*Some small spoilers, nothing that ruins the storyline though*
I was told that one must read this book three times throughout their medical career; once as a student, once as an intern, and once as a consultant. The fact that this book, full of incredibly dark humour and hilarious anecdotes, can continue to be relevant through completely different stages of a person’s life is a testament to the incredible skill of Shem, and I can say that without a doubt this is in my Top 3 list of favourite books.
The House of God tells the story of Rhodes Scholar Roy Basch, fresh out of med school and beginning his internship at The House of God, a hospital founded by the American People of Israel and now considered one of the best in the country. Idealistic and nervous as hell he enters the wards and the panicked life of an intern, with various mentors, patients, and colleagues all trying to both help and hinder him through a year that “… destroys people” (Roy Chapter 22. Page 328).
The absolute cornerstone of this novel is the various laws that The Fat Man, the eccentric medical registrar and mentor of Roy, has created in order to survive;
- GOMERS DON’T DIE.
- GOMERS GO TO GROUND
- AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE.
- THE PATIENT IS THE ONE WITH THE DISEASE.
- PLACEMENT COMES FIRST.
- THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14G NEEDLE AND A GOOD STRONG ARM.
- AGE + BUN = LASIX DOSE.
- THEY CAN ALWAYS HURT YOU MORE.
- THE ONLY GOOD ADMISSION IS A DEAD ADMISSION.
- IF YOU DON’T TAKE A TEMPERATURE, YOU CAN’T FIND A FEVER.
- SHOW ME A BMS (Best Medical Student, a student at the Best Medical School) WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET.
- IF THE RADIOLOGY RESIDENT AND THE MEDICAL STUDENT BOTH SEE A LESION ON THE CHEST X-RAY, THERE CAN BE NO LESION THERE.
- THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.
These are thrown throughout the book and are introduced at various milestones; from the first introduction of the gomers to the first death to his final few days as an intern. But perhaps the best laws come 34 years after the first publication, with some reflections from Shlem after a lifetime in medicine;
- CONNECTION COMES FIRST.
- LEARN EMPATHY.
- SPEAK UP.
- LEARN YOUR TRADE, IN THE WORLD.
It is these final points that I believe will make me, and my colleagues, the doctors that the world requires and desperately needs, especially in times such as these when compassion and humility can be so often forgotten in the name of big egos and big paychecks.
To end this review, I would like to present my absolute favourite quote from the book, and one that will resonate with me throughout both my professional and personal life;
“Life is like a penis: when it is soft you can’t beat it; when it is hard you get screwed”- The Fat Man, Medical Resident in the House of God.
Photo courtesy of Goodreads: https://www.goodreads.com/book/show/3995.The_House_of_God