DNF a third of the way in due to finding it extremely misogynistic. struggled to continue when I realised there were no female characters who weren’t hypersexualised nurses or incompetent doctors, or partners who existed simply to relieve the woes of troubled male doctors

Liked the medicine and wit at first (especially the Fat Man) and was looking forward to the rest, but seemed to be becoming strangely written hospital erotica. Understand it was written in a very different time, context and perspective (male) to what I know but doesn’t make it any more comfortable to read.

Although I struggled to initiate reading this at the beginning of the year, I'm glad I picked it up this past week. Currently in the slog of second year / burnt out, so there are many parallels to draw between the experiences of the interns in the book and what I'm seeing/experiencing myself. I think culture in medical education has changed somewhat but still there are ongoing challenges that prevent those that need it from seeking or receiving help. ...Anyway, going back to the book, it made me laugh, made me almost cry, and made me reflect a lot on how we cope day-to-day. I'm curious how the protagonist fares in the world of Psychiatry.

I had saved this book for residency for fear that if I had read it in medical school, I would’ve chickened out of medical training entirely. And not for no reason – this book is horrendous. It is so sexist, so salacious, so over the top. Yet it feels necessary in order to convey how insane residency is. You see people die and people live every day, and in the hospital somehow both can feel like punishment. How can that be? I can’t really explain it, but Samuel Shem gets it. In some ways, this book makes me feel like the culture around residency has improved a lot - duty hour limits, less hierarchy, more representation. At the same time, the for profit healthcare system has only gotten worse. There are multiple times every day where I feel like I’m a puppet at the whim of the all powerful insurance company. That sounds melodramatic, but just like this book, it is so viscerally real. During particularly busy rotations, it has been easy to fall into mind numbing outside of work - forgetting who I am outside of medicine or things I used to like to do. But picking up this book felt easy. It felt like shooting the shit with my coresident while we are getting slammed with admissions and paged non stop about bowel regimens and dispo and hypotension and “goals of care” while we keep people alive against all odds.

Actually, I rate the book at 3.5 stars.
As true as the back cover read, the book is raunchy, troubling, hilarious and another personal addition, it's DEPRESSING.
Plot Outline: The story is narrated by Dr. Roy Basch, a student of BMS, about his life during the year of his internship at the House of God. The central characters are: his constant girlfriend Berry, his co-interns Potts and Chuck, senior the Fat Man, the hospital hierarchy including Jo, Fish and Leggo, the nursing staff at the hospital with a special mention of Molly (his part-time pass-time) and, of course, the patients.
A lot of things about the book actually troubled me, most of them rooting down to the Fat Man.
1. Refering to the old people as GOMERS (Get Out of My Emergency Room) as if they are pests or pathogens, for that matter.
2. That, the GOMERS don't die, hoe absurd is that.
3. AGE+BUN=Lasix dosage, common, who the hell does that.
4. The way the hospital nursing staff is looked upon.
5. GOMERS go to ground, (this one seriously made me feel pity of the patients)
6. And the worst of all, the Fat Man teaching the rubbish, nonsense, self framed laws to the new interns, PROCESSING a batch of POTENTIALLY LETHAL doctors.

But then there also are numerous bitter truths about life, about internship, about disease and about death. The deaths described are specially depressing, be it of Dr. Sangers, who bleed in Roy's lap to death, Saul the tailor begging Roy to let him die and Roy finally letting him die of cardiac hyperpolarisation, the Yellow Man, it was all too bad.
Pott's suicide brings as much relief as shock, the poor fellow ahd being dying everyday since the admission of the Yellow Man out of his inability to help him, save him.

Then, there are also some funny instances but they are largely overshadowed by the gloomy base plot.
Inspite of all this, on the whole, I liked the book. Despite the fact that it scares the hell out of me of the life in clinics and internship, I thank the author to have put up a blunt picture (even though largely exaggerated) of a doctor's life which seems all rosy, the whites don't really remain spotless.

Till the end of the story i had pegged the rating at 2.5 stars, largely coz it left me depressed. The rating however went a notch up after I read the afterword by the author. To know that I wasn't the only one to feel bad after reading the book for the first time, came as a relief. As the author puts it, that most people read the book thrice, first, before entering the clinics and describing the book as a highly exaggerated account (just like me), second when they are in the clinics and realise that it actually is true and third, when they are through this phase and look upon at it being actually true and that they have made through the phase.
This makes me optimistic about the fact that I might come to like this book more in the coming years and that I, too, shall pass this dreadful upcoming phase.

For those who are not into medicine as profession or study, the book might not be comprehensible enough for the extensive usage of medical lingo. Also, the fresh-into-med-school shouldn't read it, it's way too hard to handle.

Has taken me a while to review this book. In short, I didn't like it as much as I did the first time I read it. Frequently billed as a classic, and a 'must-read' for doctors/future doctors, it depicts life as an intern (1st year medical graduate) in big-city US in the '70s. Although it is very readable, and some of the depictions are witty, my biggest problem was with the main character. Essentially, he is hard to like - a whiny, neurotic narcissist who cheats on his wife with various nurses, kills patients (deliberately), comes to work drunk and then somehow expects everyone to feel sorry for him as he has had a tough year. To top it off, he decides its all too hard and quits medicine to go off for a holiday and then come back and do psychiatry (for which he is probably much better suited, given his personality traits).
Certainly a lot of the terminology has entered the vernacular of modern medicine - i.e. 'Buff and turf' and 'gomers', and overall it does manage to create a bit of an insider's view of medicine (albeit in the '70s), but what lets it down is the pervading cynicism and misanthropy - clear symptoms, in the main protagonist, of what would now simply be recognised as 'burnout', for which, if he wasn't de-registered (as he richly deserves to be), he would eventually likely work his way through as his career progressed.
Anyway, worth a read for the occasional chuckle of recognition, but hardly the cult classic that it is represented as.

A satirical novel about the intern doctor and his journey thought internship in the hospital. Contains a reorganisation of a young Physician also his psychological problems connected with his motivation.

There kinda just seemed to be...no plot?

Brutalt i starten, så gjenkjennbart. Siste kapittel utgjorde hele forskjellen, mange fine refleksjoner.

Slightly satirical and overly sexual book about being an intern doctor. Written back in the 70s so things are ~a bit~ better now (no more 36 hour shifts!) but many aspects still ring true.

Borrowed this book from the library. I'm thinking of buying my own copy. I would carry it around with me all the time and hand it to everyone who asks why I'm not studying to be a "real" doctor.

The sad thing is that this dehumanization (of self as well as others) does happen to far too many people, and not just in the medical profession. And most don't have the luck to have it pointed out to them forcibly enough not just that it's happening, but that it's a bad thing.


When people are forced into inhuman situations, how can they respond humanely?


"I said, 'You sound like a male chauvinist.'
'Me?' asked Fats, genuinely surprised. 'How?'
'You're saying women like Jo make lousy doctors because they're women.'
'Nope. I'm saying women like Jo make lousy people because they're doctors, just like some men do.'"


Reminded me quite a bit of Catch-22, but easier to read because the time-line is pretty much straightforward.

Would not recommend to anyone already depressed, or to anyone having a really good day who doesn't want it spoiled.

Would recommend to everyone who has to deal with the medical establishment.

Accurate picture of reality...medical practice isn't Grey's Anatomy.

I think that if medical internship literature was an actual genre, this book would be its Lord of the Rings, its Dracula.

Without giving anything away, this book details - excruciatingly - the trials and growth of a fresh doctor in his first year of residency, deemed internship.

It is black humor at its finest, I think; a cynical reflection of a doctor who has come to hate the futility he feels in the profession, not to mention the stresses. The only break in sex with just about everything that moves in the hospital, abuse of fellow interns and staff, and running. In fact, this book reminded me less of any other medical books I've read, and much more of Hammer of the Gods - Richard Cole's biography of Led Zeppelin's onstage and offstage insanity during their touring days. Women and madness, with the occasional diagnosis or medical procedure thrown in...but rarely, as one of the laws the doctor learns is, in essence, that good medicine is doing as little as possible.

I would have given this five stars, it is definitely a must read; however, it is dated. Most of the relationships between the doctors and nurses, racial relations, and the backdrop of Nixon era politics give a great glimpse of medicine 40 years ago. Some of it rings true today, some does not.

I think the essence of the story is growth, however, and more importantly realization of the self. There is light at the tunnel at the end, or at the very least the tunnel ends. Perhaps I need to read the follow up book, Mt. Misery, to confirm this.

I would recommend this.