4.5 stars.

I'm really happy that I held onto this one to read as I prepared for my residency interviews. I found myself smiling often while I read it, either agreeing with the humour or grimacing from the honesty. Some parts of this I find exaggerated but the bulk of the trials of internship I actually do find believable. I can see why people out of the medical field often do not enjoy this book, but I definitely found much to relate to throughout. Medicine is not as neat and tidy as the public would like to believe.

I like to think that my clerkship has not been anywhere near this level of destructiveness but there are some similarities. The hours. The preceptors who expect you to give your life over to the hospital. The constant instructions to find balance without giving us the means to do so. The attitude of "I had to suffer and so will you too" attitude from our senior colleagues. ROR.

There were also a lot of differences. The sex - does anyone's modern clerkship look like this? Haha. Money hungry doctors - there are some, but honestly this doesn't work terribly well in Canada. Berry.

Read this book if you're in the burnout zone of a medical career. And then also if you're not, and you're not scared from losing faith in medicine.

Interesting to revisit The House of God. I first read it back when my husband went to medical school in the mid 80's. While I don’t remember being bothered by the overt and frequent sexual escapades then, I was bothered by them this time around.. But thankfully, the heartfelt, humanity affirming, and compassionate parts are still really good! The author's note at the end, written for the 20th anniversary of the first publication was important.

Disclaimer: I did my internship and residency at the other hospital, "MBH," in Shem's classic novel about medical training, at the same time that he was busy observing his fellow house officers and higher ups at the House of God. So my take on this book is colored by immersion in the culture he parodies, and by the fact that one of his main characters bears strong resemblance to a medical school classmate who interned in Boston at Shem's hospital.
Fresh out of five years of medical training, I read this book back when it came out and found it laugh-out-loud funny because, like all caricatures, it is based in truth. It has just appeared in audio, and the view from a few decades down the road is a little bit different, but still entertaining (though I have to admit that the raunchy sex got a little boring). The exaggerations seem a little more exaggerated, and the truths more grounded in the realities of experience. There was a Fat Man in my training program - actually several of them- and I suspect everyone who has become a doctor knows a few. The Fat Man's rules all contain germs of truth. Shem was an astute observer of the human condition at a young age. Most of us were just trying to learn and survive, but he was taking notes.

I really hated this book. I found it to be sexist and annoying. The protagonist can't come across a female character without describing her boobs, nipples, or fantasizing about the underwear she has on. Every. Single. Female. Even the ones that he doesn't bother to name. There are SO many sexual scenes (fantasies AND real) that they distract from the plot and I wondered if I was actually reading erotica.

The parts having to do with actually practicing medicine were okay. It was eye-opening to see the stress that doctors work under, and how one of the most prestigious hospitals in the country operated (surprisingly disturbing). I disliked the main character, but enjoyed the Fat Man and Chuck. That's about it.

Rating: 4/5 stars

"Gomers Never die"
Neither will that quote...

Let me try to review this book in one sentence:

This book tells the truth, nothing but the truth, but NOT the full truth...

Sounds cryptic but if it is the best I can do. The House of God adresses grim and dark topics that are usually not spoken about in literature. It does not shy away from showing the “dark side” of medicine and truly, as both a patient aswell as a doctor to be, that is the type of book that will get my 5 star rating.

What it does, it does really well. At times it feels like satire, but honestly, so does the reality in hospitals sometimes. On top of that o found it very funny and it actually had me laughing out loud ik public at times (which rarely happens with a book). If that makes me a horrible person with a demented sense of humor: so be it. I rest in my fate.

However; I take half a star off for the missed opportunities this book had. If the author had described the actual emotional impact that the events must have had on the characters, it could have added such a layer of depht. Emotions like guilt, shame, feeling of wanting to prove your worth but failing at times are hinted at, but not explored. I get maybe this was not the story the author was going for: but I feel it could have really added a lot.

So this was recommended to me by a Physician I worked for. It amazes me that 5 years in an Emergency Department and I can see some of these patients as well as the residents clear as day. It's not for everyone and if you are not in medicine in some shape or form, you probably wont get it, but if you are, then remember, its suppose to be funny and it is.

A worthy rival to Tally and O'Connor's guide to basic medicine.

This Review ✍️ Blog

Spoiler alert (esp. 3rd paragraph) Also, this book has some very *explicit* parts.

This novel follows an intern, Roy G. Basch, for his internship year at a prestigious hospital nicknamed the “House of God.” Roy must deal with sickness of the elderly, the death of the young, the competition of his peers, the lack of an outside life, and the tension with his superiors. Roy discovers providing medical care is nothing like what he was taught in medical school. Each of these stresses makes Roy withdraw more and become more cynical. He eventually decides that medicine is not for him and takes a year off before going into psychiatry.
tOne of the most interesting parts of the book is the juxtaposition of the two most prominent residents, Fats and Jo. Jo is an over-achiever who truly believes that she can cure all her patients. She never gives up, trying every intervention possible. She will come in even on her nights off to check on her patients. Fats, on the hand, makes fun of ‘”gomers” or old people who are so sick that they will never get better. Gomers are often unresponsive, so it is easy for the medical staff to not think of them as humans. Fats teaches the interns the rules of the “House of God.” He is trying to teach them how to not be hurt by working at the hospital. Fats states that the best thing to do is nothing. Often actually providing medical care actually makes the patient worse. To the interns surprise, Fats is right. As a patient, one would think that Jo would be the “better” resident, both in terms of provision of care and bedside manner. However, Fats is the one the patients love, and he has better outcomes. Yet the hierarchy of the hospital thinks he is too unorthodox and discounts him. Fats’s approach reminds me of Norman Cousin’s homeostatic theories. Sometimes it is better to let the body heal itself. It is an indication that we really do not fully understand how our bodies operate, so we cannot always properly intervene.
tThe disrespect with which the interns treat the patients, especially the gomers could be unsettling. I wonder how true this feeling about patients is. Both The Doctor and Wit depict the medical staff as not caring about the patient and not bothering to learn names. Those doctors are only interested in the disease. However, in House of God, it goes a step further to actual derision. The book is trying to make the point that some defense mechanism is necessary to be able to survive the true sadness of the situation. This point is really driven home by the suicide of Potts, the one intern who did not give in to the cynicism and contempt of the others. He let everyone and everything knaw away at him. The book recognizes how morally reprehensible it is to make fun of the sick, as shown by Berry’s (Roy’s girlfriend) disgust at Roy’s jokes. What Roy had to learn (from Fats) is that these jokes are only acceptable in the company of other interns and residents on the unit. Fats understands the boundaries of protecting yourself and being callous. Roy, on the other hand, universally applies what he deems acceptable behavior. Eventually, Roy does learn how to become a less cynical doctor.
This book is appealing for a lay-person because it describes so much of the day-to-day workings of the hospital for interns. For example, Roy rotates through several different units and schedules, and the reader learns the benefits and detriments to each type of unit. It could be surprising what Roy ended up enjoying, like the ER and the MICU over the usual wards. The usual wards were full of patients who were not going to get better, whereas there was more change and excitement in the other areas. It would be hard to describe all the details that were interesting to me as a lay-person, but I enjoyed that the book was able to give me the perspective of a hospital intern.

3.5 stars. Will certainly read it again in residency (if I have time). A bit graphic at times, but the ending really was powerful and redeemed the book for me. His writing is phenomenal and beautifully descriptive but at times …. Wordy. I liked the message. Wanted to love it more than I did, and I think some of the points were just lost on me. But that’s okay. ¯_(ツ)_/¯

Edit: forgot to mention it was really funny. I lol’d a bunch. But some of the commentary & jokes were telling of the time in which it was written and thus were … in poor taste.

the first half was a little much w its continuous explicit sexual fantasies (while cheating on his gf but then it ends up she’s okay with it?) but it redeemed itself at the end. the afterword was especially powerful.

Catch-22 in a hospital. Full stop.