God's Hotel by Victoria Sweet

As a Courage to Teach facilitator, I am on a listserv with other facilitators, some of whom support the health professions. This book was recommended on the listserv and it sounded intriguing. It was!

It's the story, from a doctor's point of view, of a hospital for the poor, in San Francisco. The hospital is called Laguna Honda Hospital, and its story takes us through the political issues, the economic issues, and many others associated with health in our culture. It's a fascinating and often depressing read. Sweet tells the story of medicine through her patients, and since most of them are homeless, their stories are often bleak. The stories of how our system fails them is so sad. And yet, there are also great heroes in this book, and their commitment is inspiring.

This doctor also studies the medical practices of an earlier time, and learns to see great value in viewing the body as a garden to be tended. The special care, caring, and rest all contribute their healing powers. She ruminates on the benefits of viewing the body as a whole, and the entire book leaves one longing for that kind of medical practice. She also (somewhat peripherally) traces the development of medical technology and how, in many cases, it dehumanizes medical practice.

I think anyone in our society would appreciate this book, but most especially someone in medicine. I'm going to give it to a doctor friend of mine, who has two sons-in-law who are also training to become doctors. I think it would be good food for thought for all of them. Plus, I'd be curious as to their reaction. However, it's a pretty long and heavy read, and may be too much for over-worked med students!

The one thing I would hope everyone would glean, though, is the value of being very present to each patient. The way Sweet describes this and what she learns is fascinating. Another fascinating aspect is her description of her learning as she periodically takes a break from the hospital to continue a pilgrimage in Spain where her spiritual learning grows. There are parts of her descriptions that read like poetry. And you have to admire her dedication...

One of the most memorable parts of the book is a several page description of a day in her pilgrimage where she meets a group of other pilgrims. Her description of --I don't even know what to call it!--stopped me in my tracks! I've had similar thoughts...and more so lately as I contemplate leaving the formal world of work. What is my unique mark on the world -- or am I like everyone else, in many ways. Anyway, what follows intrigues me still, and begins on page 295 of the paperback version of this book:

During all of this--my return to the admitting ward, Proposition D, Chambers--Rosalind and I continued our pilgrimage to Santiago de Compostela.

The third section of the pilgrimage goes over the Pyrenees and halfway across Spain.That walk was even more varied than the first two, and there were many more pilgrims. What I took back to the hospital that third year was the day we got ahead of "our group."

Not that we had a formal group. Rosalind and I traveled as the two of us; nevertheless, groups formed, just as they had for Chaucer at the inn of The Canterbury Tales. Because, starting out from the same place every day, most people walk about the same distance--a kilometer every fifteen minutes, or about two miles an hour. Some walk quickly, arrive at their destination early, and take a siesta or drink a beer. Others take their time, though they still arrive at the same destination by the end of the day. So groups naturally form: the two Americans, the French singers, the flirtatious divorcee, the talkative Spaniards, the friendly Dane, the two serious Germans.

But that particular day we somehow got ahead of "our" group--a whole day ahead, though we didn't know it. That evening we went out for dinner, sat down at a table, and ordered. As we waited for our meal, I noticed that right next to us, at the next table, were two other American women--pilgrims just about our age. They even looked kind of like us. Then I sat back in my chair and looked around. Sure enough. Over there were the two somber German pilgrims, engaged in their serious discussion, except they were not our serious German pilgrims. There was the French singing group--true, they were Belgian and they didn't sing but played recorders, but still. Way in the back was a dour Norwegian, taking the place of our friendly Dane. And the little group of Spaniards, talking loudly, just not our Spaniards.

It was uncanny. It was a whole group of pilgrims traveling together, just like our group of pilgrims, but not our group of pilgrims. All the time I'd thought we were unique, walking on the pilgrim path; I thought it was our pilgrim path, walked by us for the first time, opening its adventures, stumbles, and stones for the first time--to us. But no. Ahead of us, all the time, was a near-identical group, and, doubtless, behind us, too. For lo and behold, there "they"--that is, "we"--were, in the restaurant that night, a version of ourselves and our group. Unaware that just one day's walk behind them were their adequate replacements. And, two days ahead of them, and two days behind them, too.

That is what I brought back to the hospital that year.

I'd already begun to realize something like that. On the admitting ward, I'd noticed there was a way in which my patients were almost, if not quite, interchangeable. I always had a kind of a "group," it seemed: two Bad Boys, one Bad Girl, one querulous old woman, one stroked-out Chinese, one aging hobo, one new and miscellaneous. But after that third year of the pilgrimage, I began to see that it was also true about the nurses and the doctors and everyone else at the hospital. My group, individual as each of its members was--Dr. Jeffers, Dr. Fintner, Dr. Romero, Dr. Kay, Larissa, Christina, Mr. Conley, even Dr. S.--was not unique. After us, as before us, would assemble some other group, with our approximate equivalents. It might be in a different building, in a new Laguna Honda, even in a a different century, but such a group would arise; the nature of the hospital required it.

My patients and I and the doctors and nurses and administrators were just as accidental a group as a group of pilgrims on their way.

I found that it be a a very relaxing thought. It meant I was off the hook. If I weren't the perfect Dr. S this time--well, eventually someone would come along who would be.

It also meant that the parts we were playing were, in some sense, parts; as if this time, I'll be doctor and you'll be patient; next time, we'll switch. And so, after that third section of the pilgrimage, I began to look much more closely into the faces and eyes of my patients and the janitors and the nurses and the bus drivers. Which parts were they playing? I wondered. And I found they were looking back at me in the same searching, intimate way.