The House of God

When Roy has been at the House of God for three weeks, the Fat Man leaves for a rotation at a different hospital, and the interns’ original supervisor, a woman named Jo, returns. Unlike the Fat Man, Jo is tense and ambitious and takes a hands-on approach to medicine. She takes the interns on morning rounds to all the patients in the ward, unlike the Fat Man, who preferred to simply talk about the patients in the staff room. Jo has an interest in cardiology, and Roy notices that many of the patients are diagnosed with “some hitherto undetected cardiac disease” (85). He tries to argue with her about the Fat Man’s approach, and she says, “I deliver medical care, which, for your information, means not doing nothing, but doing something. In fact, doing everything you can, see?” (85). She dismisses the Fat Man as “nuts” and tells Roy to do a full spectrum of tests on Anna, despite her advanced age and the Fat Man’s opinion that her dementia is normal and untreatable. 

Over the next few weeks, Anna begins to suffer painful and serious complications from the tests Jo has ordered. Roy has been trying Jo’s approach of medical care, ordering extensive tests for each patient he sees. The Fat Man is on call with Roy one night a week, and he says that Jo’s only source of fulfillment in life is medicine, that she should have gone into research rather than having direct contact with patients, and that women like her shouldn’t be doctors. This comment prompts a discussion with Roy about women practicing medicine. The Fat Man says, “I’m saying women like Jo make lousy people because they’re doctors. The profession is a disease. It doesn’t care what sex you are. It can trap us, any of us, and it’s pretty clear that it’s trapped Jo” (88). The Fat Man tells Roy to stop doing anything to the gomers beyond a bare minimum and to use fake writeups to make Jo think that the patients are receiving intensive medical care. Roy listens to him, and Anna improves under his hands-off care. 

One of the other doctors, Potts, is stuck with Jo even during his on-call nights, and she essentially breathes down his neck with every patient. Potts becomes overworked, isolated, and anxious. While Roy and Chuck become friends and do things together outside of work, Potts and his wife—a medical intern at a different hospital—become increasingly distant. Potts asks Chuck and Roy what to do about a patient whose liver disease is clearly terminal but whom Jo continues to insist that Potts do everything possible to save. They tell him to stop going to extraordinary measures for the patient and to hide it from Jo. Instead, Potts tells Jo about his concerns, and she becomes enraged with him.

Over the next few weeks, Chuck and Roy both observe the Fat Man’s rules of caring for patients, and the patients do so well while being interfered with as little as possible that the ward soon starts receiving “tough” cases—younger patients who are in danger of dying from various diseases. To help cope with the pressure, Chuck turns to sex with one of the housekeepers, while Roy is sexually frustrated because Molly hasn’t let him have sex with her yet, although they’ve fooled around. Chuck and Roy discover a mutual love of basketball and begin playing pick-up games during their time off. In playing with him, Roy discovers that Chuck’s seemingly carefree demeanor hides an intensely caring nature, one that Chuck disguises with nonchalance. Someone begins writing “MVI” next to Roy’s name on a chalkboard at the ward’s nurse’s station; this stands for Most Valuable Intern, and Roy can’t figure out who is writing it. 

After much prompting from Roy, one of the other interns, called the Runt, begins dating a new nurse, Angel. While taking care of the Runt’s patients one night, Roy talks to Hooper, another intern whose marriage is in trouble because of the stress of the job, and Roy wonders if his relationship with Berry is in trouble, too. Another one of the Runt’s patients is near death, and Roy summons the Fat Man to help him save the man. The Fat Man starts to help him but quietly leaves shortly thereafter, and Roy finishes working with the man alone without realizing it. Afterwards, he realizes that he’s becoming more confident under the Fat Man’s mentorship.

Roy exercises his newfound confidence, enmeshing himself even more into hospital life. The hospital administrators create an award called the Black Crow that rewards the doctor who gets the most patient permissions to perform autopsies after death. The interns are confused about how their progress toward this goal will be counted, since they are supposed to be working toward greater health for the patients, not encouraging them to die. 

Molly and Roy begin having sex regularly, both at and outside of work. Roy feels guilty about cheating on Berry but continues to see Molly. He and Berry try to maintain a connection but end up fighting. Berry thinks Roy is becoming too enmeshed in the world of the House of God and is frustrated by his focus on the body, which is opposed to her focus on the mind as a psychologist. Roy remembers Hooper’s troubled marriage and concludes that his relationship is also in trouble.