God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine is a work of nonfiction by Dr. Victoria Sweet. Published in 2012 by Riverhead Books, this memoir is Dr. Sweet’s account of working at the Laguna Honda Hospital in San Francisco. The book received generally positive reviews upon publication for its insights into the true meaning of medical care, and it won the 2012 California Book Award for Nonfiction. Dr. Sweet is an Associate Clinical Professor of Medicine at the University of California.
Historically, the Laguna Honda Hospital served the poorest and neediest San Franciscans from the late 19th century onwards. It’s now renowned as one of the largest nursing and rehabilitation centres in the US, and it has special care facilities for the elderly and disabled. The hospital prides itself on its highly successful programs which enable residents to thrive and develop hobbies.
Dr. Sweet is fascinated by the concept of medicine and what it means to be a good doctor. She’s particularly interested in the historical evolution of physicians and the differences between treating patients and caring for them. An advocate for “Slow Medicine” or getting to know the patient, Dr. Sweet believes modern medicine, with its focus on efficiency, fails everyone.
When Dr. Sweet first arrives at Laguna Honda, it’s one of the few remaining hospitals of its kind in the US. Most counties used to have similar facilities where ill and impoverished patients stayed for months or even years. However, these hospitals have since been replaced by community-based care and a less personal touch.
Dr. Sweet describes Laguna Honda as being somewhat monastic, with beautiful architecture and an air of tranquillity. However, the patients range from the elderly to addicts with chronic medical conditions, who Dr. Sweet calls “Bad Boys” and “Bad Girls.” These patients still drink, have sex and take drugs inside the hospital, as it’s part of their lifestyle. However, the doctors here don’t chastise them—instead, they encourage patients to make better choices.
It’s all because the care staff at Laguna Honda have far more time to dedicate to each individual than in most hospitals. Dr. Sweet and her colleagues focus on observing their patients, getting to know them as individuals and learning about their lives to work out treatment plans. She recalls how many patients got well again simply through devoted care and attention, and the reminder that they matter.
When change affects the hospital and staff no longer have the same amount of time to dedicate to each patient, Dr. Sweet looks to history and physicians over the ages to prove that doctors need time to treat people. When she’s not working at the hospital, she’s studying for a Ph.D. in history. What she learns proves that doctors need time not only to administer safe care, but to reflect, and devise the best treatment plans. Patients also need proper time to heal, and medicines need time to work. She believes this move towards speedy, impersonal service is disastrous for the profession.
It’s around this time when Dr. Sweet starts writing
God’s Hotel, among other works. She talks about her patients with an obvious sense of pride. For example, she recalls a “Bad Girl,” Terry, who’s a drug addict in a wheelchair because of a severe spinal injury. When Terry leaves the hospital for visits, her boyfriend gives her drugs and abuses her. She has no support network other than the hospital. She’s thin, frail and very unwell.
Eventually, Terry leaves her boyfriend, stops smoking, drinking and taking drugs, and wants to get better. A severe bedsore she develops after the last time she passed out drunk takes over two years to heal. The point is, when Terry leaves the hospital, she’s healed. She’s ready to take on the world, and it’s the care staff at Laguna who give her those tools.
Dr. Sweet compares her own views to those of Hildegard of Bingen from the 12th century. Similarities include healing patients with happy thoughts, healthy diets, patience, and reflection. This is not Dr Sweet saying she doesn’t believe in conventional medication—instead, she says medication is most effective if administered alongside other treatment.
For example, another patient, Miss Tod, is terminally ill with cancer. All Miss Tod wants is her glasses fixed and nice food. Dr. Sweet and the others ensure she’s comfortable and in good spirits, because that’s what matters to the patient. Dr. Sweet learns more about life, death and the acceptance of fate in this hospital than in any medical textbook.
Overall, Dr. Sweet’s message is that doctors need to return to older methods. They need to show empathy and establish human connections with patients. This makes a difference in everything from choosing the right medication to simply making someone’s last few months as happy as they can be.