Slow Medicine

One of my dearest friends sent me this book for Christmas.  I’m glad she did because I had never heard of it, and it’s not something I necessarily would have picked up in the store myself, but it was a fascinating read.

God’s Hotel is the story of one doctor’s journey and experience with the last American almshouse in San Francisco called Laguna Honda Hospital.  It’s also the story of some of her patients and the changing over from practicing “slow” medicine to providing “efficient health care”.  As she is working with the patients at the almshouse, she is also studying for a PhD in medical history, focused particularly on medieval nun and physician Hildegard of Bingen.  She also weaves into the stories details about a pilgrimage she took in Europe on the Camino de Santiago.

Almshouses were a very old tradition–a leftover from the Middle Ages, a sort of long-term hospital for the poor.  When Dr. Sweet first takes a job at Laguna Honda, she intends to only be there a couple months but ends up staying there for over twenty years, charmed by the hospital, the patients, the atmosphere, the hospitality of it.  (One point of the book has a discussion about the origin of the word hospitality, hospes in Latin.  “Roman hospitality was a kind of fair exchange. It was based on the idea that every host (hospes) was also a guest (hospes) somewhere else; that one’s identity as either host or guest was interchangeable.”)  Each chapter talks about the hospital in general but also about specific patients treated there, both good and bad stories about how they arrived, how they were treated, and sometimes how they came back again, but sometimes how they went away healed.  With each chapter, Dr. Sweet describes all that she learned in her medical practice as well with her medieval medicine studies.  She finds value in the ancient slow medicine of Hildegard, though she does not throw out the use of modern medical advances.  I tend to be a bit of an eye-roller when I hear about alternative medicine and anything that seems anti-scientific, but I appreciated that she just seemed to be exploring some of these ancient ideas without throwing out the modern medicine.  A lot of it seemed to be about carefully spending time with patients and not just glancing at charts and making medical decisions too quickly.  She’s not waving her hands over them and chanting or anything nutty like that (my apologies if you’re into some kind of New Age-y hand-waving medicine).

There is a lot of criticism of the commoditization of medicine–how “practicing medicine” is instead becoming “providing health care”–more of a business than about caring for individual patients.  I think that’s a valid criticism, and it is something I worry about as I take my own family to various physicians and facilities.  One of my sons has developmental delays and some related physical issues, which means we’ve seen a lot of specialists and done a lot of testing.  I know I’ll be thinking about the slow medicine described in this book next time we’re in a medical waiting room.

The book was a real eye-opener in many ways and I appreciated Dr. Sweet’s caring descriptions of patients who would often be dismissed by society, but it also could drag along so slowly in parts.  Also, as it’s one doctor’s viewpoint, I wondered about bias and how others would describe the same situation.  Overall, it is a valid critique of modern medicine as well as containing some thought-provoking case studies about interesting people.