You might have read, Adam Kay’s This is Going to Hurt: Secret Diaries of a Junior Doctor, or Jed Mercurio’s Bodies (before he became a multimillionaire screenwriter). You know what to expect an insider account of naïve young men and women moving outside the world of books and into a cult into which they will work day and night, with little sleep and little idea what they are doing, while wearing a white coat that marks them out as being special and chosen. The House of God does all of those things—and more. It’s an insider-insider’s book, described as ‘the bawdy cult classic’, with a forward written by John Updike in April 1995.
Set during the fall of the Nixon era and the President’s impeachment, the centre cannot hold and things are following apart.
‘The House of God had been founded in 1913 by the American People of Israel when their medically qualified Sons and Daughters could not get good internships in good hospitals because of discrimination.’
The intern was at the bottom of the medical hierarchy. They didn’t sign contracts because that might legally limit the number of hours they might work, or assure them of rights. In a year in which they are both students and doctors learning new procedures on Jew bodies that are old, but refuse to die. For the House of God is a geriatric hospital, and that’s what makes it so relevant, because in the modern world with an aging population, all hospitals become care of the elderly hospitals.
Roy Basch is the narrator. Aged 30, he’s ‘old as dirt’. But he’s got the right credential to join the cult of junior doctors. He’s been to Harvard and been a Rhodes Scholar at Oxford. Medicine is just one more notch on his belt.
To reach the pinnacle of the medical profession and get hugely wealthy, ‘You had to lick your way up… like an ice cream cone… to [the] next uppermost ass…those few at the top were all tongue’.
The anti-hero and narrator’s guide through their initial year in the cult is Medical Resident, The Fat Man.
Life is like a penis:
When it’s soft you can’t beat it;
When it’s hard you get screwed.
Truth in the House of God does not depend on naturalism, but surrealism reveals a deeper reality. Despite the cartoonish Carry on Doctor view of nurses as a walking and talking sex menu, which belong to a bygone age, The Fat Man provides the laws of The House of God. He suggests how the intern should navigate the cult of the slurpers and retain his soul.
Slurpers being House Academics striving to lick their way to the top of the medical cone, and gain enormous wealth and prestige as the Chief.
The laws stand as an antidote to the cult of the Slurpers.
Rule I: Gomers don’t die.
People die. Gomers don’t. They only hang around and stink up the place.
GOMER is an acronym. Get Out of My Emergency [Room]. All other rules are derived from Rule I.
The intern’s job isn’t to admit patients, but to keep them out. Anyone hoping to get medical treatment knows these strategies. Here they’re named. BUFF and TURF.
BUFF is the triage system employed. Charts and patients are buffed so they can be sent somewhere—anywhere—else.
Rule X. The only good admission is a dead admission.
Rule XIII. The delivery of medical care is to do as much nothing as possible.
Rule XII: If the Radiology Resident and BMS both see a lesion on the chest x-ray, there can be no lesion there.
During Covid, in Scotland, for example, hospital wards were emptied and GOMERs were sent to fee-paying old folk’s homes to infect everybody else. BUFF and TURF at work in a modern setting.
Rule X: If you don’t take a temperature, you can’t find a fever (if you don’t test for Covid, you can’t find it).
The House of God calls for a more humane way of working, while acknowledging that those that have joined the cult of the white coats have invested too much of themselves, too much of their lives and have become dependent on it. For Medicine read capitalism. It’s a celebration of brashness of wealth and knowledge. Only the suckers don’t know the story. Only the slurpers do. Read this and you will too. Read on.
odonnellgrunting 