God’s Hotel: A Doctor, A Hospital, and a Pilgrimage into the Heart of Medicine
As the U.S. Supreme Court prepares to hand down its decision on the constitutionality of the Obama health care law, one book should be required reading for all nine justices: God’s Hotel: A Doctor, A Hospital, and a Pilgrimage into the Heart of Medicine by Victoria Sweet.
In this unvarnished, humane, and brilliant writing debut, doctor and medical historian Sweet traces her own evolution as a physician assigned to care for society’s poorest and most downtrodden. Her 20 years as a doctor at one of America’s last almshouses—an antiquated facility in San Francisco called Laguna Honda—coincides with her work as a graduate student exploring pre-modern medicine. These parallel experiences shape her own evolution as a practitioner, forcing her to consider more honestly and openly what the modern health care system has come to mean for hospitals, and more specifically, for the doctor-patient relationship.
Told through the stories of her patients, and with Laguna Honda itself as a lead character, Sweet’s book exposes how basic tenets of medicine—diagnosing, treating, and caring for patients--have become distorted as our nation’s health care system demands greater “efficiency” from doctors and facilities alike. Most entertaining, and poignant, are her portraits of individual patients, who become sources of inspiration for her as a practitioner.
But equally fascinating and provocative is her discussion of the changes imposed on Laguna Honda after a team of health care consultants is called in to transform the place into a “modern” health care facility. Gone are the outdoor gardens and animals tended by patients, the daily interactions of doctors, staff, and patients, and most of all, the time that Sweet believes is necessary to fully care for patients. Is it really more efficient, she wonders, to order batteries of expensive tests for patients, or to sit with them, observe, and ask lots of questions to try to get to the bottom of what is ailing them? Indeed, as she learns from working with her patients, greater “efficiency” often results in more costly, inefficient, and ineffective ways of delivering health care.
Although not a writer by background, Sweet has a natural gift for story-telling, for conveying the quirks and nuances of characters she writes about, and for weaving it all together with a singularly important message. This book is a plea for “slow medicine” and for a re-examination of the real costs and benefits associated with the choices we make about how we care for people in our society. Not only should our Supreme Court justices read it, so should every doctor, lawyer, politician, and policy expert involved in thinking about how to reform our health care system.
--Brad and Lissa
