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

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' is such a book. [A hat-tip to Jesse Kornbluth of Head Butler for introducing me to it.] There were many reasons I enjoyed the book, which is really many books at once: -- 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. -- Dr Sweet interweaves the account of her doctoral research on Hildegard von Bingen in the story. 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. Dr Sweet applies some of the premodern principles from von Bingen's healing framework to her patients, with encouraging results. -- 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. -- 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. 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. -- Ali Binazir, M.D., M.Phil., author of [...], the highest-rated dating self-help book on Amazon

In the late 80's and early 90's I used to take the bus to visit a good friend and we'd pass Laguna Honda. A co-worker's grandmother was recuperating from a stroke at one point during this time and I was awed by what I could see of the grounds and there was something comforting about the old buildings. A lot has happened since then and San Francisco is no longer home but two years ago I immediately bought the Kindle edition and promptly forgot it for two years. Earlier this year I downloaded it and was immediately immersed in medieval medicine and Dr. Sweet's exploration of slow medicine. Before finishing the second or third chapter I decided to buy the Audible unabridged version, thinking this would be enjoyable to listen to. Imagine my delight upon discovering the reader is none other than Victoria Sweet herself. She's not a professional reader polished by experience but so compelling are the stories she has to tell that no one else could bring them to life better than she. Her often candid but always respectful descriptions of co-workers, superiors and above all, her patients, their triumphs and failures, their life histories - all are recounted by the woman who has first hand knowledge of it all. Even the most roguish patient, the most unfortunate stories of mental illness compounded by physical infirmity are introduced and discussed with compassion and a subtle humor. I thoroughly enjoyed hearing her stories of her pilgrimage - an act of devotion undertaken in stages. Each segment was completed annually during vacation or leave and we are right there with her and her travel partner (if only we could all choose travel buddies as perfect as hers sounded). Having undertaken Buddhist pilgrimages I can truly relate to her happiness suffusing what would normally be considered miserable in everyday settings. One understands her faith is important to her but as she recounts the pilgrimage adventures there is no mention of religious dogma. Here is a person who quietly and without fanfare lives her beliefs and to this reviewer, embodies what one teacher terms an "undercover bodhisattva". This is a book to savor slowly or gobble up in a few sleepless nights. It's a homage to the practice of medicine of the past, a candid look at today's managed health "care", a most interesting and evenhanded look at political maneuvering and still I was left with the impression that slow medicine will once again find its way back into the mainstream - perhaps our great grandchildren will demand it.

Fascinating. At first, I thought I would not get into it .... I am squeamish ... sigh ... but I carried on, and I am so very, very glad I did. The author's knowledge, perceptions, etc., re modern medicine are interesting. I really like this gal, and would love it if she were my doc. She produced a very entertaining and informative read, however, the book needed good editing. There were the occasional redundancies ... she would start a paragraph with a statement, follow it up with the background to support her original statement, and then finish the paragraph stating exactly what she had said at the beginning of the paragraph. Also, the book included many incomplete sentences. Although none of this detracted from her basic message, for me, it did detract from the work in its entirety. I kept going back to say, "Huh, didn't she just say that? Huh, didn't she just say that in an incomplete sentence?" Minor quibbles, for sure, but then why should I have had to quibble at all? I do not have an English degree, but these things definitely jumped out at me. In any event, it was a good read, provides much food for thought, and I do recommended it.

This is how we are drawn to read books. On a recent trip to San Francisco, sitting at the Forest Park bus station, I gazed across the street and asked my friend what kind of hospital is Laguna Honda, that pinkish Spanish looking hacienda style building across the street. Oh, my friend said, my friend "Barbara", was a nurse and retired from there....and I am told there is actually a book written about the hospital. Later in my visit I met Barbara and listened to her story, which in turn led to me downloading "God's Hotel". Having worked in Medicine in my career, possessing an interest in the meditative qualities of medieval music, and somewhat of a "pilgrim" in my approach to life I was quickly engaged with the book's story all the way to the end. "God's Hotel" is written by Victoria Sweet who we meet at the beginning of the book, a new MD clinician at the beginning of her career in medicine. She is drawn to work at Laguna Honda because of it's unusual status as one of the last free public hospitals for the chronically ill poor, a medieval alms house, in the world. It is patterned on the Hotel Dieu in Paris. However, practically it allowed Dr. Sweet to pursue a Ph.D in the History of Medicine by only requiring her to work in the Admitting Ward part-time. At the hospital she quickly becomes very engaged in caring for patients because the hospital's operating method allowed both physicians and nurses a great deal of freedom to pursue their healing art and science. At the same time, she finds a mentor for her Ph.D studies in pre-modern medicine with a doctor whose office is in one of the almost forgotten tower rooms. In the early chapters, "God's Hotel" juxtaposes Sweets increasing knowledge of pre-modern medicine through the study of the Benedictine Nun, Hildegard von Bingen and her treatment of patients. You, the reader may be familiar with her music! These first chapters lay out this medieval nun's understanding of the human body and what determines health and illness. Sweet frequently finds opportunities to examine her patients, understand their illness, and by applying Hildegard von Bingen's insights in pre-modern medicine. Lest you, the prospective reader of this book leap to the conclusion this is yet another book on homepathy, quack remedies, and the danger of vaccinations - it is not that. The main story in the book is the tension between Laguna Honda, as an Alms House, and it's progressive encounter with the pressures for modern, efficient health care delivery driven by insurers and hospital administrations. Sweet walks us through this encounter in a very personal way through the lives of her patients and her journey as a physician. Later in the book, she actually makes her thought and belief pilgrimage real by walking over fours years the famous St. Jean de Compostela pilgrimage route in France and Spain. If you work or study medicine, enjoy medieval music, and consider yourself a "pilgrim" in life......this book is for you.

I learned about God's Hotel from a blog by Dr. Danielle Ofri, one of my favorite medical essayists. She wrote the essay several days before the book was available and I got it as soon as I could order it and was definitely not disappointed. Dr. Sweet is an internist who was looking for a hospital in which she could work part time while pursuing graduate studies in the history of medicine. She found Laguna Honda hospital,probably the last almshouse in the country, caring for the castoffs of society in the way that medicine should be practiced....slowly, with attention to detail and individual caring for each patient. She speaks of her triumphs and tragedies and of what she has learned from her patients. I have often felt that as a physician, I have learned as much from my patients as I have given them. I went to medical school in the Midwest at a time when you could still give that care that Dr. Sweet discusses. A place not unlike hers, in a building that was about a hundred years old with the occasional bat flying down the corridor on the top floors. I learned as she has, the incredible healing power that sitting with the patient and listening to concerns, fears, nuances of tone and voice could not only help healing but lead to the correct diagnosis. I expected somewhat of a slow read but was delighted to find that her book is a page turner and written in an easy,lighthearted way but very authoritatively. A great book and experience.

Wow. This gives a whole different view of medical practice. If I could, I'd give this book 10 stars! One of the best I've read in a long time. Victoria is passionate about this "slower" way of caring for sick people and also explains her theories. But it's so much more than a theory book. She gives so many real stories of the people she has cared for in this way, and their recovery (or not). It's genuine and heart-warming. At the end it makes you sad to see the transition from old to new because she has won your heart about how effective the "old" way is. I wish there were still some "God's Hotels" in America where people could be healed not just medically, but also healed in their whole body and mind because they have a community of care around them, a family. And that doctors would truly be allowed the extra time it takes to truly listen to their patients amidst the myriad of things they must do to meet regulations. I myself have had a few doctors who lean toward this way of doctoring, and I've been truly grateful for them because they took time to listen to me. Wonderful book.

God's Hotel is about a physician's early experiences with a hospital that provided true patient care and the effort over a number of years and administrators to make it into a modern hospital with political and budgetary constraints. The resulting hospital ended up being designed by accountants and media engineers with little regard for patient care. I understand that physicians have little power to change the direction that health care is heading, but she didn't seem to make any effort at all. Instead she spends years on earning a PhD in medieval medicine including Latin (along with lots of references to roots of words and language differences), and going on a yearly `pilgrimage` in Europe (meanwhile being a doctor part-time). She tries to make the point that ancient medical practices (be more alert to body functions than relying just on expensive test results) have value to a modern physician and cites a few cases where it helped her with diagnosis. Maybe so, but I suspect she is smart enough and compassionate enough and thorough enough that she could have gotten just as far without that knowledge, seems like common sense. It seems to me that she could have done a whole lot more for her patients by spending more time with the patients(rather than working on PhD). The cases that she cites in the book are very interesting, she could have had many more interesting tales to tell, and I would have enjoyed the book much more. I enjoyed most of book, but since I am not a physician I found the medieval medicine and Latin references tedious and uninteresting. The references to her pilgrimages were kept short but I don't see a relevance to the hospital. I guess that the purpose of writing the book was to show how thinking `out of the box' and slowing the diagnoses time can save lives. I suppose that it is possible that she saved a few lives because of her exposure to a time when medical knowledge was limited and the physician was forced to work with nature. Maybe in her next book we will read how she improved health care or will improve health care for the future, taking into account the disastrous financial problems that are growing daily.

I loved this book. I recommend it highly to anyone who will listen. I originally got it at the library, but loved it so much that I bought 2 copies to lend out to friends. The author has a way of laying out just what has happened to the practice of medicine over the past decade or more ... with the advent of "managed care." The politics of that are presented in the context of the overarching story of one hospital, or alms house, in such a way that you feel the loss and the consequences of this "care." At the same time, she presents the stories of many patients, drawing you in, making you care about the people. Having worked in "behavioral health" in a hospital myself, having seen much of the kind of thing the author describes, I especially appreciated the way she wove in her pilgrimage along the Way of St. James in Spain. It helped to remind me that underlying all of the chaos and human suffering and bottom line thinking of those controlling and profiting from our current health care system, there is a slow and constant provision of true care and love by the individuals on the front lines, and we are in the flow, if we only stop to become aware of it.

Today's society norm of taking care of its sick poor originates from the time when monks in the Benedictine era (600 A.D.) were charged to put this duty above all other duties. The Hôtel-Dieu Hospital, regarded as the oldest hospital in the city of Paris, France, was founded by monks in the seventh century. Eventually nuns had sole charge of their patients and only invited physicians in occasionally for difficult patients! This was the time of pre-modern medicine when the world was still understood in Greek terms to consist of four elements, earth, water, air and fire and the body consisted of four humors black bile, yellow bile, blood and phlegm. Everything had to be in balance and the remedy for illness was to correct that balance using diet, bleeding, herbal medicines & changes to climate. The interpretation became known as the "System of Fours" and is all very strange to us. Dr. Victoria Sweet is a contemporary American doctor who developed an interest in pre-modern medicine. In her remarkable book called God's Hotel published in 2012, she gives a riveting account of her practice at Laguna Honda Hospital in San Francisco whilst studying the work of Hildegard of Bingen, who practiced the old art of medieval medicine. Laguna Honda Hospital is reputedly the oldest "almshouse" (charitable institution for the poor) in America. It was built in 1866 and was based on the "Hôtel-Dieu" principle, that of seeking to relieve pain of one who does not deserve. Its role was particularly significant during a smallpox epidemic in 1868 and in the earthquake and fire of 1908. In the 20 years that Dr Sweet spent in the original hospital building, she cared for patients not covered by insurance including complex medical cases, failed surgical cases, terminally ill patients, revolving door patients (repeatedly being readmitted), drug addicts, alcoholics and the street sleepers. With "progress" in such matters as health economics, privacy laws, disability rights and the march against institutional care the hospital came under one expensive investigation after another. Hildegard (1098 to 1179 A.D.) of Bingen, Germany was a truly remarkable woman. Not only a devout nun, she was a composer, author, theologian, lexicographer (wrote a dictionary) and expert in pre-modern medicine. She advocated such things as a good diet, quietness, sex, liquids (deep sleep), fresh air and sunlight. She was well known for her healing powers using tinctures, herbs, and precious stones. As a result of the enlightenment and the scientific revolution that followed in the 18th century the system of fours that had been around for centuries was finally & totally discredited. We now know that the body is not healthy through a balance of four humors but by respecting its remarkable composition of living cells. But the question that arose in Dr Sweet's mind was whether or not one could learn anything from Hildegard's practice. Could Hildegard's approach to the patient be usefully applied to any of Dr Sweet's patients in Laguna Honda Hospital? God's Hotel is a gripping book and a must read for all health care and allied professionals. In the light of the NHS scandal at the Mid Staffordshire Hospital and the subsequent report by Robert Francis QC, it is also a must read for politicians and NHS Managers! It is also a good read for anyone who is interested in getting back the balance in their troubled lives through societal issues or sickness.

Although the use of language was quite good and some stories were interesting, this book is nothing more than a simple diary of a doctor. Most importantly even it lacks the emotions that should exist in a diary.

A beautiful book for nurses, doctors, healthcare professionals, and patients alike. One of the best books I have read in a long time. Victoria Sweet sucks you in; you become part of her world in the hospital, and can see everything she describes. It is a moving, compelling, and wonderfully human read. It is also pretty heart-breaking to read about the bureaucratic nonsense that governs healthcare and that ultimately wins out because, as we all know, money usually does. She gets to the heart of it all, and she does it with such poise and grace in her writing and interpretation of situations and encounters that both makes me happy that she is a Physician, and sad that there aren't more like her. I am so happy Dr. Sweet wrote this book; it is so accessible. She writes with understanding and compassion, and as someone who seems to *get* it, rationally and realistically speaking. She describes so perfectly one of the fundamental problems of north american healthcare: lack of time. Taking away time destroys the ability to give optimal healthcare, and she captures this perfectly. As Dr. Sweet finds herself doing with Hildegard of Bingen, I now find myself thinking, "hmmm...what would Dr. Sweet do?" - which tells me that this book really impacted me and my nursing practice!

Una profesional de la medicina plenamente cualificada cuestiona los criterios de eficiencia y eficacia al uso en los sistemas sanitarios occidentales, desde su experiencia de largos años en una institución "benéfica" más allá de la primera acepción del término. El estilo narrativo es el relato sencillo, directo y ameno, pero también plagado de opiniones y reflexiones. Debería traducirse.

Really enjoyed this memoir of a Dr’s personal and professional journey. It’s so refreshing to hear from someone who has wrestled through what works and doesn’t with both modern and pre-modern methods and ideologies. A reminder that progress doesn’t have to throw out the baby with the bath water as far as what has worked before. I believe we are coming to realize as a society that maybe industrialism and efficiency have taken as much as they have given. (Some reviews had issue with her using patient and colleague names in the book - she does make a note that all the names she used were pseudonyms. It’s important to read the whole book!).