Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Tuesday, August 25, 2009

House of God; House of the Dinosaur

There's been a bit of a buzz recently over the 30th anniversary of the publication of the "raunchy, troubling and hilarious novel that turned into a cult phenomenon devoured by a legion of medical students, interns, residents and doctors" known as the House of God.

I read it many years ago at a time when it was already quite well known. My impression was that it was a rather overwrought, hyperbole-filled version of what medicine would look like if there were no such thing as a Do Not Resuscitate order: inhumane to both patients and physicians-in-training. Still, although not formally required, reading it was a rite of passage that allowed me to sagely concur that gomers did not die (although they did go to ground), the patient was the one with the disease, and that there was no body cavity that could not be reached with a #14 needle and a good strong arm.

Time passed. I survived my medical training (although my mother did not) and went on to practice medicine, start a blog, and write a book whose First Law ("The art of medicine consists of amusing the patient while nature takes its course") looks suspiciously similar to the House of God's Thirteenth Law:
The delivery of medical care is to do as much nothing as possible.
That's not where I got it from. Really. It was a gift from a friend, and is unattributed only because the plaque was unsigned.

Reading through the rest of both sets of laws I find a similar snarky tone, but no specific correspondence of content. This is because the Laws of the House of God are specific to the hospital setting -- actually, the training hospital -- whereas the Laws of the Dinosaur apply to outpatient practice. Truly, each set of Laws embodies these different aspects of medical practice.

Just as the House of God, while dated in some respects, may have words of wisdom for future generations of physicians, it is my outrageously conceited humble hope that Declarations of a Dinosaur; 10 Laws I've Learned as a Family Doctor may serve a similar purpose for those who practice in the office setting.


At Tue Aug 25, 10:34:00 PM, Anonymous drcharles said...

Fortuitous timing on the anniversary! I think your laws are less cynical and more good-hearted, and will be an inspiration to a lot of students who are disillusioned by the "do everything" approach to inpatient care that sometimes defies logic and humanism.

At Wed Aug 26, 07:00:00 AM, Anonymous Anonymous said...

Mercy! Has it really been 30 years?

At Wed Aug 26, 07:18:00 AM, Blogger Dragonfly said...

I read it in my first year of med school, and was not sure whether to believe it or not. A lot of my classmates are rereading it as we are on the home stretch, saying they now have a completely different perspective on it. I might if I get the time.

At Sat Aug 29, 01:29:00 PM, Blogger ccinnkeeper said...

"The delivery of medical care is to do as much nothing as possible."

My grandfather, also a doctor and who I am SURE never read "House of God", used to say:

"Left to themselves, most patients will get better."

Some things don't change.

At Sat Sep 05, 01:45:00 PM, Anonymous Anonymous said...

Voltaire said it first.

At Mon Feb 08, 04:58:00 AM, Anonymous loke said...

I love the house of god.


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