The House of God

Shem provides a satirical look at the often sadistic training of physicians.

This was a classic when I was coming up in my training. Trigger warning: While this book importantly highlights the hidden underbelly of medical training and culture, some of the stories are so egregious that they should be used in educational settings to discuss what NOT to do. But under every satire lies some truth and something to be learned.

Reading this novel as a junior doctor was like eating chocolate-coated, barbed wire. I was shocked, appalled, and outraged. I laughed. I cried. I wanted to stop and throw it away across the room. And yet, I remember it decades later. A book I will never forget.

Since then, there have been blogs and websites and many more recent similar stories of life as a recent graduate, but this one covers the same message that I needed so much. It is about caring as much as diagnosis. Being a doctor means relating to people first and illness second.

THOG (yes, we called it by its acronym) was released around the time I entered medical school, and was widely referenced during my training.

Fortunately I was far too occupied to read it at the time, as its revelations, however parodied and overblown, would likely have caused me to leave medicine before earning my license to practice. Encountering it years later, when the whole experience could be reviewed through a humorous retrospective lens, I found the book to be wonderfully entertaining, and spot on in many of its particulars.

Shem’s masterpiece of revelatory satire is the safest, silliest way for… show more.

I first read this book after completing medical school and before starting residency and I recently reread it some 30 years later. 

Samuel Shem took his experiences as an intern to pen a sarcastic look at the life of a 1970s intern.  To the non-medical person, these experiences may come as a shock, but to those I have met who were residents in that era, they say it is closer to the truth than people want to believe.

Though technically a work of loose fiction based on his experiences as an intern, I do not feel it is right to have a list of medical memoirs without The House of God holding down the anchor. Several decades old now, it remains the standard for the delicate space between self-disclosure in medicine and irreverence. Physician writers know it can be hard to thread that particular needle, but Shem does it so well that there is seldom a medical student who comes through training who has not picked up a copy at one point or another. 

By equal measure, horrifying, cynical and laugh-out-loud hilarious. A satire on the realities of medicine, but illustrating a fundamental truth of what it is to be a doctor. When this book was published in the 1970s, it rapidly became a medical classic, but was despised by some as showing an overly dark view of the medical world.