Tending a garden of the sick
As the 2010 Affordable Care Act marks its second anniversary this spring, the arguments about so-called Obamacare continue. Our overly complex—some say “broken”—healthcare system might function a lot better if every single American citizen, healthcare professional, politician and legislator would read Victoria Sweet’s insightful, beautifully written and moving book God’s Hotel.
When Dr. Sweet—now a professor of medicine at the University of California, San Francisco—came to work at San Francisco’s old-fashioned, “low-tech” Laguna Honda Hospital, it was only for a few months. But she fell in love with the place and its patients, residents of America’s last almshouse, and stayed on for more than 20 years.
Laguna Honda, a public institution that cares long term for people with severe and debilitating medical conditions, the chronically ill and the dying, was originally modeled on the medieval European “hotel-Dieu” that ministered to the sick in the Middle Ages. Its unique layout, consisting of long, open wards, each functioning like a “separate minihospital,” was like nothing Sweet had ever seen. What hospital, she marveled, had an orchard and greenhouse, an aviary and a barnyard? Here, she found she could “practice medicine the way I’d been taught . . . and the way I wanted.”
As Sweet begins her practice of “slow medicine,” caring for a diverse population of patients with complicated and often horrible medical problems, she also studies pre-modern medicine, focusing on the work of medieval healer and monastic Hildegard of Bingen. The doctor, according to Hildegard’s doctrine, should be seen more as a gardener than as a mechanic: a healer who takes time to observe the body’s “garden”—with its natural cycles, functions and ability to heal itself. As she began applying this philosophy to her own work, Sweet learned that simply taking the time to talk with and observe a patient could effect profound solutions to terrible mental and physical suffering.
Yet God’s Hotel also offers a behind-the-scenes look at the politics and policies of the 21st-century healthcare model and its sometimes cold, clinical approach to providing care while keeping a constant eye on the bottom line. Indeed, the “old” Laguna Honda Hospital now is gone, replaced by a modern, new facility. “It was beautiful, but it wasn’t warm,” writes Sweet, regretting the loss of a place where she had “discovered the hospitality, community and charity that were in the walls and the air”: a place where she could “just sit” with patients and accept “the gift” of God’s Hotel.