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

by Victoria Sweet

Overview

Victoria Sweet's new book, SLOW MEDICINE, is on sale now!

For readers of Paul Kalanithi’s When Breath Becomes Air, a medical “page-turner” that traces one doctor’s “remarkable journey to the essence of medicine” (The San Francisco Chronicle). 

San Francisco’s Laguna Honda Hospital is the last almshouse in the country, a descendant of the Hôtel-Dieu (God’s hotel) that cared for the sick in the Middle Ages. Ballet dancers and rock musicians, professors and thieves—“anyone who had fallen, or, often, leapt, onto hard times” and needed extended medical care—ended up here. So did Victoria Sweet, who came for two months and stayed for twenty years.
     Laguna Honda, relatively low-tech but human-paced, gave Sweet the opportunity to practice a kind of attentive medicine that has almost vanished. Gradually, the place transformed the way she understood her work. Alongside the modern view of the body as a machine to be fixed, her extraordinary patients evoked an older idea, of the body as a garden to be tended. God’s Hotel tells their story and the story of the hospital itself, which, as efficiency experts, politicians, and architects descended, determined to turn it into a modern “health care facility,” revealed its own surprising truths about the essence, cost, and value of caring for the body and the soul.

Product Details

ISBN-13:	9781594486548
Publisher:	Penguin Publishing Group
Publication date:	04/02/2013
Pages:	432
Sales rank:	92,967
Product dimensions:	5.40(w) x 8.10(h) x 0.60(d)
Age Range:	18 Years

About the Author

Victoria Sweet has been a physician at San Francisco’s Laguna Honda Hospital for more than twenty years. An associate clinical professor of medicine at the University of California, San Francisco, she is also a prize-winning historian with a Ph.D. in history and social medicine.

Table of Contents

Introduction. How I Came To God's Hotel 1

1 First Years 11

2 The Love of Her Life 34

3 The Visit of Dee and Tee, Health-Care Efficiency Experts 56

4 The Miraculous Healing of Terry Becker 77

5 Slow Medicine 103

6 Dr. Diet, Dr. Quiet, and Dr. Merryman 130

7 Dancing to the Tune of Glenn Miller 157

8 Wedding at Cana 188

9 How I Fell in Love 220

10 It's a Wonderful Country 251

11 Recalled to Life 281

12 The Spirit of God's Hotel 314

Acknowledgments 349

Notes 351

What People are Saying About This

Oliver Sacks

Victoria Sweet writes beautifully about the enormous richness of life at Laguna Honda .. and the intense sense of place and community that binds patients and staff there. Such community in the medical world is vanishingly rare now, and Laguna Honda may be the last of its kind. ... God's Hotel is a most important book. ... It should be required reading for anyone interested in the "business" of health care—and especially those interested in the humanity of health care. (Oliver Sacks, author of The Man Who Mistook His Wife for a Hat and The Mind's Eye)

Jerome Groopman

This is a unique book about a healer and those in need of her healing. Charting her journey in God's Hotel, Victoria Sweet shows us that medicine is still fundamentally a sacred calling. By illuminating this truth, Sweet provides comfort and inspiration. (Jerome Groopman, M.D., Recanati Professor, Harvard Medical School, co-author of How Doctors Think and Your Medical Mind)

Rachel Naomi Remen

Victoria Sweet is a master storyteller and a consummate physician. Her beautifully written stories from the frontline of health care document the struggle of all modern-day healers, to hold fast to the immortal soul of Medicine despite the pressures of economics, the self-interest of politics, and the reductionism of science. God's Hotel reminds us of the fundamental truth that medicine is and has always been an act of love and brotherhood ... and of the vulnerabilities we share and the compassion we aspire to. (Rachel Naomi Remen, MD, author of Kitchen Table Wisdom and My Grandfather's Blessings)

Julie Salamon

A profoundly moving account of a remarkable hospital and the people who inhabit it, God's Hotel reveals intimate knowledge of the shift in modern medicine, from personal tending to industrialized 'health care.' Author and physician Victoria Sweet embodies the traits of a persevering and compassionate doctor, while conveying the wisdom of a philosopher, and the instincts of a born storyteller. (Julie Salamon, author of Hospital and Wendy and the Lost Boys)

From the Publisher

A Barnes & Noble and San Francisco Chronicle Best Nonfiction Book of 2012

“Transcendent… readable chapters go down like restorative sips of cool water, and its hard-core subversion cheers like a shot of gin… God’s Hotel [is] a tour de force… Others have written about the relationship between time and medical care with similar eloquence and urgency, but the centuries of perspective that Dr. Sweet brings infuse the point with unforgettable clarity.” –The New York Times

“A radical and inspiring alternative vision of caring for the sick.” –Vanity Fair

“Engaging… You might not expect a book about San Francisco's most downtrodden patients to be a page-turner, but it is. With its colorful cast of characters battling the tide of history, God's Hotel is a remarkable journey into the essence of medicine.” –San Francisco Chronicle

"Victoria Sweet writes beautifully about the enormous richness of life at Laguna Honda, the chronic [care] hospital where she has spent the last twenty years, and the intense sense of place and community that binds patients and staff there. Such community in the medical world is vanishingly rare now, and Laguna Honda may be the last of its kind… God's Hotel is a most important book which raises fundamental questions about the nature of medicine in our time. It should be required reading for anyone interested in the 'business' of healthcare – and especially those interested in the humanity of healthcare." –Oliver Sacks, M.D. author of The Man Who Mistook His Wife for a Hat and The Mind's Eye

“A beautifully written and illuminating book… [Sweet’s] metaphors are poetic and hint at the mystical, but then she pulls back with the educated eye of a scientist… For both the agnostic and the believer, Sweet pinpoints the element of medicine that makes it a calling rather than a job: the unique and sustaining love that is sparked between a doctor and patient.” –Jerome Groopman, The New York Review of Books

"Remarkable… [Sweet] would appreciate that it took time for me to journey to and through her work since that may be one of the many compelling messages she so eloquently, yet simply by storytelling, conveys… permitting ‘tincture of time’ to also do its job." –The Huffington Post

"Sweet's warm, anecdotal style shines… The author's compelling argument for Laguna Honda's philosophy of 'slow medicine' will make readers contemplate if perhaps the body should be viewed more as a garden to be tended rather than a machine to be fixed." –Kirkus (reviewed as a Best Book of 2012)

“Captivating… with this humane and thoughtful work, Sweet joins physician-authors such as Oliver Sacks, Jerome Groopman and Abraham Verghese.” –The Dallas Morning News

“[A] watershed book ...Vital, exquisitely written, and spectacularly multidimensional, Sweet’s clinically exacting, psychologically discerning, practical, spiritual, and tenderly funny anecdotal chronicle steers the politicized debate over health care back to medicine and compassion. –Booklist (starred review)

“Visionary… thoroughly subversive in all the best ways… This book’s lessons and conclusions should challenge doctors, nurses, hospital administrators, and policy makers to stop and rethink their core beliefs.” –Journal of Health Affairs

“A remarkable, poignant portrait of a committed physician on a quest to understand the heart, as well as the art, of medicine… A marvelous, arresting read.” –Library Journal (starred review)

“[Our] healthcare system might function a lot better if every single American citizen, healthcare professional, politician and legislator would read Victoria Sweet’s insightful, beautifully written and moving book.” –Bookpage

Reading Group Guide

INTRODUCTION

More than twenty years ago, Dr. Victoria Sweet arrived at San Francisco's Laguna Honda Hospital, intending to stay for a brief time. A descendant of the Hôtel-Dieu (God's Hotel) that cared for the sick poor in the Middle Ages, Laguna Honda was the last almshouse in the country. Ballet dancers and rock musicians, professors and thieves-"anyone who had fallen, or, often, leapt onto hard times" and needed extended medical care-ended up there.

At Laguna Honda, lower-tech but human-paced, Sweet had the opportunity to practice a kind of "slow medicine" that has almost vanished, and falling under the hospital's spell, she decided to stay. Gradually, her remarkable patients transformed the way she understood medicine. Alongside the modern view of the body as a machine to be repaired, they evoked an older idea, of the body as a garden to be tended. God's Hotel is their story, and the story of the hospital itself, which-as efficiency experts, politicians, and architects descended, determined to turn it into a modern "health care facility"-revealed its own surprising truths about the essence, cost, and value of caring for body and soul.

 

ABOUT VICTORIA SWEET

A member of the medical staff at Laguna Honda Hospital in San Francisco for more than twenty years, Victoria Sweet is an Associate Clinical Professor of Medicine at the University of California, San Francisco, and a prize-winning historian with a Ph.D. in history and social medicine. God's Hotel has been praised by Oliver Sacks, Jerome Groopman, and numerous other medical authorities; has won numerous awards; and has deemed "hard-core subversion" (The New York Times), "radical and inspiring" (Vanity Fair) and "subversive in all the best ways" (Health Affairs).

 

DISCUSSION QUESTIONS

Throughout the book, Victoria Sweet talks about what she learns from her patients. How do their stories inform the author's vision of her profession?

With whom did you identify more as you read her account, the patients or the nurses and doctors? Why?

In many ways the workings of Laguna Honda go against modern medical culture and standards. Can you find parallels in your own life, in which you have had experiences that ran counter to the norm or to your own expectations? How did you respond?

In what ways does Dr. Sweet criticize modern medical practice? Are there ways in which her critique is applicable to society in general?

Sweet invokes two metaphors for the practice of medicine: the contemporary one, of a mechanic repairing a broken machine; and an older, "premodern" one, of a gardener tending a garden. What are the strengths and limitations of each? Which do you gravitate to, and why?

What is "slow medicine"? Have you had any experiences of a "slow medicine" approach in your own life? Have you experienced parallel "slow" approaches in other endeavors of which you have been a part?

What does Sweet mean by "the efficiency of inefficiency"? Have you encountered this phenomenon in your own life? Where and when?

A major theme that runs through the book is that of community. How is community created? Who creates it? How is it sustained? What parallels can you envision between a hospital and other settings-a school, a college, a corporate workplace?

Another major theme that runs through the book is hospitality. What does hospitality mean in the context of the book? How might this translate from a hospital setting to other settings?

Dr. Sweet makes a pilgrimage to Santiago de Compostela in Spain. How does this pilgrimage play out in her life? What role does discernment play in her life? What role does it play in yours?

Editorial Reviews

PRAISE FOR GOD'S HOTEL

“Transcendent… readable chapters go down like restorative sips of cool water, and its hard-core subversion cheers like a shot of gin… God’s Hotel [is] a tour de force… Others have written about the relationship between time and medical care with similar eloquence and urgency, but the centuries of perspective that Dr. Sweet brings infuse the point with unforgettable clarity.” –The New York Times

“A radical and inspiring alternative vision of caring for the sick.” –Vanity Fair 

 “Engaging… You might not expect a book about San Francisco's most downtrodden patients to be a page-turner, but it is. With its colorful cast of characters battling the tide of history, God's Hotel is a remarkable journey into the essence of medicine.” –San Francisco Chronicle 

"Victoria Sweet writes beautifully about the enormous richness of life at Laguna Honda, the chronic [care] hospital where she has spent the last twenty years, and the intense sense of place and community that binds patients and staff there. Such community in the medical world is vanishingly rare now, and Laguna Honda may be the last of its kind… God's Hotel is a most important book which raises fundamental questions about the nature of medicine in our time. It should be required reading for anyone interested in the 'business' of healthcare – and especially those interested in the humanity of healthcare." –Oliver Sacks, M.D. author of The Man Who Mistook His Wife for a Hat and The Mind's Eye 

“Victoria Sweet has written the best non-fiction book I've read this year… The qualities that make her a great doctor are the same qualities that make her book so powerful, original and relevant… For a very long time, a gang of renegades got away with practicing medicine the way it should be: sitting with patients, watching, listening, often doing nothing more than being present. And then Victoria Sweet, a candidate for sainthood, wrote a book that is a beacon in the darkness.” –Jesse Kornbluth, Huffington Post

“A beautifully written and illuminating book… [Sweet’s] metaphors are poetic and hint at the mystical, but then she pulls back with the educated eye of a scientist… For both the agnostic and the believer, Sweet pinpoints the element of medicine that makes it a calling rather than a job: the unique and sustaining love that is sparked between a doctor and patient.” –Jerome Groopman, The New York Review of Books 

"Remarkable… [Sweet] would appreciate that it took time for me to journey to and through her work since that may be one of the many compelling messages she so eloquently, yet simply by storytelling, conveys… permitting ‘tincture of time’ to also do its job." –The Huffington Post

“Sweet writes fluidly and well… She weaves a fascinating account of the historical forces that transformed our view of the body… It's high time that someone gets medieval on modern medicine's morass, and Victoria Sweet is just the woman to do it.” –Cleveland Plain Dealer

“Captivating… with this humane and thoughtful work, Sweet joins physician-authors such as Oliver Sacks, Jerome Groopman and Abraham Verghese.” –The Dallas Morning News

“Sweet’s tone in God’s Hotel nicely matches her subject. Her writing has a lovely, antique quality… This hospital, with its chronically ill patients, crumbling buildings, and never-ending budget woes, was 'a gift.' In this beautiful and unique book, she shares that gift with us generously.” –The Boston Globe

"Intelligent and moving… In this often lyrical book, Dr. Sweet reveals a deep spirituality and unsentimental compassion." –Minneapolis Star-Tribune

"Sweet paints a dynamic portrait… [which] is at its core testimonial to the body’s remarkable ability to heal when it is provided with the simple ingredients of time and care." –Utne Reader 

“Visionary… thoroughly subversive in all the best ways… Sweet proposes ways that we might reimagine our way forward by looking into the distant past… This book’s lessons and conclusions should challenge doctors, nurses, hospital administrators, and policy makers to stop and rethink their core beliefs.” –Journal of Health Affairs

"Containing no medical jargon… nothing too gory or gut-wrenching; just descriptive stories of patients, unusual treatments, a hospital in transition, and a doctor on a journey, learning to practice 'a beautiful art.'" –East Bay Express 

"By braiding… historical searches with her time at Laguna Honda, [Sweet] arrives at a compelling critique of modernized health care and a vision for transforming it." –Books & Culture

“[Our] healthcare system might function a lot better if every single American citizen, healthcare professional, politician and legislator would read Victoria Sweet’s insightful, beautifully written and moving book.” –Bookpage 

From the Publisher

Medical doctor Sweet's search for a position that would allow her to practice while earning a doctorate in the history of medicine brought her to Laguna Honda Hospital in San Francisco, the last almshouse for the poor and chronically disabled in America. "Old-fashioned and plain," dilapidated and imperiled, its six spacious, many-windowed wings housing 1,178 patients were surrounded by 60 acres on a hilltop with an ocean view. Here Sweet came to profoundly appreciate and learn from resilient patients who survived poverty, addiction, abuse, and severe maladies. She also immersed herself in the writings of the brilliant twelfth-century German mystic and medical practitioner Hildegard of Bingen, conducting extensive research in Europe, and making the famous medieval pilgrimage to Santiago de Compostela. Sweet's diverse experiences engendered her commitment to what she calls "slow medicine." Meanwhile, Laguna Honda came under siege, threatened first with burdensome bureaucracy, then with closure. But voter support led, instead, to a new building. Sweet's watershed book ambushes and transforms you with its visionary middle way between the irreplaceable skills of doctors and the benefits of holistic medical knowledge and twenty-first-century technology and standards. Vital, exquisitely written, and spectacularly multidimensional, Sweet's clinically exacting, psychologically discerning, practical, spiritual, and tenderly funny anecdotal chronicle steers the politicized debate over health care back to medicine and compassion. — Donna Seaman

Booklist

This is a remarkable, poignant portrait of a committed physician on a quest to understand the heart, as well as the art, of medicine. Laguna Honda Hospital, the last remaining almshouse in the United States—a therapeutic community that houses and cares for the chronically ill or impoverished—offers veteran physician Sweet (clinical medicine, Univ. of California, San Francisco) a unique education in ministering to the body, heart, and soul. Her experiences there inspired her to study medieval physician, poet, and abbess Hildegard of Bingen's alternative approach to medicine of advocating that the human body be nurtured like a garden. Ultimately, Sweet embraced the notion and practice of slow medicine, an approach at odds with the contemporary rush for efficiency, a misguided trend to which even Laguna Honda eventually succumbs. VERDICT A marvelous, arresting read for anyone interested in medical practice. Of particular appeal to aficionados of spiritual medical narratives such as Tracy Kidder's Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World. [See Prepub Alert, 9/29/11.]—Lynne F. Maxwell, Villanova Univ. Sch. of Law Lib., PA

Library Journal

The "slow medicine" ideals of twelfth-century Benedictine nun Hildegaard don't get much attention in modern hospitals. However, Victoria Sweet finds they help in her work at San Francisco's alms house, the last in the nation. Her stories about patients are evenhanded; one about a homeless man who eats coins is followed by one of how a defiant wife ended up being treated as a mental case. Her caring is always evident as she narrates her own book, and her reading is gripping. Sweet's account of how a bureaucratic type became involved in the hospital's life is as mischievous as it is heartfelt. Even dry information is conveyed in engaging style. J.A.S. © AudioFile 2013, Portland, Maine

JULY 2013 - AudioFile

A doctor's experiences in a unique corner of the medical world. At Laguna Honda Hospital in San Francisco, the doctors and nurses provide long-term care for the sick poor; the working and living environments are unlike that of any other hospital in the country. Physician Sweet accepted a job at Laguna Honda because they were willing to offer her a part-time position (extremely rare at the time), and she was interested in continuing to practice medicine while simultaneously pursuing a doctorate in the history of medicine. The author had come to realize that modern medicine did not mesh with her idea of being a physician, and she sought answers in the teachings of Hildegard of Bingen, a German nun who practiced medicine in the Middle Ages and who had, miraculously, penned a medical textbook. Laguna Honda turned out to be the perfect place to put many of Hildegard's ancient theories into practice. What was originally supposed to be a months-long stopover turned into a career spanning more than 20 years and countless life-altering realizations about the nature of medicine. Sweet writes of Laguna Honda with unguarded affection, but she doesn't gloss over the negative phases. She is remarkably honest about the darker side of her experiences at the hospital: the patients who couldn't be saved, patients whose bad behavior was openly tolerated (smoking, drinking, gambling, etc.), the political infighting among the staff and bad managerial decisions. In the dozen or so patient success stories, Sweet's warm, anecdotal style shines brightest. The author's compelling argument for Laguna Honda's philosophy of "slow medicine" will make readers contemplate if perhaps the body should be viewed more as a garden to be tended rather than a machine to be fixed.

Kirkus Reviews