Literature Annotations


Kohn, M. & Donley, C., eds.
Return to The House of God: Medical Resident Education 1978-2008


Genre Anthology (Essays) (241 pp.)
KeywordsAlcoholism, Art of Medicine, Caregivers, Communication, Depression, Doctor-Patient Relationship, Drug Addiction, Empathy, Grief, History of Medicine, Hospitalization, Human Worth, Humor and Illness/Disability, Impaired Physician, Marital Discord, Medical Education, Medical Ethics, Medical Mistakes, Nursing, Patient Experience, Physical Examination, Physician Experience, Power Relations, Professionalism, Psychiatry, Sexuality, Suffering, Women in Medicine
Summary Samuel Shem's (Stephen Bergman) The House of God, first published in 1978, has sold over two million copies in over 50 countries (see annotation).  Its 30th anniversary was marked by publication of Return to The House of God: Medical Resident Education 1978-2008, a collection of essays offering historical perspectives of residency education, philosophical perspectives, literary criticism, and women's perspectives, among others. Contributors include such well-known scholars as Kenneth Ludmerer, Howard Brody, and Ann Hudson Jones, as well as physician-writers Perri Klass, Abigal Zugar, Susan Mates, and Jack Coulehan.  The closing section, "Comments from the House of Shem," includes an essay by psychologist and scholar Janet Surrey (Bergman's wife) and one by "both" Samuel Shem and Stephen Bergman. 
CommentaryFew books have received the attention, both positive and negative, that The House of God has garnered since its publication over 30 years ago, and it continues to evoke strong feelings in readers today.  Editors Kohn and Donley argue that, "like all art, it gives rise to a range of emotions and makes us wonder more deeply about this world we live in, specifically the world of medical training" (xii). This range is apparent in the essays.  Family physician Howard Brody's essay focusing on the Fat Man's laws in the House of God argues that they actually contain a great deal of medical wisdom and "sneak in" elements of primary care; physician and historian Kenneth Ludmerer contends that not only was the portrayal of residency education accurate for that time but that many of the problems remain; psychiatrists Neeta Jain and Dagan Coppock examine Shem's claim about the cathartic process of writing The House of God,  likening it to their similar experience of crafting an anthology, which "made the burden of human suffering and the exhaustion of medical training more bearable" (121).

Other essayists are less enthusiastic about the merits of the book.  Nurse and scholar Amy Haddad writes that her experiences were dramatically different from those described in the book and were marked by discrimination and verbal abuse from attending physicians. Physician and poet Jack Coulehan argues that students reading The House of God "internalize the message that clinical training is dehumanizing without sufficiently noticing that the group most dehumanized in the novel is patients. . . . It glorifies gallows humor but avoids self-deprecating humor" (115). Other noteworthy essays include Julie Aultman's assessment of virtue in The House of God, and Susan Mates's short story "The Madwoman in the Attic," which finds the much-maligned character Jo the author of her own "laws."

The final two essays by Surrey and Bergman offer insights on the book and their personal, spiritual, and professional journeys taken since its publication. The collection is a valuable scholarly contribution to understanding the educational, historical, and literary significance of this iconic novel.   
PublisherKent State University Press
Edition2008
EditorsMartin Kohn & Carol Donley
Place PublishedKent, Ohio
Annotated by Wear, Delese
Date of Entry 05/05/09