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God's Hotel: A Doctor, a Hospital, and…
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God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of…

by Victoria Sweet

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One of the best memoirs I have read for some time. ( )
  bness2 | May 23, 2017 |
I enjoyed reading this book. Victoria Sweet is a careful thinker who has obviously worked hard in her medical career to be a moral person. Sweet examines all presumptions about medical care without prejudice, using her experiences in a 20 year career to illustrate her evolving thought. She is no Luddite but at no point does she allow herself to blindly believe in the march of progress. A doctor who questions "progress" is already a surprise to me--for me, it's hard to think about the "history of medicine" without framing it as a triumph of science over mythology. But over and over again Sweet discovers what we have lost, as well as gained, as the practice of medicine has evolved over the centuries.

The book is weirdly non-prescriptive, and deliberately vague about time--for chapters on end I wasn't sure when it takes place, and between chapters I didn't know how much time had passed--to the point where at many times I couldn't know what decade we were talking about in a given chapter, until some marker (a mention of AIDS patients, or of Obama) gave it away. In this manner Sweet almost recreated for me, as a reader, what medical care would be like if it focused, as Sweet advocates, on giving the body time to heal itself, rather than forcing an ill patient's treatment to fit the schedule of the health care system. For a memoir the book was also refreshingly non-autobiographical. I got to know the author only through her observations of other people and events, which in an era of James Frey-like self aggrandizing confessional memoirs is remarkable all on its own.

After reading, I know Sweet feels very strongly about many issues, but I never felt preached to. I felt instead that, as I read, my mind was being continuously presented with new things to think about. Sweet threads a needle here, rather than choosing sides. A discussion of the sadness and wrongness of allowing a schizophrenic patient decline life-saving treatment is followed up immediately by a discussion about the dangers of taking an individual's right to choose medical treatment away from them. This somehow doesn't feel contradictory--it feels instead as if Sweet allows for complexity of thought, and doesn't give herself, or her readers, the right to be content with easy answers. Instead of being hammered by a particular point of view, the way a typical nonfiction book about the health care system would read, I feel expanded as a reader, and as a human being. ( )
  poingu | Jan 29, 2015 |
So well written and engaging, this is an entertaining, informative, and inspirational book and I loved it. It demonstrates how health care used to be and How it should/could be now. Every legislator, bureaucrat, and consumer involved in health care, especially in the framing of policy and in the decision making process should be required to read this book. Actually, everyone would benefit from reading it. Highly recommended. ( )
  m2snick | Feb 19, 2014 |
An amazing--and amazinigly--important book. Her unique position and perspective allows for an intriguing exploration into the inefficiency of efficiency (and her argument for seeing the efficiency of inefficiency). Her stories make it highly readable, and her topic makes it interesting to people in healthcare, business, and just general interest. ( )
  ebnelson | May 25, 2013 |
Showing 1-5 of 14 (next | show all)
It is probably pointless to suggest that all the individuals presently shaping our health care future spend a quiet weekend with “God’s Hotel,” Dr. Victoria Sweet’s transcendent testament to health care past. Who interrupts cowboys in the midst of a stampede?

But if you’re one of the millions of doctors and patients out there choking on their dust, this is the book for you. Its compulsively readable chapters go down like restorative sips of cool water, and its hard-core subversion cheers like a shot of gin.
added by kidzdoc | editNew York Times, Abigail Zuger (May 29, 2012)
 
In “God’s Hotel,” Sweet weaves several interrelated narratives gracefully: her experiences as a physician at Laguna Honda; her pilgrimage by foot from France to Santiago de Campostela in northwest Spain, which she undertook in sections during a series of vacations; the world of Hildegard and medieval medicine; the (alas!) inevitable succumbing of Laguna Honda to “progress.” The old open wards in which patients tended to their more infirm neighbors, we learn, have been replaced by a sleek facility that touts “wellness” programs, “health care data” systems, and flat screen TVs.

Sweet’s tone, in “God’s Hotel,” nicely matches her subject. Her writing has a lovely, antique quality. For example, she almost never refers to Laguna Honda’s exact location. Instead, she calls San Francisco “The City,” as opposed to “The County” — the acute care hospital from which so many Laguna Honda residents arrive. The vagueness of location also conveys a distance in time, as if Sweet were writing from both far away and long ago. She reinforces this impression by launching into anecdotes with the word “now,” as in “Now Mr. Conley was a nice man…,” as if we readers were fellow pilgrims, resting by the side of the road, listening to Sweet tell her story.

Sweet would likely be pleased to have left this impression, because she comes to consider all of life, including medicine, as a kind of pilgrimage. After one of her treks in Europe, she returns to Laguna Honda with a pilgrim’s eye for allegory, seeing those around her as “characters…patients, nurses, delivery men, doctors — with spiritual and moral messages, if I chose to decipher them.” Sweet invites us to view the modernization of Laguna Honda as an allegory, a cautionary tale about what is lost when healers and their patients are replaced by bureaucrats and “clients.”
added by kidzdoc | editBoston Globe, Suzanne Koven (Apr 22, 2012)
 
I can't tell you exactly when it happened, but sometime in the past two decades, the practice of medicine was insidiously morphed into the delivery of health care. If you aren't sure of the difference between the two, then "God's Hotel" is the book for you. It's an engaging book that chronicles this fin-de-siecle phenomenon from the perspective of San Francisco's Laguna Honda Hospital, the last almshouse in the United States.

Dr. Victoria Sweet, a general internist, came to Laguna Honda for a two-month stint more than 20 years ago and ended up staying. Laguna Honda was home to the patients who had nowhere else to go, who were too sick, too poor, too disenfranchised to make it on their own. The vast open wards housed more than a thousand patients, some for years. Laguna Honda was off the grid, and this, Sweet discovered, was to the benefit of the patients.
 
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For my parents and for the patients of Lagunda Honda Hospital in San Francisco, California
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It was my first autopsy, my first day in the clinical clerkship of medical school called pathology.
Quotations
And although I never heard it talked about, the longer I was at Laguna Honda, the more sure I was that its first principle was not medicine, nursing, or a balanced budget, but hospitality in the sense of taking care of anyone who knocked at the door because—it could be me. It was me. (page 176)
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From Amazon.com:

San Francisco's Laguna Honda Hospital is the last almshouse in the country, a descendant of the Hôtel-Dieu (God's hotel) that cared for the sick in the Middle Ages. Ballet dancers and rock musicians, professors and thieves-"anyone who had fallen, or, often, leapt, onto hard times" and needed extended medical care-ended up here. So did Victoria Sweet, who came for two months and stayed for twenty years.

Laguna Honda, lower tech but human paced, gave Sweet the opportunity to practice a kind of attentive medicine that has almost vanished. Gradually, the place transformed the way she understood her work. Alongside the modern view of the body as a machine to be fixed, her extraordinary patients evoked an older idea, of the body as a garden to be tended. God's Hotel tells their story and the story of the hospital itself, which, as efficiency experts, politicians, and architects descended, determined to turn it into a modern "health care facility," revealed its own surprising truths about the essence, cost, and value of caring for body and soul.
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"San Francisco's Laguna Honda Hospital is the last almshouse in the country, a descendant of the Hotel-Dieu (God's Hotel) that cared for the sick in the Middle Ages. Ballet dancers and rock musicians, professors and thieves--"anyone who had fallen, or, often, leapt, onto hard times" and needed extended medical care-ended up here. So did Victoria Sweet, who came for two months and stayed for twenty years.Laguna Honda, lower tech but human paced, gave Sweet the opportunity to practice a kind of attentive medicine that has almost vanished. Gradually, the place transformed the way she understood her work. Alongside the modern view of the body as a machine to be fixed, her extraordinary patients evoked an older idea, of the body as a garden to be tended. God's Hotel tells their story and the story of the hospital itself, which, as efficiency experts, politicians, and architects descended, determined to turn it into a modern "health care facility," revealed its own surprising truths about the essence, cost, and value of caring for body and soul"--"Choosing service in the last remaining almshouse in America, and tracing our understanding of medicine back to its medieval roots, a physician uncovers lost lessons in the care of body and soul"--… (more)

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