Medical School & Shem's House of God

I've previously posted about the difficulties of caregiving.  How about the difficulties of being a doctor -- or even just training to be one?

From today's Boston Globe article "Empathy gap in medical students:"

Flint Wang was eager to start his third year of medical school, when he would finally break free of the classroom and treat patients. But once in the hospital, Wang, like many classmates, felt insecure and discouraged. Doctors don’t hesitate to point out students’ knowledge gaps. And neither do some patients. Medical training can be so stressful that it is sometimes difficult to connect with those being treated. “Your knowledge is shaky and you walk around the wards frazzled,’’ said Wang, 25, who nonetheless is glad he decided to become a doctor. 

The third year of medical school can be particularly bruising. But growing research suggests that something about this formative but punishing experience may harden students toward patients — a transformation that could persist years down the road. At Boston University School of Medicine, where Wang is now in his fourth year, Dr. Daniel Chen has found in studies that students’ empathy scores fell between the time they started medical school and the time they graduated. The most significant drop occurred in the third year, just as students started caring for their first patients.

For a novel about medical school, try The House of God by Samuel Shem:

The hilarious novel of the healing arts that reveals everything your doctor never wanted you to know. Six eager interns -- they saw themselves as modern saviors-to-be. They came from the top of their medical school class to the bottom of the hospital staff to serve a year in the time-honored tradition, racing to answer the flash of on-duty call lights and nubile nurses. But only the Fat Man --the Clam, all-knowing resident -- could sustain them in their struggle to survive, to stay sane, to love-and even to be doctors when their harrowing year was done.

And according to the 2009 NYT article "A Book Doctors Can’t Close," the book is still frequently read among the medical community:

It was a raunchy, troubling and hilarious novel that turned into a cult phenomenon devoured by a legion of medical students, interns, residents and doctors. It introduced characters like “Fat Man” — the all-knowing but crude senior resident — and medical slang like Gomer, for Get Out of My Emergency Room. Called “The House of God,” the book was drawn from real life, and 30 years after its initial publication, it is still part of the medical conversation. Written by a psychiatrist, Stephen Bergman, under the pseudonym Samuel Shem, M.D., the novel is based on his grueling, often dehumanizing experiences as an intern at Harvard Medical School’s Beth Israel Hospital in 1974... 

What makes “The House of God” singularly compelling is its brutally honest portrayal of the absurd tragedies and occasional triumphs of hospital life; the once-common abuse of young physicians by their superiors; and the anger and frustration these interns directed at themselves and patients. The novel introduced many derogatory terms to the medical culture. Gomer referred to the elderly, chronically ill patients no intern wants to deal with. The shorthand LOL in NAD (Little Old Lady in No Apparent Distress), was for patients needlessly admitted by their private physicians for expensive work-ups...