The house of God

[Planktonmd]

I was on a 2 weeks vacation so I decided that it was time to revisit my all time favorite book "The House of God" . This book was written in the 70s, and at that time it reflected what internship and residency was all about in a top tier residency program.
The story line is vivid and full of sexual and politically incorrect ideas, but it is truthful and painfully accurate even today.
I know the world has changed, and we can no longer speak this openly about what we go through to become "Doctors", but if you read the book you will be shocked how accurate it is and how it still applies today!
It's 40 years old... but it truly tells the whole story.
We start idealists and motivated, then we become cynical and depressed, then we acclimate and we learn how to navigate the BS.
We constantly deal with the Gomers, Slurpers, and Leggos.
We all aspire to be "Fats" the wise doctor who figured out the system and used it to his benefit while providing the best care to his patients.
We all should learn the House Of God laws and apply them everyday, especially law # 13:
The delivery of good medical care is to do as much nothing as possible.
Anyone who tells you otherwise is a slurper.

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[deleted171991]

I never read that book during residency.

I heard so much about it that I picked it up years after graduation. I read the first few chapters and found it BORING. Immensely. Like a bad sitcom. Maybe I didn't read enough of it, I don't know, but it was a darn bad book. As far as I know, it was about a Harvard program, BI I think.

But then I found Scrubs almost ret@rded, too. And I am not a big fan of The Office either, for the most part, even if realistic.

I do agree with the law you quoted though, hence I am a proud minimalist. Or a lazy arse, if you were to ask a knee-jerk hyperbilling busybody.

 

[MoMoGesiologist]

Buff the charts!

 

[deleted59964]

i still do as much nothing as possible

 

[nimbus]

I read it as a premed. Thought it was entertaining. What solidified my decision to apply to medical school and influenced which medical school I attended was The Youngest Science: Notes of a Medicine Watcher by Lewis Thomas.

 

[dannyboy1]

I was on a 2 weeks vacation so I decided that it was time to revisit my all time favorite book "The House of God" . This book was written in the 70s, and at that time it reflected what internship and residency was all about in a top tier residency program.
The story line is vivid and full of sexual and politically incorrect ideas, but it is truthful and painfully accurate even today.
I know the world has changed, and we no longer can speak this openly about what we go through to become "Doctors", but if you read the book you will be shocked how accurate it is and how it still applies today!
It's 40 years old... but it truly tells the whole story.
We start idealists and motivated, then we become cynical and depressed.

I was never idealistic, and was always cynical. I think that’s why I’m not depressed😉

 

[OTCAwesome]

If any of you guys were lucky enough to have attended the Harvard of the Caribbean, "The doctor factory" is a must read if you haven't read it already.

 

[wanttoreadforum]

I never read that book during residency.

I heard so much about it that I picked it up years after graduation. I read the first few chapters and found it BORING. Immensely. Like a bad sitcom. Maybe I didn't read enough of it, I don't know, but it was a darn bad book. As far as I know, it was about a Harvard program, BI I think.

But then I found Scrubs almost ret@rded, too. And I am not a big fan of The Office either, for the most part, even if realistic.

I do agree with the law you quoted though, hence I am a proud minimalist. Or a lazy arse, if you were to ask a knee-jerk hyperbilling busybody.

You must be really fun at parties.

It's stunning to me how accurately that book depicts medical training even now, 40 years on. You've inspired some pool reading for me. Thank you!

 

[Shimmy8]

I never read that book during residency.

I heard so much about it that I picked it up years after graduation. I read the first few chapters and found it BORING. Immensely. Like a bad sitcom. Maybe I didn't read enough of it, I don't know, but it was a darn bad book. As far as I know, it was about a Harvard program, BI I think.

But then I found Scrubs almost ret@rded, too. And I am not a big fan of The Office either, for the most part, even if realistic.

This explains a lot.

House of God is my favorite book of all time. Didn’t read until the end of residency. Found my self giggling hysterically throughout. Don’t think you can really appreciate it unless you’ve already been through the **** a little bit as an intern/resident. Especially if you trained in New England.

And The Office and Scrubs are two of the best of all time, so...yea, explains a lot.

 

[deleted162650]

@FFP at parties:

 

[Twiggidy]

I was on a 2 weeks vacation so I decided that it was time to revisit my all time favorite book "The House of God" . This book was written in the 70s, and at that time it reflected what internship and residency was all about in a top tier residency program.
The story line is vivid and full of sexual and politically incorrect ideas, but it is truthful and painfully accurate even today.
I know the world has changed, and we no longer can speak this openly about what we go through to become "Doctors", but if you read the book you will be shocked how accurate it is and how it still applies today!
It's 40 years old... but it truly tells the whole story.
We start idealists and motivated, then we become cynical and depressed, then we acclimate and we learn how to navigate the BS.
We constantly deal with the Gomers, Slurpers, and Leggos.
We all aspire to be "Fats" the wise doctor who figured out the system and used it to his benefit while providing the best care to his patients.
We all should learn the House Of God laws and apply them everyday, especially law # 13:
The delivery of good medical care is to do as much nothing as possible.
Anyone who tells you otherwise is a slurper.

I abide by law #13 to the fullest especially when you have numbers driven staff that want to throw medications at every lab result you get.

“What do you want for that glucose of 160?”

“I want you to do nothing”

 

[Twiggidy]

I never read that book during residency.

I heard so much about it that I picked it up years after graduation. I read the first few chapters and found it BORING. Immensely. Like a bad sitcom. Maybe I didn't read enough of it, I don't know, but it was a darn bad book. As far as I know, it was about a Harvard program, BI I think.

But then I found Scrubs almost ret@rded, too. And I am not a big fan of The Office either, for the most part, even if realistic.

I do agree with the law you quoted though, hence I am a proud minimalist. Or a lazy arse, if you were to ask a knee-jerk hyperbilling busybody.

I question you sense of humor.....and if you don’t like Scrubs or The Office, if you have one at all. You hate puppies too?

 

[Twiggidy]

I almost felt like Samuel Shem should’ve been an anesthesiologists because we have the same mindset. It really makes me reminisce when a nurse asked me, “As an anesthesiologist what’s your favorite procedure to do?” I literally answered “Doing nothing. I don’t like touching patients. Everytime I touch someone something can go horribly wrong. So sorry, I don’t like doing anything to anyone”

I definitely was reading House of God like once a year at that point, and had probably just finished it.

 

[Noyac]

If any of you guys were lucky enough to have attended the Harvard of the Caribbean, "The doctor factory" is a must read if you haven't read it already.

What’s the “Harvard of the Caribbean”?

 

[deleted171991]

I question you sense of humor.....and if you don’t like Scrubs or The Office, if you have one at all. You hate puppies too?

Humor is cultural, my friend. That's why it's so hard to translate jokes. I cringe when I watch most American standup "comedy". And most foreigners are like me, hence few (if any) standup comedians have success abroad.

 

[Twiggidy]

Humor is cultural, my friend. That's why it's so hard to translate jokes. I cringe when I watch most American standup "comedy". And most foreigners are like me, hence few (if any) standup comedians have success abroad.

I get that. Not all stand up is funny. The Office is pretty much cringe comedy so I not liking that. Scrubs is pure satire and the first few seasons when it was on NBC was comedy gold.

 

[deleted171991]

I get that. Not all stand up is funny. The Office is pretty much cringe comedy so I not liking that. Scrubs is pure satire and the first few seasons when it was on NBC was comedy gold.

I may have not watched enough Scrubs. I just didn't identify with the actors.

 

[deleted171991]

@FFP at parties:

Not funny. 🙂

 

[nimbus]

What’s the “Harvard of the Caribbean”?

St. George’s in Grenada

 

[deleted50478]

I get that. Not all stand up is funny. The Office is pretty much cringe comedy so I not liking that. Scrubs is pure satire and the first few seasons when it was on NBC was comedy gold.

I liked The House of God when I read it in college in like 1998. Haven’t read in since but maybe I will.

I hate The Office (US). The Steve Carell character is so pathetic it’s painful to watch. Ricky Gervais was better but still just a pretty good show, not amazing in my opinion.

I love stand up comedy.
Jim Jeffries
Dave Chappelle
Louis CK
Sarah Silverman
Bill Burr
Aziz Ansari
Anthony Jeselnik
Daniel Tosh
Etc.

 

[blockstar]

I almost felt like Samuel Shem should’ve been an anesthesiologists because we have the same mindset. It really makes me reminisce when a nurse asked me, “As an anesthesiologist what’s your favorite procedure to do?” I literally answered “Doing nothing. I don’t like touching patients. Everytime I touch someone something can go horribly wrong. So sorry, I don’t like doing anything to anyone”

I definitely was reading House of God like once a year at that point, and had probably just finished it.

SPECIALTY ADVANTAGES DISADVANTAGES
RAYS Money (100K/annum) Gomers. Dark offices, narcolepsy. Damaged gonads; 8 fingered progeny. Barium enemas and bowel runs.
GAS Money (100K/annum) Gomers. Boredom punctured by panic. Astronomical malpractice premiums. Noxious gases, producing bizarre personalities.
Contempt, daily, of surgeons.
PATH No live bodies. Gomers (rare). Low malpractice Dead bodies. premiums Smell of dead bodies and formalin Basement office. Contempt, daily, of all but other pathologists. Depression.
DERM Money (100K/ annum) Gomers. Travel to sunny conventions Contagion. Naked skin attraction Naked skin repulsion
OPTHALMOLOGY Astronomical money (millions/annum) Gomers Astronomical maplpractice premiums Opportunity, daily, to torment GAS
Surgical internship requires. Occasional patient care
PSYCHIATRY
NO GOMERS! Hourly wage. ATRY Never touch bodies Hard on lumbar spine. except in sex-surrogate Multiple accusations from rightwingers, Voyeurism, perversion, cf. 'communist,' 'queer,' 'pervert.'. eroticism, autoeroticism, polyeroticism. Easy on feet. Long lunch hours. Cure?alleged-many others

 

[Planktonmd]

40 years ago 100K/annum was considered big money!
Today that's lower middle class.

 

[WholeLottaGame7]

Didn't read it til after intern year, which I think helped me appreciate it more. Obviously not everything translates well after 40 years, but as others have said, it is remarkable how much of it remains pertinent, especially philosophically.

Early/middle Scrubs was hilarious, later years, meh. Even that probably won't age particularly well. I feel like having a main male character repeatedly refer to another male character with feminine names in a derogatory fashion would get a lot of flak in the current environment, amongst many other things.

 

[Twiggidy]

40 years ago 100K/annum was considered big money!
Today that's lower middle class.

In 1978, 100k would be like 376k today.

 

[chocomorsel]

40 years ago 100K/annum was considered big money!
Today that's lower middle class.

Lower middle class? Really?
I would think that’s solid middle class.

 

[Chip N Sawbones]

What’s the “Harvard of the Caribbean”?

Tulane.

 

[nimbus]

In 1978, 100k would be like 376k today.

But in 1978 you could buy a 3bedroom house in San Francisco for 100k and a Porsche 911 was $20k.

 

[Apollyon]

What’s the “Harvard of the Caribbean”?

St. George’s in Grenada

I graduated from St George's in 2002. It was said then - "the Harvard of the Caribbean". Or, in other words, "the best of the worst".

Eh, I don't know. I'm board certified in my specialty now (not anesthesia), and I have not, and will not have, gone back to Grenada. Means to an end, and not especially proud of it.

 

[Noyac]

I graduated from St George's in 2002. It was said then - "the Harvard of the Caribbean". Or, in other words, "the best of the worst".

Eh, I don't know. I'm board certified in my specialty now (not anesthesia), and I have not, and will not have, gone back to Grenada. Means to an end, and not especially proud of it.

So would you have not gone to medical school or would you have gone elsewhere?

 

[Apollyon]

So would you have not gone to medical school or would you have gone elsewhere?

I was at the end of my rope. I only applied to 2 foreign schools - St. George's, and Sackler. Honestly, I don't know what I would have done.

 

[AdmiralChz]

I was at the end of my rope. I only applied to 2 foreign schools - St. George's, and Sackler. Honestly, I don't know what I would have done.

St. George’s, as well as Ross, benefit from some degree of brand recognition - most people out there know of a few people who went there and have done well. Anyone who has worked on residency app committees sees stuff from much more dubious schools in the Caribbean and abroad. It’s sort of sad, really - many of these folks take on enormous debt and don’t have a lot of options for residency (certainly anesthesia is out).

 

[MirrorTodd]

I've been a resident for two years and I still haven't ****ed a nurse in the hospital. Maybe I haven't been trying hard enough.

 

[deleted162650]

I've been a resident for two years and I still haven't ****ed a nurse in the hospital. Maybe I haven't been trying hard enough.

Slacker.

I’m on #4 (and that’s just today).

 

[coffeebythelake]

I was at the end of my rope. I only applied to 2 foreign schools - St. George's, and Sackler. Honestly, I don't know what I would have done.

What is Sackler?

 

[Mman]

What is Sackler?

Sackler Medical School

 

[coffeebythelake]

Sackler Medical School

So the school is in Israel but rotations in nyc?

 

[Apollyon]

So the school is in Israel but rotations in nyc?

Sackler is accredited by New York State, so, in NY's eyes, they're AMGs.

It used to be (>20 years ago) that all the rotations were in Israel. Electives could be done in the US.

And, that brings me back to something that used to really irritate me. Sackler was the only foreign school that Mt. Sinai would take; they wasted my time with an interview, to not rank me. How do I know this? Because they didn't fill in EM that year.

 

[Saddleshoes]

I am an attending for a dental residency program. The House of God is on the reading list I suggest for all my residents.

 

[deleted171991]

I've been a resident for two years and I still haven't ****ed a nurse in the hospital. Maybe I haven't been trying hard enough.

Because nowadays it's the other way round. They **** (with) you.

 

[MoMoGesiologist]

Because nowadays it's the other way round. They **** (with) you.

The number one obstruction to good medical care...

 

[Twiggidy]

I've been a resident for two years and I still haven't ****ed a nurse in the hospital. Maybe I haven't been trying hard enough.

I would make you repeat a year on this post alone, no matter what you scored on the ITE. Lol

 

[Twiggidy]

Sackler is accredited by New York State, so, in NY's eyes, they're AMGs.

It used to be (>20 years ago) that all the rotations were in Israel. Electives could be done in the US.

And, that brings me back to something that used to really irritate me. Sackler was the only foreign school that Mt. Sinai would take; they wasted my time with an interview, to not rank me. How do I know this? Because they didn't fill in EM that year.

New York City can be funny like that, especially some years ago. If weren’t of certain “demographic” there were a lot of residency spots that you couldn’t match into, and I’m not talking race. The urology program where I was an intern got called out as the the next few years they had an Asian guy, black female, and white male in successive years.

 

[JWebar]

I read it as a premed. Thought it was entertaining. What solidified my decision to apply to medical school and influenced which medical school I attended was The Youngest Science: Notes of a Medicine Watcher by Lewis Thomas.

DUDEEEE that book is so freaking awesomeeeee! 😍

The physician by Noah Gordon also is a very good read.

I've been thinking about reading the House of God for a while, I think this post has turned the scales. Thanks OP!