“XII If the radiology resident and the BMS [Best Medical School Student] both see a lesion on the chest X ray, there can be no lesion there”

I was reluctant to read the novel, House of God by Samuel Shem (Dr. Steve Bergman) mostly because one day during medical school I opened the cover and read the words “Except for her sunglasses, Berry was naked.” Uh… I’m all for art and free expression but I figured the book held the words of a male chauvinist-surgeon type and I was already annoyed with half of the male population in my medical school class. But as fate would have it, I ended up with a copy a few weeks ago and just finished it today.

It was written in the 70’s, before the ACGME insisted upon humane treatment of residents, when residents took q3 or q2 call without going home at noon post-call. Good Lord, I cannot imagine what that must have been like. It’s bad enough as it is. After having completed an emotionally draining adult neurology year, I can relate. I think everyone can. The calls alone put my pediatrics intern year to shame. And I can’t complain because I know my surgeon friends work even more.

I’m so grateful to all my sane medical and non-medical friends who kept me somewhat normal. Because after reading this book, I saw how easily I could've fallen off the deep end taking care of Neuro ICU patients. I’m already worried that I know residents who have. I mentioned once to a non-medical friend about a recent call I had, when the ER paged me on two patients who arrived with large brain bleeds. I had to tell their families about the imaging results, likely poor outcomes and consoled one of the families with a Spanish translator at 3am which felt wrong somehow. When I told my friend this, maybe I didn't realize how easily I laughed off the coincidence of having not one, but two horribly critical patients roll in the ER, my comment ‘man that really makes you feel helpless every time.' or how quickly I changed the subject afterwards. I don’t think I’ll forget the next question he asked, after a long pause: “Um, did you ever think of therapy?”

We probably all need therapy as residents, and The House of God highlights that. It’s an amazingly honest book about internship year that demanded change from the medical system. And it worked! In fact, there’s a rumor floating around that the 80 hour workweek limit will be shortened to 60 hours and interns will no longer do 24 hour shifts in the hospital. Hallelujah!

For me, my therapy was the ocean, friends and family who remind me that there IS life outside the hospital and it is wonderful. And my patients- those really sweet old ladies who'd tell me stories every morning when I’d check on them. And one ridiculously cute old gentleman with a fisherman’s cap who’d always ask me about Texas and talk about dancing. He wanted to learn how to incorporate his new cane into his dance moves. :)

It's nice to finally get all those House of God references people throw around. I’m also grateful to be a pediatrician again. It’s so much happier here. :)