Samuel Shem: The House of God
Selected Excerpt
Laws Of The House of God
I. Gomers don't die.
II. Gomers go to ground.
III. At a cardiac arrest, the first procedure is to take your own pulse.
IV. The patient is the one with the disease.
V. Placement comes first.
VI. There is no body cavity that cannot be reached with #14 needle and a good strong arm.
VII. Age + BUN = Lasix dose.
VIII. They can always hurt you more.
IX. The only good admission is a dead admission.
X. If you don't take a temperature, you can't find a fever.
XI. Show me a BMS who only triples my work and I will kiss his feet.
XII. If the radiology resident and the BMS both see a lesion on the chest x-ray, there can be no lesion there.
Discussion Questions
Are there rules from House of God that stood out to you? Which ones, and why?
Have you read House of God? What do you think of it, and have your opinions changed over time?
Have you ever told a “gallows humor” joke that made you wonder, “Was that ok?” Please share your reflections, and if you feel comfortable sharing the joke, please share that as well.
How have you found gallows humor useful in your life? Moving forward, are there lessons from this text that you can see yourself using when you’re joking with others? Do these lessons feel applicable to the situation with COVID19?
Reflections from #MedHumChat
“They can always hurt you more” and “the patient is the one with the disease” always stand out to me. They both speak to the vulnerability of healthcare workers—And potentially the reason we turn to gallows humor as a defense.”—@Ndouthit
“I first read it when I was descending into depression on my MS3 surgery rotation. What I saw of the hospital was dehumanizing and brutal and [House of God] spoke to my experience. I reread it recently and was horrified by it. So I get both the love and the hate.”—@colleenmfarrell
“[To be honest] I disliked HOG when I read it, but as I've gone through my training, I've come to appreciate it. Slang affords a sometimes-necessary distance from patients and their suffering; you can't think clearly if you reflect too deeply on the enormity of their suffering”—@MargotHedlin
“Yes, useful to get through the difficult times, such as this COVID pandemic. I have fear and anxiety like everyone around me, it helps to be able to lighten the mood. Important to ensure you maintain your humanity and not become callous or detached.”—@Jazbeena
About this #MedHumChat
This excerpt from The House of God was paired with “Gallows Humor in Medicine,” an article by Dr. Katie Watson for a #MedHumChat discussion on April 1, 2020 exploring Gallows Humor in Medicine.
The pieces for this chat as well as the accompanying discussion questions were curated by Drs. Margot Hedlin and Colleen Farrell.
We were joined by special guest Dr. Margot Hedlin, NYU Internal Medicine resident and one of the executive producers of Core IM Podcast. Dr. Hedlin recently released a podcast exploring gallows humor in which she interviewed Samuel Shem and Katie Watson.
About the Author
Samuel Shem is the pen name of Dr. Stephen Joseph Bergman, American psychiatrist, writer, and playwright. His book, The House of God, has been named by The Lancet as one of the two most important medical novels of the 20th century.