I rarely say or type those words. When I pick up a book on purpose - I finish it. Sure I've been handed a book by a friend that I read a few pages and then given it back. But when I decide to read something - I finish it. I slogged through 864 pages of Anna Karenina and hated nearly every page...but I finished it.
When I was offered a copy of "The House of God," I jumped at the chance. I've heard of this book since I started medical school. Every medical student has because it's famous. It's called the "Catch-22" of medicine. It debunks the "heroic doctor" myth and shows medicine how it really is down in the trenches.
When I was working in my first hospital as a medical student I heard about the dark humor in the book. Example: The jokes about how to "turf" a patient to another specialty using the motorized hospital bed. The idea is basically that old people always fall out of bed, or as the book says "GOMERs go to ground." So if you want them turfed to Orthopedics - you raise the bed high enough that they'll break a hip when they fall out. If you want them turfed to Neurosurgery you raise the bed high enough to cause a brain bleed when they fall out.
Even in the book this is portrayed as sadistic humor only funny to overworked interns.
The book has much more than that. The author creates now famous acronyms to describe the most typical patients.
LOL in NAD = Little Old Lady in No Apparent Distress (but you have to admit her becuase she has some vague complaint and will not go away. Just try to avoid running any tests - or then you'll have to treat what you find - and make her worse)
GOMER = Get Out of My Emergency Room (old dememted patients bordering on death, but they never do because doctors are great at keeping them alive)
The book also presents the "laws of the house of god "as told by the senior resident.
A few are:
1. GOMERS GO TO GROUND.
2. AT A CARDIAC ARREST, THE FIRST PROCEDURE IS TO TAKE YOUR OWN PULSE.
3. THERE IS NO BODY CAVITY THAT CANNOT BE REACHED WITH A #14 NEEDLE AND A GOOD STRONG ARM.
4. IF YOU DON'T TAKE A TEMPERATURE, YOU CAN'T FIND A FEVER.
5. SHOW ME A MEDICAL STUDENT WHO ONLY TRIPLES MY WORK AND I WILL KISS HIS FEET.
6. THE DELIVERY OF GOOD MEDICAL CARE IS TO DO AS MUCH NOTHING AS POSSIBLE.
Seriously - I think the creators of the comedy T.V. series "SCRUBS" took half of their ideas from this book. Scrubs is a hilarious show, but I can't recommend it to my family or friends - because there is too much stuff that's just wrong: Inappropriate, macabe, and just plain offensive.
This book is worse.
The three line introduction is vulgar. The first paragraph is bordering on pornographic, and it only gets worse from there. The book may have gems, it may have won awards, it may be sadly hilarious for medical professionals, but it is not for me.
I understand why people liked it, and why they recommended it to me. But it's just too gross, too unfeeling, and too sexual.
I'm sure I'll still hear medical students talking about "GOMERs", and "Orthopedic Height" for the hospital bed. We'll talk regularly about hoof beats being a sign of horses, not zebras. And I'll remember the good lesson: that often the best medical care is to do as much nothing as possible.
I'll remember all those things, and probably appreciate them - but I'll never finish this book.
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