House of God

About the Author

Samuel Shem (Stephen Bergman M.D.) graduated magna cum laude and Phi Beta Kappa from Harvard College and earned a Ph.D in physiology from Oxford University, where he was a Rhodes Scholar. He graduated from Harvard Medical School. He is the author of the novels
The House of God, Mount Misery
and
Fine
and seven plays, including, with Janet Surrey,
Bill W
. and
Dr. Bob
. He is on the faculty of Harvard Medical School and the Stone Centre, Wellesley College. He lives with his wife and daughter near Boston.

‘Undiluted fun for the physician reader, with abundant self-reminiscing prompted by each of the mad situations described . . . It takes off in the first chapter at a fast, hilarious pace reminiscent of M*A*S*H and never slows down'
Medical Tribune

‘A wonderfully wild, ribald, erotic, bitter, compassionate, at times disgusting novel about the lives of interns in a major hospital'
Seattle Daily Times

‘Wildly funny, sad, laugh-out-loud, outrageous, moving . . . a story of modern medicine rarely, if ever, told'
Houston Chronicle

Also by Samuel Shem

MOUNT MISERY

and published by Black Swan

To J and Ben

This eBook is copyright material and must not be copied, reproduced, transferred, distributed, leased, licensed or publicly performed or used in any way except as specifically permitted in writing by the publishers, as allowed under the terms and conditions under which it was purchased or as strictly permitted by applicable copyright law. Any unauthorised distribution or use of this text may be a direct infringement of the author's and publisher's rights and those responsible may be liable in law accordingly.

Epub ISBN: 9781407071657

Version 1.0

  

THE HOUSE OF GOD

A BLACK SWAN BOOK: 9780552991223

Originally published in Great Britain

by the Bodley Head Ltd

PRINTING HISTORY

Bodley Head edition published 1979

Corgi edition published 1980

Black Swan edition published 1985

30

Copyright © Samuel Shem 1978

The author wishes to express appreciation for permission to quote from the following:
The Man with the Blue Guitar
by Wallace Stevens from the Collected Poems of Wallace Stevens © 1971 Faber & Faber Ltd. Lines from
Let the Mermaids Flirt with Me
are by Mississippi John Hurt. © Wynwood Music.

The right of Samuel Shem to be identified as the author of this work has been asserted in accordance with sections 77 and 78 of the Copyright Designs and Patents Act 1988.

All the characters in this book are fictitious, and any resemblance to actual persons, living or dead, is purely coincidental.

Conditions of Sale

This book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, re-sold, hired out or otherwise circulated in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed on the subsequent purchaser.

Black Swan Books are published by Transworld Publishers,

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a division of The Random House Group Ltd.

Addresses for Random House Group Ltd companies outside the UK

can be found at:
www.randomhouse.co.uk

The Random House Group Ltd Reg. No. 954009.

INTRODUCTION

We expect the world of doctors. Out of our own need, we revere them; we imagine that their training and expertise and saintly dedication have purged them of all the uncertainty, trepidation, and disgust that we would feel in their position, seeing what they see and being asked to cure it. Blood and vomit and pus do not revolt them; senility and dementia have no terrors; it does not alarm them to plunge into the slippery tangle of internal organs, or to handle the infected and contagious. For them, the flesh and its diseases have been abstracted, rendered coolly diagrammatic and quickly subject to infallible diagnosis and effective treatment.
The House of God
is a book to relieve you of these illusions; it does for medical training what
Catch-22
did for the military life – displays it as farce, a mêlée of blunderers laboring to murky purpose under corrupt and platitudinous superiors. In a sense
The House of God
is more outrageous than
Catch-22
, since the military has long attracted (indeed, has forcibly drafted) detractors and satirists, whereas medical practitioners as represented in fiction are generally benign, often heroic, and at worst of drolly dubious efficacy, like the enthusiastic magus, Hofrat Behrens of Thomas Mann's
The Magic Mountain
.

Not that the young interns and residents and nurses conjured up by Samuel Shem are not sympathetic; they all bring to the grisly fun house of hospital care a residue of their initial dedication, and the most cynical of them, the Fat Man, is the most effective and expert. Our hero, Roy Basch, suggests Voltaire's Candide in his buoyant innocence and his persistent – for all the running hypochondria of his hectic confessional narrative – health. Three things serve him as windows looking out of the claustral hospital fun house onto the sunlit lost landscape of health: sex, boyhood nostalgia, and basketball. The sex is most conspicuous, and in the orgies with Angel and Molly acquires an epic size and pornographic ideality. A glimpse of Molly's underpants becomes, in one of the book's many impetuous parlays of imagery, a sail bulging with the breath of life:

. . . in the instant between the sit down and the leg cross, there's a flash of the fantasy triangle, the French panty bulging out over the downy mons like a spinnaker before the soft blond and hairy trade winds. Even though, medically, I knew all about these organs, and had my hands in diseased ones all the time, still, knowing, I wanted it and since it was imagined and healthy and young and fresh and blond and downy soft and pungent, I wanted it all the more.

In the prevailing morbid milieu, spurts of lust arrive from a world as remote as the world of Basch's father's letters, with their serenely illogical conjunctions. Sexual activity between female nurse and male doctor figures here as mutual relief, as a refuge for both classes of caregiver from the circumambient illness and death, from everything distasteful and pathetic and futile and repulsive about the flesh. It is the coed version of the groggy camaraderie of the novice interns: ‘We were sharing something big and murderous and grand.'

The heroic note, not struck as often and blatantly as the note of mockery, is nevertheless sounded, and is perhaps as valuable to the thousands of interns who have put themselves to school with the overtly pedagogic elements of Shem's distinctly didactic novel: the thirteen laws laid down by the Fat Man; the doctrines of gomer immortality and curative minimalism; the hospital politics of TURFING and BUFFING and WALLS and SIEVES; the psychoanalysis of unsound doctors like Jo and Potts; the barrage of medical incidents that amounts to a pageant of dos and don'ts. It would be a rare case, I imagine, that a medical intern would encounter and not find foreshadowed somewhere in this Bible of dire possibilities.

Useful even to its mostly straight-faced glossary,
The House of God
yet glows with the celebratory essence of a real novel, defined by Henry James as ‘an impression of life.' Sentences leap out with a supercharged vitality, as first novelist Shem grabs the wheel of that old hot rod, the English language.

The jackhammers of the Wing of Zock had been wiggling my ossicles for twelve hours.

From her ruffled front unbuttoned down past her clavicular notch showing her cleavage, to her full tightly held breasts, from the red of her nail polish and lipstick to the blue of her lids and the black of her lashes and even the twinkly gold of the little cross from her Catholic nursing school, she was a rainbow in a waterfall.

We felt sad that someone our age who'd been playing ball with his six-year-old son on one of the super twilights of summer was now a vegetable with a head full of blood, about to have his skull cracked by the surgeons.

We have here thirty-year-old Roy Basch's belated bildungs-roman, the tale of his venture into the valley of death and the truth of the flesh, ending with his safe return to his eminently sane and sanely sensual Berry. Richard Nixon – the most fascinating of twentieth-century presidents, at least to fiction writers – and the mounting Watergate scandal form the historical background of the novel, pinning it to 1973–74.
The House of God
could probably not be written now, at least so unabashedly; its lavish use of freewheeling, multi-ethnic caricature would be inhibited by the current terms ‘racist,' ‘sexist', and ‘ageist'. Its '70s sex is not safe; AIDS does not figure among the plethora of vividly described diseases; and a whole array of organ transplants has come along to enrich the surgeon's armory. Yet the book's concerns are more timely than ever, as the American healthcare system approaches crisis condition – ever more overused, overworked, expensive, and beset by bad publicity, as grotesqueries of mismanagement and fatal mistreatment outdo fiction in the daily newspapers. As it enters its second million of paperback sales,
The House of God
continues to afford medical students the shock of recognition, and to offer them comfort and amusement in the midst of their Hippocratic travails.

JOHN UPDIKE

April 1995

Part I

France

Life's like a penis:

When it's soft you can't beat it;

When it's hard you get screwed
.

—The Fat Man, Medical Resident in the House of God

1

Except for her sunglasses, Berry is naked. Even now, on vacation in France with my internship year barely warm in its grave, I can't see her bodily imperfections. I love her breasts, the way they change when she lies flat, on her stomach, on her back, and then when she stands, and walks. And dances. Oh, how I love her breasts when she dances. Cooper's ligaments suspend the breasts. Cooper's Droopers, if they stretch. And her pubis, symphasis pubis, the bone under the skin being the real force shaping her Mound of Venus. She has sparse black hair. In the sun, she sweats, the glisten making her tan more erotic. In spite of my medical eyes, in spite of having just spent a year among diseased bodies, it is all I can do to sit calmly and record. The day feels smooth, warm, pebbled with the nostalgia of a sigh. It is so still that a match flame stands upright, invisible in the clear hot air. The green of the grass, the lime-white walls of our rented farm-house, the orange stucco roof edging the August blue sky—it is all too perfect for this world. There is no need to think. There is time for all things. There is no result, there is only process. Berry is trying to teach me to love as once I did love, before the deadening by the year.

I struggle to rest and cannot. Like a missile my mind homes to my hospital, the House of God, and I think of how I and the other interns handled sex. Without love, amidst the gomers and the old ones dying and the dying young, we had savaged the women of the House. From the most tender nursing-school novitiate through the hard-eyed head nurses of the Emergency Room, and even, in pidgin Spanish, to the bangled and whistling Hispanic ones in Housekeeping and Maintenance—we had savaged them for our needs. I think back to the Runt, who had moved from two-dimensional magazine sex into a spine-tingling sexual adventure with a voracious nurse named Angel—Angel, who never ever did, the whole long year, to anyone's knowledge, string together a complete sentence made of real words. And I know now that the sex in the House of God had been sad and sick and cynical and sick, for like all our doings in the House, it had been done without love, for all of us had become deaf to the murmurs of love.