God’s Hotel by Victoria Sweet
Review by Barbara Shorrock
Have you ever wondered how health care worked before the dawn of modern medicine with its antibiotics and intravenous procedures and levels of specialists with computers and advanced technology? Suppose you had the chance to compare how medical care is conducted today with how it was managed in the middle ages?
For 20 years, Dr. Victoria Sweet M.D. found herself working at Laguna Honda in San Francisco, the last of the American almshouses, created to treat the “sick poor”. Also known as God’s Hotel, it was a kind of shelter, halfway house, rehabilitation centre, hospital for the chronically ill, farm, and greenhouse. Having read a book written in the twelfth century by Hildegard of Bingen, a nun, theologian, and medical practitioner, Sweet had the opportunity to compare Laguna Honda’s “slow medicine” with the “fast medicine” practiced in the current acute care hospitals in the USA. Out of this experience came a fascinating book, God’s Hotel, which chronicles her experiences and study of the differences between medicine then and now.
Imagine an institution with almost 1800 patients, some who recover and go home, some who will live out the balance of their lives here. Everyone has been discharged from a modern acute care hospital to complete treatment in this place. Imagine open wards with 30 beds, each with a window that opens, a solarium at the end of the ward, all visible to the head nurse presiding over the entrance, and doctors who visit each patient daily or more frequently. Imagine, if you can, a doctor who has no time constraints, who can spend hours taking your history and exploring your condition, observing your body and listening to your story in the interest of giving you the most appropriate care. Perhaps she determines that your original diagnosis was in error, and your treatment will be for something else entirely, because she has had the time to consider other possibilities.
Victoria Sweet takes us through her two decades of service in this place, as well as her study of the medieval manuscript and subsequent PhD, telling us of patients who taught her how to practice medicine at Laguna Honda/God’s Hotel. These patients each taught her something she did not know before meeting them, and she shares these stories with the reader.
Time stands still for no one, however, and the old almshouse form of treatment ultimately has to morph itself into modern health care. New budgets involve more administration and less nursing staff; studies by management companies result in changes ruled more by insurance companies than caring doctors. Yes, studies are done and reports created without interviewing either patients, nurses, or doctors. New laws give psychiatric patients the right to refuse medications with often unfortunate consequences. Step by step the original buildings are replaced by modern ones, along with modern techniques and procedures. Some of this is good and appropriate, of course, but along the way, most of the older methods of treatment are discarded for more economical modern ways. Dr. Sweet regrets many of the changes, as do we, the readers. Once progress is set in place, however, there is no going back.
If you appreciate a historical perspective on the nature of medicine in our time, and relish a peek into the lives of her patients at Laguna Honda, you will like God’s Hotel by Victoria Sweet.
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