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<i>God's Hotel</i> by Victoria Sweet: A Book Review

Slow medicine does not disavow fast medicine: A broken bone still needs to be set, a heart attack kept from killing someone, and appendicitis requires surgery. But when acute care has done its job then recovery needs the right milieu, a different form of medicine, where the barriers to healing are removed.
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I bought God's Hotel in 2012, when it was published, at the urging of a number of friends whose wisdom minds taking. But it went into a pile of good intentions to read and sat there untended. Then some months ago I went to find it and it was gone! Without much detective work I discovered my wife had taken it to read and joined my other advisors in saying, "You have to read this book!"

Now I can say I have. And its release as a paperback gives me the opportunity to write about this remarkable piece of creative non-fiction. I imagine its author, Dr. Victoria 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: We're all on a journey, and when we see the way, value it and use it, then we have found The Way.

There is an ancient pilgrimage, 1,600 kilometers to walk, from south central France to the frontier of Spain and then due west to Compostella. In France, the path is called le chemin and the route the Saint Jacques de Compostelle Pilgrimage. In Spain, it is el camino and known as the Santiago de Compostella Pilgrimage. But the term that pilgrims for a thousand years have used is The Way. It is a journey of body and soul, a means of seeing, feeling and being that a person unleashes from within: This is a spiritual force, non-sectarian and universal, and a means of finding the purpose and human connection that are as essential to a life well lived as they are hard to achieve (Journey for Body and Soul).

Dr. Sweet has walked the pilgrimage trail in Europe. And she walked it, as well, as a physician practicing in the very last of the alms houses in this country, The Laguna Honda Hospital in San Francisco. She committed to working there for two months and stayed 20 years. When she began Laguna Honda had 1,178 patients whose medical conditions were so severe and persistent that there was no other place for them to go.

Terry, in her late 30s, had a bedsore on her back bigger than a dinner plate and had failed numerous grafts and needed "slow medicine" to heal.

Paul had amputations of both legs, finally at the hip, the result of clots that shut off circulation and produced gangrene, and needed slow medicine to rebuild a life in a wheelchair from which his skills with computers and bootlegging DVDs made him one of the more popular people in the hospital.

Radka, an older woman and immigrant from Bulgaria, had been sent from the county hospital to die from lung cancer, but she rallied with human warmth and slow medicine before she chose to go to hospice and then let go of life.

Steve, a former truck driver and present-day pain in the ass, was thought to have had a stroke (and was not taking well to the idea of rehabilitation) until careful observation and critical thinking revealed he had a rare form of familial muscular dystrophy. He too was the beneficiary of slow medicine.

God's Hotel
abounds with stories of patients, and their caregivers, with all variety of chronic neurological, heart, lung and liver conditions, strokes, cancers, AIDS, and psychoses sent from acute care facilities to Laguna Honda for what might be a chance to find life again or to die with dignity.

Slow medicine does not disavow fast medicine: A broken bone still needs to be set, a heart attack kept from killing someone, and appendicitis requires surgery. But when acute care has done its job then recovery needs the right milieu, a different form of medicine, where the barriers to healing are removed, including unnecessary medications, abuse of drugs, alcohol and cigarettes, inadequate nutrition, and fear and hopelessness.

Dr. Sweet, also an historian of pre-modern medicine, wrote her Ph.D. while working at Laguna Honda. She studied the writings of a 12th century German nun, Abbess, philosopher, writer, composer and medical practitioner named Hildegard of Bingen -- a course of study which, like The Way, makes all the sense in the world once you read Dr. Sweet. Hildegard regarded the body as more like a plant than a machine and thus needed a way to reawaken its capacity for growth (greening or viriditas) rather than to be fixed like a machine (the metaphor of our industrial age). Hildegard's work led Dr. Sweet to consider how to remove the barriers to recovery and fortify a person with the basics of healthy sleep, nutritious food, and protection from toxic substances and people while permitting "tincture of time" to also do its job.

The great irony expressed by the book (and sharply portrayed in Dr. Sweet's TEDx talk The Efficiency of Inefficiency) is that slow medicine is actually efficient! Sometimes doing less is actually more, and it can save a lot of money. She takes to task consulting companies hired to update and improve medical facilities, politicians, myopic or ambitious administrators, and agonizingly entrenched or zealous government agencies and regulators that don't know how to save themselves from themselves, no less the people they are charged with serving.

I may have missed God's Hotel the first time around, but not this time. Nor should you if you want to feel hopeful that (and see how) modern medicine may come to realize that slow medicine can -- and should -- co-exist with fast medicine. Or as Dr. Francis Peabody of Harvard Medical School said in 1927, well after Hildegard of Bingen but true to her tradition: "The secret of the care of the patient is in caring for the patient."

Dr. Sederer's new book for families who have a member with a mental illness, The Family Guide to Mental Health Care, published by WW Norton (with a foreword by Glenn Close), is now available, as is his even newer book (with Jay Neugeboren and Michael Friedman), The Diagnostic Manual of Mishegas.

The opinions expressed here are solely mine as a psychiatrist and public health advocate. I receive no support from any pharmaceutical or device company.

For more by Lloyd I. Sederer, M.D., click here.

For more on personal health, click here.

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