Book Review: God's Hotel

I got several recommendations to read Victoria Sweet's nonfiction book, God's Hotel. An anesthesiologist who does creative writing and a resident in internal medicine both recently read this book and told me about it. When I looked at the jacket description, I knew why. Victoria Sweet explores the fascinating history and modern reimagination of one of the oldest institutions in San Francisco, Laguna Honda Hospital. For Bay Area physicians, it's especially personal because we've often sent patients to and received patients from Laguna Honda. Initially an almshouse, Laguna Honda inherited the role of caring for the poor and indigent of San Francisco, those who have nowhere else to go. It plays a critical role in the health care safety net of the city, a place for rehabilitation, AIDS patients, dementia, and chronic illness. Victoria Sweet paints a vivid picture of its history and occupants and describes its rocky recent history as budget cuts, increased regulations, and political powerplays threaten its existence. This, too, is relevant to me because when I was a medical student, I heard a lot about the various propositions regarding Laguna Honda. I drove past it regularly, but never investigated its character - its beautiful landscape, historic architecture, and unusual throwbacks to the past.

Along with describing the history of an institution, Victoria Sweet writes about her growth as a physician, interesting patient cases, and opinions on modern medicine. As a blogger who enjoys writing clinical vignettes, I liked reading her patient encounters, fun diagnoses, and descriptions of complex medical phenomena; she does a great job making it accessible to the lay public. I also agree a lot with her commentary on what's important in medicine. Although the book does not primarily seek to change the way medicine is practiced, she makes a case for returning medicine to its roots. She describes the growth of bureaucracy, regulation of medicine, influence of lawsuits, and tightening budgets affecting health care. I was shocked to learn how much administrators, politicians, and bureaucrats interfere with the delivery of medicine at Laguna Honda. I got a glimpse into the community, charity, and values of medicine of a by-gone era.

Lastly, Victoria Sweet weaves in her own personal interest, a journey into understanding medieval history of medicine. She describes tenants of pre-modern medicine such as how to treat the evil humors. She writes about her studies, sabbaticals, and pilgrimages to understand history of medicine. Though this was least interesting to me, it gave me appreciation of the many facets of our profession. Overall, God's Hotel was an enjoyable nonfiction book with a lot of relevance for a Bay Area doctor. Of the many books out there written by physicians, I thought this was one of the more unique and worthwhile.

Image from victoriasweet.com, shown under Fair Use.