The House of God is a hilarious novel with information on everything doctors do not want patients to know. The author based the story on his experience at the Beth Israel Hospital. The novel caused a scandal when it first appeared. The work glamorized traits of dehumanizing and unprofessional attitudes towards ailing patients, which are a set of very unethical issues. Such include a sadistic and dark humor such as how to “turf” patients to other specialties. Another idea is that GOMERs go round.
The text promotes a detachment from the patient, which causes them to act in ways that may prove unsafe to the patients. A patient needs care and attention from a humane perspective. For a clinical officer whom is the person supposed to care for the patient to decide that they can raise the patients’ bed too high so they fall and have them transferred to another hospital department. The text portrays a brutal honesty on such absurd tragedies occurring in the hospital life. This is perhaps attributable to frustrations, which interns have and direct towards patients. The ideas of stating that the only good admission is dead admission display a detachment to the patients and their wellbeing.
It is dehumanizing to have a rule such as one of the rules on the House of God that good medical care delivery means doing as much of nothing as possible. This would mean that the hospitals interns learn that the patients did not need much care, rather than be fully dedicated to curing the patients. The residents taught the interns to do less to assist the patient.
The idea of having patient turfed to another department displays the height of unethical behavior. The concept is to thrive on the idea that old people whom they refer to as GOMERs. The term is a cruel term referring to the old and demented patients who border on death yet they never do since the doctors do a great job keeping them alive. This is wrong in its sense. The result, however is terrible and life threatening. The idea is based on the fact that old people are always falling out of their beds, as the book states, “GOMERs GO TO GROUND,” if they want, the patients turfed to Orthopedics, they would raise their beds way to high so on their fall, their backs would break. If they needed to move them to neurosurgery, they raised their beds to a level high enough for the fall to cause the patient a bleeding brain. The author portrayal of these activities is but a sadistic humor that only appeals to overworked interns and medical officers. This is highly unethical and puts the patients who put their trust in the medical profession at risk of death. It is an unwarranted act and the fact that the interns are overworked does not justify the behavior (Shem 36).
LOL in NAD was acronyms the interns used to refer to Little old ladies who were in no apparent distress, but they had to admit them into the hospital ant attend to her vague complaint and would not leave. The remedy, as the residents taught the interns to admit them but avoid running any tests since they would have to treat the illnesses they would find. In no world is it okay to ignore a distressed old woman on the assumption that she does not need any help, rather she is only persisting for attention. The medical profession founds upon the idea that the needy and ailing should come seeking help and would find it. It is unethical to let them leave in unsafe conditions, which may later lead to great suffering since they may have actual illnesses that the doctors can cure if they attend to them in good time.
Potts failed to aid the ailing man with steroids, which would have served, greatly in keeping him alive. After testing the man at night, he failed to take the results to Fats who would have advised him on the right thing to do. This led to having a man “turfed” to the North. This practice of overworking interns and according them responsibility they may not have the qualifications to attend to are unethical. The interns should only serve to aid in matters which they have met the qualifications for (Shem 34). In practice, however, this issue is subject to great debate due to the deficit of qualified medical personnel in hospitals. This causes them to have no choice but to share the responsibility with the unqualified interns.
Another practice displaying terrible inhumanity on the part of the medical officers are when they needed to take the patient’s blood pressure and rode the peddle turning the patients up and down in a terrible and risky position. They then took their blood pressure while they were in this position. This temperature they took from a specific baseline rather than measuring it from an independent point of view (Shem 35).
Runt used Valium while on the job to keep his nerves calm. This is prescription drug which when used wrongly can be addictive. It is unethical for any medical officer to go to work having taken such a drug. This is a practice, which goes on, happens in everyday practice, and is largely unethical (37). Runt takes this behavior to another level and wants to prescribe the drug for his patients claiming that they need it since they are nervous that he is their doctor. This is by assumption and the text does not reveal the expression of any one patient confirming it to be true.
The residents teach the interns that in order to “turf” some patients they scare them off by performing extra-painful procedures. The author tells of a time when he received advice to perform a Lumbar Puncture on Sophie because the procedure was very painful although he knew that she did not have meningitis.
The interns learn that it is to forget what they learnt in school. When one patient has pneumonia and CHF, becomes septic, refuses to eat and desires death and a series of other issues, he suggested having an LP conducted. Advised against it, the fourth law came up as placement always came first. He had to make a set of assumptions about the patient. This is highly unethical and is only similar to treating the patient as if she is a piece of baggage.
Fats encourage the use of an old woman Anne O to learn about the medical practice so that when a younger patient comes in to the hospital ailing and in need of assistance they would treat him efficiently. This is highly unethical since the patient was not dead yet. This dehumanizing practice is inexcusable. This shows that they hold with very little value the lives of Gomers (Shem 53). The lesson that Fat taught was that every part of the body cavity is easy to reach with a good strong arm and a fourteen needle.
In the measure for the correct doses to offer the patients, doctors and medical officers often use unethical measures of assumptions. Although they are right some times which are attributable to their vast experience, it is highly risky to make guesses and assumptions when it comes to matters that are life threatening such as heart failures. Fats use a sun of the patient’s age and their BUN, which is their Blood Urea Nitrogen to determine the Laxis dose to give to the patient (Shem 55).
The text continues to reveal different unethical undertakings, which took place during the process of treatment. The interns learn to shortcuts, which as much as they assist in the process of diagnosis; they leave the patients at risk. These are dangerous yet it happens under the watch and authority of the residents.
This information put the interns in a position where there were a clash between the medical systems, the received wisdom and the call of their humanity and human hearts. The question remains that if nobody takes care of the professionals in the field, how will they manage to care for the patients. This then may lead one to interpret the lack of ethics prevalent in the practice as seen in the House of God as a form of nonviolent resistance, voluntary or otherwise.
Malpractice is evident when Donowitz thought to teach the interns a bedtime test for amyloid since people with the disease bruise easily. Reaching down he pinched the patient’s arms and took a pinch. He ended up taking one that was harder than he intended and pinched out a large pinch of the patient’s arm. He left blood squirting out of the patient’s hands after attempting to put the skin back. He ran off in embarrassment but revealed that some practitioners are careless with such issues. Fats used a bandage on the patient and this revealed a careless behavior, which is prevalent in the practice. This shows that there are many malpractices occurring in hospitals when medical officers are careless about handling the patients. This goes to extents that cause problems and health risks to patients.
Interns learn to treat the old and ailing patients as if they do not have value. It is evident throughout the text that they view the aging and ailing patients as baggage that only comes in handy in training and practice for treating younger patients. The language used in the text displays a sense of detachment from the patients, which perhaps is the cause for all the bad treatment accorded to the patient.
The treatment accorded to the interns involving an overworked staff is the cause for most careless evident. It is unethical for the doctors to work so many shifts on call. This is the practice in House of God, which leaves them exhausted, and perhaps this may excuse the attitude of detachment they possess. However, death and life are indeed the most prevalent themes in the medical practice. The line between what is necessary and what is unethical is quite thin. However, the activities occurring in the text are beyond bordering the line and exceed the common measures.
The idea that interns would learn that taking care of patients involves doing a lot of nothing goes against the very foundation of the medical practice where people go to hospitals looking for care and attention from medical professionals. The interns who go there looking for guidance and experience on what happens in the practice seem to get the wrong teachings as part of the package. Teaching them to plan for falls of patients instills some unethical practices in them, practices that they take with them to their professional lives once they are in their own practice. This will increase the frequency of such distraught activities throughout the profession. The methods and systems, which they instill in them, are wrong and as much as they shorten the procedures, they are still wrong and unethical.
The ethical issues emerging in the text are sever, yet since the book is a common read among members of the profession, it comes off as common hilarity. This may lead one to overlook the sadistic behaviors underlying the laugh that are perhaps only so funny to practicing physicians. The book reveals the actions that occur behind the scenes and the issues that the patients and their families do not get to know. It brought to an attention the various results of an overworked staff. Whether the issues are voluntary or are due to circumstances, the fact that the acts are wrong and dangerous to the patient remains. Although no rule exists on the attitude one holds towards their patients, the effect of the attitude is distinct and this text displays a lack of humanity in most of the characters.
Shem, Samuel. The House of God: A Novel. New York: R. Marek Publishers, 1978. Print.