Monday, June 18, 2012

God's Hotel

The last time I saw a doctor the admitting nurse took my blood pressure and then escorted me to the room where I waited for the doctor to come in. After a few minutes he popped in and a few minutes later he popped out. He did one procedure on one part of my body and answered one question, smiled and left. I put my shirt back on and showed myself out to the receptionist who handled insurance and co-pays and scheduled next visits. It was a fairly customary visit to the doctor.

God's Hotel is a book about another world of medicine. That is no longer practiced anywhere in the country. When Victoria Sweet started practicing medicine at Laguna Honda Hospital in San Francisco it was a throwback to the old concept of almshouses, God's Hotels, long term care facilities where someone could stay until they died or got better and went home as some did. Many hospitals were started by Christian monasteries in the middle ages. Physical care giving was seen as an extension of the care of the soul, the person. St Hildegard of Bingen was one such nun who started a monastery and a hospital and wrote a 12th century medical text. Dr Sweet was interested in premodern medicine and especially in St Hildegard. She pursued further studies in the history of medicine and did her thesis on Hildegard. She went to Europe to study Hildegard in context finding an old wall of her monastery and reading her original manuscripts (Hildegard wrote other theological and devotional and mystical works as well). While Hildegard's medical works were typical of the times, Sweet found the ideas of premodern medicine intriguing. She called what Hildegard was doing "slow medicine". Hildegard emphasized taking time with a patient, learning the history of his or her life. She would treat patients with a variety of herbs and interesting procedures but her big idea seemed to be getting out of the way so the body could heal itself. She wanted to remove what was preventing the healing. She wanted the patient to take the time needed to rest, to get on a proper diet, and recover a sense of happiness.

Dr Sweet was in the right place and at the right time, at first, to take what worked in a more modern setting and test it out with her patients. Most of the patients she saw were at the end of the line. Laguna Honda was the last resort in health care and they had come there to die. So, Dr Sweet had time to work with them, to be with them, to learn their histories, to look them in the eyes and carefully examine them. She found clues to what was ailing them as she saw the whole picture of their lives. At Laguna Honda they could rest apart from their toxic surroundings outside the hospital. Many of them were alcoholics or drug users or homeless or all three. Most of them had been sick for a long time. At Laguna, Dr Sweet could practice slow medicine and try to remove the toxicities from their lives.

Of course, time marches on, and health care had to enter fully the modern world of efficient, technological treatment with all the new drugs and tests and specializations. Government bureaucrats in the name of protecting the rights of patients mandated shorter and shorter hospital stays and more and more residential treatment centers. Eventually, Laguna was torn down and a modern rehabilitation center (no longer a hospital) took its place with far fewer nursing staff but many more computers and technicians.

God's Hotel is the story of the modernization and depersonalization of health care. It is the story of how slow medicine became fast medicine driven by intensive drug therapies and specialization. That's an important story in itself. But this book is not a critique of modern medicine by any means. This is a book of stories, of patients Dr Sweet knew and treated and learned from. And it's a story about taking time to be with people and the healing that takes place in those relationships.

I was thinking as I read this book about the parallels to the Church. That is the one place we have time for people. In our busy, noisy, distracted world the Church is a sanctuary in time and place. We don't have to accomplish anything. Programs need to serve people not the other way around. We need to practice the "cure of souls" to use another premodern term. But, the idea is to get to know people and their histories, to look them in the eyes. To stay with them for a long time.

 St Hildegard's idea of health care being  the removal of what is preventing good health is a good model of  soul care or spiritual health. What needs to go in our lives that is preventing a growing relationship with God and other believers? What is distracting us or working against what God wants to do in our lives and relationships? The walk with God is often a long one. God seems to have all the time in the world for us. We need to be patient with people, too. It takes a long time to heal a body especially one that has been poisoned by toxins but it will heal. It takes just as long or longer to heal a sick soul.