Shem’s ‘House of God’ simultaneously twisted and darkly humorous

(by Kennedf2)

‘The House of God’ is a satirical novel published in 1978 by psychiatrist Stephen Bergman, under the pen-name Samuel Shem. Bergman is a graduate of Harvard University College and Medical School, and also one of Oxford University, where he was a Rhodes Scholar.

After reading only twenty pages of Shem’s classic novel, it is clear to me that it is simultaneously twisted and darkly humorous. In its morbidity, it seems realistic, and yet the absurdity of the attitudes of the novel’s characters makes the events of the plot utterly unbelievable. Although the emotions within the novel (or at least of chapter three) are charged, and there is an urgency to the writing, the plot is minimal as the seemingly important events that happen within the House of God Hospital have very little impact upon the novel’s protagonists, and hence upon us as readers (For example on page 42, when Basch seems to quickly forget his distress at the thought of Professor Rokitansky overhearing the conversation between himself and The Fat Man. The incident is not mentioned again). This, however, seems to be a redeeming quality in the novel, as it is the characters and their morality that takes centre stage instead of the somewhat ridiculous events. In my opinion, the only way to read this novel is with an accepting attitude and a large pinch of salt, because without the absurdities that we associate with characters like The Fat Man, and the macabre humour that is so prevalent within the plot, the novel becomes wholly dark, twisted and ultimately disturbing.

Within the novel, the protagonist, Roy Basch battles between his professionalism and his humanity, between his former perception of reality and the reality that is forced upon him by the nightmare of his situation as an intern in The House of Gpd (For example, on page 39-“All was chaos. They were patients and all I knew was in libraries”). Shem offers us a uniquely honest account of the (occasional) triumphs and tragedies of hospital life, the anger and frustration that festered among interns, the abuse of young physicians by their superiors and the melee of poor practice and treatment of patients that fed into a murky purpose under the supervision of platitudinous residents (For example on page 35 when The Fat Man says In internal medicine, there is virtually no need to see patients. Almost all patients are better off unseen”).

While the prevailing mood within the novel was quite morbid and macabre, there was an aspect to the way in which the story was told that I found refreshing. After completing only two months of medical school, I already feel as though I am out of my depth, and I found it honest and uplifting to hear that Basch felt somewhat similar as a new intern under the supervision of someone like The Fat Man (for example on page 40 “I started to panic” and on page 36 “He was he first person to tell us he knew about our terror”). There was also a heartening revelation made by Basch on page 51, when he remembers the reasons why he chose the profession he did, and this was somewhat relieving for me after often asking myself “what have a gotten myself into?” during earlier sections of the chapter-“I was moved. I was a doctor. For the first time that day, I felt excited, proud. They believed in me, in my art”. At risk of sounding too upbeat, however, Shem quickly quenches Basch’ enthusiasm in the paragraph that follows “We all expect the American Medical Dream-the whites, the cures, the works. Modern medicine is different”. Shem’s honesty, although somewhat cynical and pessimistic, comes as a welcome relief when I placed this text in comparison with one like “Under the Ether Dome”.

Overall, Shem’s novel is certainly one I enjoyed, but not in a way I have ever experienced before. The cynicism, macabre humour and morbidity are strikingly apparent from the onset, which adds a sense of absurdity to the text, but is certainly something I enjoyed. On first reading, ‘’The House of God’’ was not a novel I thought I would have enjoyed, but after my somewhat inexperienced analysis of it, I found it became a text that I could relate to and certainly recommend.


Student notes on House of God by Samuel Shem


Samuel Shem’s ‘The House of God’ follows a young doctor’s internship in the eponymous ‘House of God’ hospital. Following the experiences of Dr. Basch and his colleagues, Shem’s writing ranges between insightful and crass. The satirical often veers into the farcical, while Shem’s own brand of ultra-realism can sometimes come across as exaggerated.

With that being said, there are excellent moments in the text. The sincerity of the main character is endearing and though the humour is probably more miss than hit, there are genuinely funny moments. ‘The Fat Man’, the intern’s first resident who believes that there is no patient ‘whose medical characteristics cannot be listed on a three-by-five index card’, is a prime source of humour.

However, Shem’s attempt to make the novel as realistic as possible can appear more like hyperbole. The seemingly never-ending nicknames and acronyms (GOMER, LOL, NAD…) can be tiresome and the idiomatic speech of some characters, a Chicagoan who speaks nothing but hipster and a foreign patient who shouts ‘go avay’, is simply hackneyed. ‘You dig?’

Though these elements detract from the novel, taken with a grain of salt (or more, as prescribed) ‘House of God’ can be read for what it is, a frank though perhaps exaggerated take on an intern’s story, from a man with real-life experience.