A book that can delight you through its entertainments or instruct you with useful knowledge is a good book; one that does both is a great book. Rarely, a book comes along that not only instructs and delights but also deepens your humanity, carving out extra space inside us to carry even more compassion. God’s Hotel by Victoria Sweet is such a book. [A hat-tip to Jesse Kornbluth of Head Butler for introducing me to it.]
There were many reasons I enjoyed this book, which is really many books at once:
1) The author, Dr Victoria Sweet, who has a PhD in medieval history as well as an MD, shares the ancient Latin and Greek etymologies of many terms used in patient care today. Hospitality, community, charity – what do they really mean? Through her stories about her time taking care of patients, Dr Sweet shows how those formed the three foundational principles of Laguna Honda Hospital.
Hospital comes from hospitality, the root of which is hospes, which means both ‘guest’ or ‘host’. This is how Sweet explains this:
The essence of hospitality — hospes — is that guest and host are identical, if not in this moment, then at some moment. Whatever our current role, it was temporary. With time and the seasons, a host goes traveling and becomes a guest; a guest returns home and becomes a host. That is what the word hospitality encodes. And in a hospital, the meaning of that interchangeability is even more profound, because in the hospital, every host will for sure become a guest; every doctor, a patient.
Community has two derivations: one from Latin munio meaning wall, so it means “to build a wall around”. It also comes from munis, gift, so it also means “those who share a gift in common”:
That was true of the hospital’s community, too, though it was not as obvious as the wall. At the Teals’ wedding, when I saw almost all of Laguna Honda pouring into that church, sitting rapt during their vows, and, yes, even crying, I understood that it wasn’t only me who was interested in the Teals, who made time, who was touched by them. Almost everyone was there; the wedding was a gift we shared in common, and that sharing made us a community.
As for charity:
Charity came into the West when Saint Jerome translated the Greek word agape by the Latin caritas, which became the English charity. Today agape is usually translated as love, but agape was more nuanced; in ancient Greek it meant “to treat with affectionate regard.” Caritas, charity, is closer because the root of caritas is cara — “dear” — as in expensive and cherished. So caritas has the sense of “dearness” — of a love that is precious and sweet.
2) Dr Sweet interweaves the account of her doctoral research on Hildegard von Bingen and premodern medicine in the story. This is delighteful stuff, because it’s not taught in medical schools at all, even though it was the basis of Western medicine for two thousand years.
Von Bingen was the original 11th century superwoman: head cleric, builder, farmer, physician, author and composer at a time when women weren’t allowed much power at all. Hildegard believed in viriditas — the greenness of living things and their ability to grow. Get the blocks out of the way, and a patient’s own viriditas would take over and he’d heal. Dr Sweet applies some of the premodern principles from von Bingen’s healing framework to her patients, most memorably one with the worst bedsore she had ever seen that went all the way to the patient’s spine. The results are well-nigh miraculous.
3) Dr Sweet describes in great detail and without spite the encroachment of modern medicine with its “efficiencies” into the cozy, personable and strangely effective ways of Laguna Honda, even though there is much to provoke the reader’s dismay. The personal, health and financial consequences of cost-cutting, both on patients and staff, turn out to be much higher than the dollars that those measures purport to save. It’s a cautionary tale about what medicine can be vs. what it has become, and should be required reading for every medical student.
4) And most of all, the stories of the patients. Laguna Honda being a hospital for the care of the indigent – the last almshouse in the US – its patients are people that the good life left behind. The poor, the mentally ill, the unlucky, those with nowhere else to go: these are the patients that Laguna Honda treats equally and without prejudice. Sometimes the patient goes to the brink of death, the ‘anima’ already halfway in ascent, and turns back. Other times, the patients make miraculous recoveries only to succumb to alcohol or neglect once discharged. These case histories are at once invigorating, enlightening, infuriating and heartbreaking. They are the human heart of the book.
This may also be a book the likes of which will never get written again. Why? Because nobody has the luxury of observing a patient over weeks, months and years as that patient’s debilitating bedsore, cirrhosis or dementia heals millimeter by millimeter. There are few structures in the US that support that kind of patient care. This is a book about slow medicine, which is rapidly going out of fashion these days.
One of the side effects of reading any book is to become partially imbued with the spirit of its author. Reading God’s Hotel, you get a sense that Dr Victoria Sweet is a deeply thoughtful and compassionate person, and one of the very best kind of caregivers one could hope to have. As a result, this book will not only delight and instruct you, but is also likely to leave you a better human being.
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Written by Ali Binazir MD MPhil on 7 December 2012
, God's Hotel
, Hildegard von Bingen
, medical education
, modern medicine
, the four humours
, Victoria Sweet