The House of God Chronicles

So lately I've been reading Samuel Shem's The House of God, which has been more or less dubbed the Catch-22 of medicine.  Samuel Shem is the pen name of Dr. Stephen Bergman, a psychiatrist who wrote The House of God in response to his internship year at Beth Israel Hospital.  I heard about this book from a friend at Ohio State University College of Medicine who is currently on his rotations.

I have decided to do something different with this book.  Rather than wait until I am done with it I want to chronicle my reading through the book as it happens, putting up excerpts and sharing my thoughts.  I feel this makes sense because not only does it keep me writing but I also anticipate that I will have a lot to say about this novel.  In fact, I probably should have done this with many of the novels I have read previously that deal with the training of a physician.

One of the things I love about the book already is the colorful colloquialisms that the narrator, Dr. Roy Basch, and his peers have.  One of the first ones is Slurpers.  The following except illustrates the meaning:

     The House medical hierarchy was a pyramid---a lot at the bottom and one at the top.  Given the mentality required to climb it, it was more like an ice-cream cone---you had to lick your way up.  From constant application of tongue to the next uppermost ass, those few toward the top were all tongue.  A mapping of each sensory cortex would show a homonculus with a mammoth tongue overlapping an enormous portion of brain.  The nice thing about the ice-cream cone was that from the bottom, you got a clear view of the slurping going on.  There they were, the Slurpers, greedy optimistic kids in an ice-cream parlor in July, tonguing and tonguing and tonguing away.  It was quite a sight.


I love this.  The humor is in the stark truth of it.  As students we are encouraged to start "networking" early for opportunities, recommendations, etc.  The term "networking" has a benign enough connotation and, truthfully, it is important.  However, medicine has historically been notorious for the cut-throat competition between trainees and subordinates.  The bar is constantly being raised by the more shameless but ambitious peers who progressively escalate "networking" into ass-kissing or "slurping".  It becomes less about merit and more about charisma---how well you can work people.  One of my top priorities as a student is learning to become good at what I am doing.  It is frustrating sometimes when that does not seem to count as much as how many people I know out there.  Still, I decided a long time ago to stick to my guns and hope that the people that recognize my work will be the kind of people I want to work with.