San Francisco’s Laguna Honda Hospital is the last almshouse in the country, a descendant of the Hôtel-Dieu (God’s hotel) that cared for the sick in the Middle Ages. Ballet dancers and rock musicians, professors and thieves—“anyone who had fallen, or, often, leapt, onto hard times” and needed extended medical care—ended up here. So did Victoria Sweet, who came for two months and stayed for twenty years.
Laguna Honda, relatively low-tech but human-paced, gave Sweet the opportunity to practice a kind of attentive medicine that has almost vanished. Gradually, the place transformed the way she understood her work. Alongside the modern view of the body as a machine to be fixed, her extraordinary patients evoked an older idea, of the body as a garden to be tended. God’s Hotel tells their story and the story of the hospital itself, which, as efficiency experts, politicians, and architects descended, determined to turn it into a modern “health care facility,” revealed its own surprising truths about the essence, cost, and value of caring for the body and the soul.
“Transcendent… readable chapters go down like restorative sips of cool water, and its hard-core subversion cheers like a shot of gin… God’s Hotel [is] a tour de force… Others have written about the relationship between time and medical care with similar eloquence and urgency, but the centuries of perspective that Dr. Sweet brings infuse the point with unforgettable clarity.” –The New York Times
“A radical and inspiring alternative vision of caring for the sick.” –Vanity Fair
“Engaging… You might not expect a book about San Francisco’s most downtrodden patients to be a page-turner, but it is. With its colorful cast of characters battling the tide of history, God’s Hotel is a remarkable journey into the essence of medicine.” –San Francisco Chronicle
“Victoria Sweet writes beautifully about the enormous richness of life at Laguna Honda, the chronic [care] hospital where she has spent the last twenty years, and the intense sense of place and community that binds patients and staff there. Such community in the medical world is vanishingly rare now, and Laguna Honda may be the last of its kind… God’s Hotel is a most important book which raises fundamental questions about the nature of medicine in our time. It should be required reading for anyone interested in the ‘business’ of healthcare – and especially those interested in the humanity of healthcare.” –Oliver Sacks, M.D. author of The Man Who Mistook His Wife for a Hat and The Mind’s Eye
“Victoria Sweet has written the best non-fiction book I’ve read this year… The qualities that make her a great doctor are the same qualities that make her book so powerful, original and relevant… For a very long time, a gang of renegades got away with practicing medicine the way it should be: sitting with patients, watching, listening, often doing nothing more than being present. And then Victoria Sweet, a candidate for sainthood, wrote a book that is a beacon in the darkness.” –Jesse Kornbluth, Huffington Post
“A beautifully written and illuminating book… [Sweet’s] metaphors are poetic and hint at the mystical, but then she pulls back with the educated eye of a scientist… For both the agnostic and the believer, Sweet pinpoints the element of medicine that makes it a calling rather than a job: the unique and sustaining love that is sparked between a doctor and patient.” –Jerome Groopman, The New York Review of Books
“Remarkable… [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… permitting ‘tincture of time’ to also do its job.” –The Huffington Post
“Sweet writes fluidly and well… She weaves a fascinating account of the historical forces that transformed our view of the body… It’s high time that someone gets medieval on modern medicine’s morass, and Victoria Sweet is just the woman to do it.” –Cleveland Plain Dealer
“Captivating… with this humane and thoughtful work, Sweet joins physician-authors such as Oliver Sacks, Jerome Groopman and Abraham Verghese.” –The Dallas Morning News
“Sweet’s tone in God’s Hotel nicely matches her subject. Her writing has a lovely, antique quality… This hospital, with its chronically ill patients, crumbling buildings, and never-ending budget woes, was ‘a gift.’ In this beautiful and unique book, she shares that gift with us generously.” –The Boston Globe
“Intelligent and moving… In this often lyrical book, Dr. Sweet reveals a deep spirituality and unsentimental compassion.” –Minneapolis Star-Tribune
“Sweet paints a dynamic portrait… [which] is at its core testimonial to the body’s remarkable ability to heal when it is provided with the simple ingredients of time and care.” –Utne Reader
“Visionary… thoroughly subversive in all the best ways… Sweet proposes ways that we might reimagine our way forward by looking into the distant past… This book’s lessons and conclusions should challenge doctors, nurses, hospital administrators, and policy makers to stop and rethink their core beliefs.” –Journal of Health Affairs
“Containing no medical jargon… nothing too gory or gut-wrenching; just descriptive stories of patients, unusual treatments, a hospital in transition, and a doctor on a journey, learning to practice ‘a beautiful art.'” –East Bay Express
“By braiding… historical searches with her time at Laguna Honda, [Sweet] arrives at a compelling critique of modernized health care and a vision for transforming it.” –Books & Culture
“[Our] 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.” –Bookpage
The Patients at God’s Hotel
An essay by Victoria Sweet
I came to God’s Hotel to escape.
It was twenty years ago, and the hurried, efficiency-obsessed model of medicine we now take for granted was just beginning to take hold. I didn’t like it much, and God’s Hotel—Laguna Honda Hospital in San Francisco—seemed just the place to escape it. Although it was on sixty two acres in the middle of the city, it was literally over the hill to the poorhouse, and no one—regulators, economists, or budgeters—paid it much attention.
But that wasn’t why I stayed. I stayed for the place and the patients.
The place was old and ramshackle, spread out high on a hill overlooking the ocean. Outside it looked like a medieval monastery, with bell tower, turrets, and a red-tiled roof. Inside it was the 1930s, though the long, open wards went all the way back to when a hospital was still a hospice, where monks took care of the pilgrim, the traveler, and the poor for free.
It was also fascinating. Originally it had been the city’s almshouse, what the French call a Hôtel Dieu (God’s Hotel), and it still was the city’s almshouse, despite its name. That meant it took in anyone and everyone who fell through the cracks in the medical system. It had murderers from San Quentin and dancers from The Royal London Ballet; failed stock brokers and the West Coast fat model for artists; merchant marines and rock musicians; telegraph operators, professors, poets, and thieves. They had one of just about every kind of disease, too, so I saw almost everything in the 2260 pages of my Harrison’s Textbook of Internal Medicine.
The patients taught me a lot. They were always themselves, for better and for worse. Which is not to say they were all good. Mr. Dennis, for instance, was a convicted rapist who hid out at the hospital with a fake paraplegia. But he was the purest, the most evil Mr. Dennis there could be.
They were utterly attuned to cant, hypocrisy and falsehood and if they sensed it, they would turn their backs and walk or wheel away; shout or even throw things; close their eyes and refuse to answer. They responded to the truth and withdrew at the false, and the only way I could take care of them was to meet their true selves with mine.