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Loading... God's Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of… (edition 2012)by Victoria Sweet
11   kidzdoc | Jul 2, 2012 | 
Recommended by Erin Ward JennyArch | Apr 12, 2013 | Fascinating story of what a doctor learned from treating patients at the oldest almshouse hospital in the United States. She also studied premodern medicine which viewed the body as a garden to be tended as opposed to the modern medicine view of the body as a machine to be repaired. These experiences continue to inform her practice today. (  ) Milehighlibrarian | Mar 8, 2013 | Loved it. Sweet mixes her story, with the story of Laguna Honda and also provides info on Hidegarde of Bingen, an amazing woman who was way ahead of her time. Many though provoking questions about how medicine is practiced in the US none of which are flattering. I loved seeing Sweet's transformation, her persistent devotion to humanity and her increasing awareness of how our system is failing those most in need. I don't know how a "traditional" doctor would view the books but I would be interested to know. ( ) ccayne | Oct 22, 2012 | Slow medicine wins the day. I enjoyed the way she was able to deliver her medicine and the stories her patients generated. 5/28/12 (  ) peggygillman | Oct 12, 2012 | Dr. Sweet came to the historic almshouse hospital searching for a way to work part time in internal medicine while pursuing an advanced degree in medieval medicine. The intersection is one of time, where Laguna Honda is being drawn into 21st century modern medicine, while Dr. S. is moving back in time to study the lost roots of that same medical system. The narrative chronicles her 20+ years of work at the hospital through sketches of particular patients of the hospital at various times. These are not clinical case studies, but narrative case studies including not only the medical condition(s) of the person, but their personalities, relationships, social and economic situations. And each study demonstrates an aspect of medicine that goes beyond clinical absolutism and shows us a little of the various aspects of the heart of medicine that produces healing. Dr. Sweet's desire to study medieval medicine came about because of her awareness of the current mechanistic approach which has been evolving since the late 19th century and has obliterated all of the thinking about medical care and healing which preceded it. Her quest is to study, especially through the medical writings of Hildegarde of Bingen to see how these early healers viewed patients and their presenting conditions in order to develop treatments. What she learned is that medical practitioners in that time period approached patients much as one would approach tending a garden. Through the arc of the story we see the US Dept. of Justice enter the hospital on behalf of patients' rights. There are stories of the implementations of efficiencies imposed by outside consultants that failed to recognize the hidden efficiencies of the system they dismantled. Dr. Sweet travels to Switzerland to study Hildegard's original manuscripts as part of her doctoral program. At the completion of her studies she embarks on a pilgrimage tracing the path of St. James from France through Spain. She broke the journey into 3 separate trips over three years time. each time returning to Laguna Honda with new insights and more challenges wrought by the modernization of the hospital under financial duress. My personal experiences in providing care to the indigent lead me to suspect that Dr. Sweet may romanticize Laguna Honda a bit. However, this is a physician who loves humanity and the patients entrusted to her care. The lesson: it's not the destination, but the journey. She presents the foundation for her thinking about slow medicine: closely assessing the patient, watching the patient's response to treatment and then responding accordingly. This approach may not only be more efficient and effective for patients, but for the management of our systems of delivery of healthcare as well. (  )1 tangledthread | Aug 23, 2012 | I liked this author so much! Although this was sort of a memoir about a place rather than a person I would now like to know much more about the author herself---she provides bits and pieces, of course, in the story about the hospital. What a wonderful description of medicine as Sweet would like to provide it---pulled from far back in history. And the descriptions of particular patients as well as administrators are remarkable in the detail she provides---you can picture them in their appearance and their movements. And what a complicated problem to manage the overwhelming problems and the difficulties of politics and funding every year. This is a terrific book but at the end I sort of took a breath and wondered if we are heading in the right direction with medicine, or not---have we left something very special behind? ( )1 nyiper | Jul 9, 2012 | Laguna Honda Hospital was built in San Francisco in 1867 as an almshouse, which provided medical and spiritual care and a sense of community to the early residents of the city who could no longer support themselves. After it served as a place of refuge for many of the survivors of the devastating 1906 earthquake, Laguna Honda was rebuilt in 1909 as a 1,178 bed facility at the base of Twin Peaks, making it one of the largest almshouses in the United States throughout the 20th century. The concept of the almshouse dates back to medieval Europe, as a Christian tradition that existed in most larger communities. These almshouses, initially run by monks and nuns, became the earliest hospitals, the most famous being the Hôtel-Dieu de Paris, which was founded in the year 659 and remains in existence today. Lagunda Honda Hospital's main focus was on long term comprehensive care for people with dementia, traumatic brain injury, and end-stage illnesses such as cancer, alcoholic cirrhosis and, in later years, AIDS. It also provided rehabilitative care for patients with non-life threatening conditions whose physical limitations, lack of caretakers, poverty and homelessness, mental illness or substance abuse did not allow them to recuperate fully at home. Most of its residents lived there for months and years; some succumbed to a peaceful death surrounded by family members and hospital staff, and many were released to a supportive environment after they were physically and spiritually healed. Victoria Sweet was a newly minted internal medicine physician who sought a position in which she could practice on a part time basis while she pursued a doctoral degree in the history of medicine. She was somewhat familiar with Laguna Honda from her medical training, but was skeptical that practicing in an almshouse was the right fit for her. She accepted a temporary two month position, and more than 20 years later she continues to practice there. God's Hotel is Sweet's chronicle of her career at Laguna Honda, the patients, staff and colleagues who taught and enriched her, and the transformation of the hospital from one of the last almshouses in the United States to a newly built hospital and rehabilitation center. The hospital's changed mission coincides with the transition from 20th century medicine provided to patients by doctors, nurses and ancillary staff, to 21st century health care management, in which hospital administrators, government officials, insurance companies, efficiency experts and lawyers dictate what services "clients" should receive from the "system". The author also describes her study of Hildegard of Blingen a 12th century nun, theologian and medical practitioner, who wrote a textbook about medicine that combined the "four humors" theory of premodern medicine with her own knowledge of medical botanicals. Sweet's study of Hldegard formed the basis of her PhD in the history of medicine and resulted in an award winning book, Rooted in the Earth, Rooted in the Sky: Hildegard of Bingen and Premodern Medicine. In addition, Sweet also embarked on a pilgrimage from Le Puy in southwestern France to Santiago de Compostela in Spain, a 1200-mile journey based on a medieval route originally taken by St. James. She describes these two intellectual and physical journeys in detail, and how they influenced the care of her patients and her view of the ideal practice of inpatient medicine for chronically ill patients, one in which holistic and deliberate care (which she describes as "slow medicine") rather than stabilization and rapid discharge could be shown to be more cost effective, due to lower readmission rates and decreased cost of unnecessary outpatient medications. God's Hotel is a powerful rebuttal and loving testament from a wise and sensitive doctor practicing "in the trenches", one who works diligently to provide the best care to her patients, while bemoaning the negative effects of health care reform and the influence of bureaucrats who make untoward decisions by evaluating data rather than communicating directly with patients and those who provide direct care to them. ( )11 kidzdoc | Jul 2, 2012 | Thought-provoking book about SF's last almshouse, the Laguna Honda Hospital, and the value of "slow medicine!" (  ) SignoraEdie | Jun 24, 2012 | Subtitle: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine ( ) Elishibai | May 28, 2012 | |
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The concept of the almshouse dates back to medieval Europe, as a Christian tradition that existed in most larger communities. These almshouses, initially run by monks and nuns, became the earliest hospitals, the most famous being the Hôtel-Dieu de Paris, which was founded in the year 659 and remains in existence today.
Lagunda Honda Hospital's main focus was on long term comprehensive care for people with dementia, traumatic brain injury, and end-stage illnesses such as cancer, alcoholic cirrhosis and, in later years, AIDS. It also provided rehabilitative care for patients with non-life threatening conditions whose physical limitations, lack of caretakers, poverty and homelessness, mental illness or substance abuse did not allow them to recuperate fully at home. Most of its residents lived there for months and years; some succumbed to a peaceful death surrounded by family members and hospital staff, and many were released to a supportive environment after they were physically and spiritually healed.
Victoria Sweet was a newly minted internal medicine physician who sought a position in which she could practice on a part time basis while she pursued a doctoral degree in the history of medicine. She was somewhat familiar with Laguna Honda from her medical training, but was skeptical that practicing in an almshouse was the right fit for her. She accepted a temporary two month position, and more than 20 years later she continues to practice there.
God's Hotel is Sweet's chronicle of her career at Laguna Honda, the patients, staff and colleagues who taught and enriched her, and the transformation of the hospital from one of the last almshouses in the United States to a newly built hospital and rehabilitation center. The hospital's changed mission coincides with the transition from 20th century medicine provided to patients by doctors, nurses and ancillary staff, to 21st century health care management, in which hospital administrators, government officials, insurance companies, efficiency experts and lawyers dictate what services "clients" should receive from the "system".
The author also describes her study of Hildegard of Blingen a 12th century nun, theologian and medical practitioner, who wrote a textbook about medicine that combined the "four humors" theory of premodern medicine with her own knowledge of medical botanicals. Sweet's study of Hldegard formed the basis of her PhD in the history of medicine and resulted in an award winning book, Rooted in the Earth, Rooted in the Sky: Hildegard of Bingen and Premodern Medicine. In addition, Sweet also embarked on a pilgrimage from Le Puy in southwestern France to Santiago de Compostela in Spain, a 1200-mile journey based on a medieval route originally taken by St. James. She describes these two intellectual and physical journeys in detail, and how they influenced the care of her patients and her view of the ideal practice of inpatient medicine for chronically ill patients, one in which holistic and deliberate care (which she describes as "slow medicine") rather than stabilization and rapid discharge could be shown to be more cost effective, due to lower readmission rates and decreased cost of unnecessary outpatient medications.
God's Hotel is a powerful rebuttal and loving testament from a wise and sensitive doctor practicing "in the trenches", one who works diligently to provide the best care to her patients, while bemoaning the negative effects of health care reform and the influence of bureaucrats who make untoward decisions by evaluating data rather than communicating directly with patients and those who provide direct care to them. (