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Friday, October 19, 2012


God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of MedicineGod's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine by Victoria Sweet
My rating: 5 of 5 stars

God's Hotel is the story of what may have been the last almshouse in America. Dr. Victoria Sweet writes a riveting account of her experience practicing medicine in a place that exists between what she calls 'premodern medicine' and our modern health care system. In such a place, she discovers that "Tincture of Time" and a bit of attention can have a profound effect on how well the patient fares.

Set up during the Gold Rush, Laguna Honda is a hospital from a different era. Wide hallways and open, separate wards from the days before antibiotics are set up in a way that would make Florence Nightingale proud.  Staff was limited, and mostly used for patient care. Doctors would certainly take a patients' vital signs in person, possibly do their own x-rays,  and perhaps even prepare slides in order to examine necessary fluids. Laguna Honda was a facility where people ended up who had no where else to go. Outside the modern health care customer base (and funding) the hospital was short on money but long on time.

At least, that is how it was when Dr Sweet arrived. Eventually, however, the modern notions of efficiency and bureaucratic accountability caught up with Laguna Honda. Outdated architecture succumbed to the pressure of modern earthquake regulations, and a new Laguna Honda was born.

Dr. Sweet came to Laguna Honda because she wished to practice as a part-time physician, a notion all but unheard of in modern times. Ironically, this was because she wanted to pursue her PhD in medical history, studying a period in which practioners of medicine were always part time, and had other roles in their communities. Like her historical counterparts, Sweet had other interests. Specifically, she was intrigued by Hildegaard of Bingen, a 12th century infirmarian who also happened to be a nun. On the journey toward her PhD, Sweet learns that Hildegaard's approach to medicine had some value and truth. She found herself approaching her more challenging cases with a new perspective that often had miraculous results.

With all of our modern equipment, testing, and pharmaceuticals, today's medicine still faces many challenges in helping people find wellness in their lives.  Modern medicine relies on these technologies, often to the detriment of everyone involved. A new doctor admitted to Sweet that she didn't really know how to perform a complete physical workup on a new admission; there was so much else to learn that they didn't cover that in school anymore. Considering the amount of incorrect diagnoses that Dr. Sweet discovered, this does not bode well for the delivery of appropriate care.

If you are intrigued by the evolution of medicine, you will find this book fascinating. Finding the balance between modern technology and old-fashioned time and attention is essential to the future of medicine. If we can do this, we can create a better future, increasing wellness, reducing the cost of health care and most importantly, saving lives.


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