during my gap year before med school and this time was as a 4th year med student. I got a lot more about of it the second time around. When I first read it, I was a scribe in the ED, so I thought I understood medicine culture. This time, I could relate a lot more to the jokes, situations, and stresses of medicine having been immersed more fully. With this background, i found the jokes hilarious, the depiction of the medical hierarchy all too accurate, and the emotions painfully relatable. Though I know this is satire, as I look to start intern year soon, I know the underlying truths of this book will inevitably hit even closer to home. I hope to re-read this at the end of residency!

A note about the sex: obviously this book is out-dated in terms of views of gender roles, racism, objectification of women, paternalism in medicine, etc. I think if you are able to look past it, you can still enjoy this book. There is a lot more to it than sex.

I felt I should read this book, described as the "Catch-22 of medicine" before graduating from med school. It was scary how accurate most of it is, right down to the 'Laws' of the House of God quoted throughout. Remember, Age + BUN = Lasix dose. But well written and a good read, although I don't know how funny it will be to those outside the medical profession (probably still so to spouses).

I hated The House of God. My one law after reading this is DO NOT TRUST ANYONE THIS INTO FREUD. Every single female in this book is described sexually, the main character just going around fantasising about women to the point I thought I was reading a prepubescent kid's diary. It was a poorly-written male fantasy. One main female character acts as a Freudian translator who tells us what each change in the narrative signifies according to Freud. She does not get any development, she is stagnant as the oh-so-understanding partner while the unsubtle authorial stand-in goes around having sex with everyone. It's ok though, Freud warned her about it. The other female character is villified because she is "frigid" and thus not willing to accompany interns on their journey of self-discovery.

The emotion of this book, the despair and fear and hopelessness, is hidden and gouged at by a rotating cast of characters and CAPITALISATIONS and M.A.T.I.C.D.W (more acronyms than I could deal with). It’s like someone took all the traits I hate about poorly-written discharge summaries and then let it ferment in a strangely pornographic greenhouse. And this is not to mention how awkward the sentence structures in this book are.

The elevation of this book to near-biblical proportions amongst the medical community is more a testament to how few books accurately capture the feel of burnout and the fear of being an intern, as opposed to a commentary on how well-written Shem's book is. The depiction of burnout does not need to be accompanied by sexism that was already dated on arrival or sentences that fear ever approaching beauty.

I had been meaning to read this forever and it had been languishing on my TBR pile. I have quoted the laws of the House of God numerous times and despite being over 40 years old, most laws remain true today. While medicine and residencies have completely changed over the past 40 years, making parts of this novel obsolete, the core story, of Roy G. Basch, newly minted MD, navigating his internship at a prestigious teaching hospital remains true. While there is exponentially more technology and medications to choose from, the interns are still the doctors running the inpatient services which are now comprised of sicker and older patients. The abject terror that these young doctors experience continues today, when the service is signed out to them and your goal is to have the same number of patients in the morning as when everyone left you. The larger number of therapies sometimes makes the job harder as they can dither over which treatment or medication to choose. Samuel Shem wrote about this in a humorous way, pointing out the humor in horrible situations. Humor remains a way stress is relieved in medicine, as we all have at times felt we are in a crazy situation with a patient or family and there is no straight or sane way through the night. While highlighting the humor in stressful situations, Shem helps Basch find his way back to humanity after his long year of internship, reminding us that most of us in the medical field are basically caring, sensitive, smart people who have chosen to take care of the sickest and neediest among us.

I read this in college, then again my first year of medical school, then again my last year of medical school, then again during my internship, and I'm reading it once more now as a senior resident. Along with the television show Scrubs, it's the most accurate portrayal of American medicine that I'm familiar with. I gave it to my father and he called me saying that he wanted to go medical school. I gave it to my mother and she called me crying, asking if my job really is as bad as Shem makes it out to be.

I think when it first came out it must have been truly shocking. Though today, with so much of medicine being patient-directed (and not physician-directed), I think you could look as this as a quaint little black mark on American history -- like the old cartoon cigarette commercials, or the movie "Freaks".

Yeah but the thing is...a ton of this still rings true. The essence of medical care continues to be placement. Gomers still, without fail, go to ground. Any medical student who doesn't triple my time is worth his or her weight in gold.

There's a rumor that the Fat Man was fired from his position due to his indiscretions which were detailed in this book, which is a shame. I continue to learn from him even at this stage in my career.

Ein auf und ab, viel ab. Gegen Ende immer besser, aber zwischendurch anstrengend zu lesen.

“How can we care for our patients if nobody cares for us?“

I’ve never felt so conflicted about a book. I hated everything about this book in the beginning. I couldn’t get past the cynicism (and objectification of women, 1970’s humor I guess?). But the further I got along in the story, the more I found myself relating to the author and his frustrations at the healthcare system. I think I will be reflecting on this one for a long time.

I'm going to have to reread this after my 3rd or 4th year of medical school, and perhaps another time during/after residency. Right now I think I'm not jaded enough to really (want to) understand all the different subtleties Samuel Shen is trying to convey. I do get the overall gist of what he's saying though--medicine hurts more than helps. Medicine destroys not only patients, but physicians. We go into medicine with a preconceived notion of saving, to only realize that we are killing our patients in the vain effort to keep them alive. Medicine, at least in the U.S., has become more about profit. Physician trainees lose themselves and all the relationships outside of medicine, they become people they don't recognize anymore.

I actually liked the afterword by the author SO much more than the actual novel. It was much more direct. I didn't realize abstractness bothered me as much as it did until after reading this.

A segment that really stuck with me was that physicians think they're better than other people for entering such a "noble" profession. We're really not.

Gomers go to ground.

As I tell people: I liked the morals, not the story.

The message on why "the boys" didn't like the chief, how doing nothing is good medicine, and the difference between gomers and old folks are very pertinent to me and how I practice in healthcare. My favorite Laws include:

3. At a cardiac arrest, the first procedure is to take your own pulse.
4. The patient is the one with the disease
10. If you dont take a temperature you can't find a fever.
13. The delivery of medical care is to do as much nothing as possible.

Healthcare in the 21st century has gotten better at following the "less is (sometimes) more" idea, and the ethics of end-of-life care (beneficence and pt autonomy) are much better than that portrayed in the book--and yet the issues are still prominent today.

That being said: I couldn't keep track the different interns, making the story difficult to follow. I didn't find the characters terribly likeable. I totally skimmed over all the sex stuff (completely unnecessary IMHO and caused a break in the flow of the story).

And, as usual, I HATE the term "respirator". It's a ventilator, dag-nab it!

Summary, I like what Shem had to say, I didn't particularly like the way he said it.

Istorija? Jų čia galima rasti įvairių. Aš pasirinkau žmogaus kovą su aplinka: kaip aplinka verčia žmogų nužmogėti, kaip jis su tuo kovoja ir kaip galų gale tik aplinka sugeba jį išgelbėti.
Pereinama per įvairias kovos su nepakeičiama aplinka stadijas, rodoma, kaip sunku ištvęrti be aplinkinių pagalbos. O tarp viso to - daug ligonių su įvairiausiomis ligomis, seselių su prigludusiom uniformom.
Bendrai - daug cinizmo, nusivylimo, tad knyga ne iš maloniųjų. Bet rašymo stilius toks, kad skaitėsi lengvai (deja, tik pabaigoje pamačiau, kad knygos gale buvo žodynėlis, kuris skaitant būtų priminęs kai kurių trumpinių reikšmes).