From Chris Garland
Author: Victoria Sweet
Title: God’s hotel : a doctor, a hospital, and a pilgrimage to the heart of medicine
Victoria Sweet chronicles her experience as a physician at San Francisco’s Laguna Honda Hospital which is cited as the last almshouse in the U.S. The almshouse was a place of refuge, housing people who were chronically ill or impoverished with no place else to go. Many times Dr. Sweet’s patients would come to Laguna Honda with an incorrect diagnosis from the county hospital, because the patients were not carefully examined. These diagnoses would lead to bad treatment and the patients getting sicker. Dr. Sweet asserts that modern medical treatment relies too much on tests, x-rays and less on the doctor’s physical examination of the patient. The reason is money. Doctors are paid by the amount of patients they see, so examinations must be quick to maintain financial viability. As a result, efficiency and managing disease are stressed over treatment that is more hands on with the doctor. Working at Laguna Honda, Dr. Sweet had the luxury to practice what she calls slow medicine which is just taking the time to talk to and examine and even re-examine a patient; to consult other doctors, to go over lab tests and X-rays, to think about a diagnosis, to discontinue medications that are no longer needed, and to try a new medication—but carefully. Dr. Sweet feels that slow medicine is efficient because it’s about restoring health not managing disease, and saves money. The current fast medicine practiced in the U.S. is very expensive and the outcomes for patients are worse.
The author discusses how her studies of ancient medicine influenced her work, specifically the twelfth-century mystic and nun Hildegarde of Bingen who wrote a practical medical text. Sweet even applied some of Hildegarde’s methods to her patients when she ran out of modern medical tools. She would say to herself “What would Hildegarde do?” To the best of her ability, she would consult Hildegarde’s texts and apply the treatment to her patients, and for the most part she had positive results. Dr. Sweet beautifully highlights how the Laguna Honda almshouse gave her the opportunity to learn about ancient and modern medicine, and ideas to improve healthcare.