46 pages • 1 hour read
Samuel ShemThe House of God
Fiction | Novel | Adult | Published in 1978A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Chapters 9-13 Chapter Summaries & Analyses
Chapter 9 Summary
Roy and Chuck begin having sex with social service workers to get their patients placed out of their care, fulfilling one of the Fat Man’s “rules” of medicine—get the patient out of your care as soon as possible. Roy endures an uncomfortable dinner at Jo’s house, where her unpacked belongings indicate that she is too heavily invested in her work. She mentions that it’s hard to meet men as a female physician and asks what she can do to be a better supervisor. Roy tells her to let the interns have more autonomy and to try doing less for the patients. She says she’ll try but still goes in to the hospital on her next day off.
Dr. Sanders, who was diagnosed with leukemia and underwent chemotherapy, dies an agonizing death in Roy’s arms, upsetting him. Jo tells Roy to do a postmortem autopsy, but Roy doesn’t want to see the man’s body be put through the procedure. He fights with Jo about it and tells her that the reason their patients have been being transferred out of the ward is because he and Chuck are sleeping with social service workers. A confrontation ensues between Roy and some of the doctors higher up in hospital administration, and Roy vocalizes some of his complaints about the hospital’s system. The Runt continues to have sex with Angel, and Roy keeps having sex with Molly. Roy and Chuck are about to leave the ward for the next one in their rotation, and they mark their departure by having an orgy with Angel, Molly, one of the women from another ward whom Roy previously had sex with, and the Runt.
Chapter 10 Summary
Berry hears that Roy has been seen out in public with other women—the hospital workers he sleeps with, presumably—and seems to accept that he’s working through psychological issues by being with them, but their relationship is still strained. They agree to allow each other some “freedom” in their relationship. Roy begins his new rotation, working in the House of God’s emergency ward. He remembers that an interest in being an emergency room doctor was one of the first things that drew him to medicine.
Two policemen whom Roy met earlier in the story—named Gilheeny and Quick—regularly spend part of their own shift in the emergency ward and are friendly toward Roy. He treats various patients during his first shift, including a teenager with appendicitis and a young man in cardiac arrest whom the staff barely saves from dying. Roy leaves after his shift feeling confident and proud of the work he did in the ER.
Chapter 11 Summary
Roy and Berry go to Roy’s hometown in upstate New York for Thanksgiving. Roy’s father, a dentist, moved his family there from New York City when Roy was a little boy. During their visit, the family follows the Watergate scandal, Roy’s mother pushes Roy and Berry to get married, and Roy naps after several long days in the ER. Roy’s grandfather is unhappy in the nursing home where he lives and privately asks Roy to talk to his father about letting him move back to his old neighborhood in New York City. Depressed by his grandfather’s plight, and knowing how the frail elderly are treated in hospitals, Roy muses, “as he began to get demented, I’d visit him in the home, a syringeful of cyanide like a bar of candy in my pocket. He wouldn’t be a gomer, no” (177).
That night, Roy returns to the ER at the House of God, where he talks with Gilheeny and Quick. They offer to send any problematic potential patients they encounter on the street to a rival hospital (“Man’s Best Hospital” or MBH) across town and reveal that they know that Roy’s first choice for an internship was MBH and that his application was rejected. Roy wonders how they could have known that, and when he asks them why they’re so sure, they merely say, “Would we be policemen if we were not?” (181).
Chapter 12 Summary
It’s Christmastime, and Roy continues his work in the ER, where he sees an increasing volume of psychiatric cases come in. He meets one of the psychiatrists in the hospital, Jeff Cohen. He’s impressed by Cohen’s calm, intellectual, curious demeanor and envious of his on-call schedule (one night per week rather than Roy’s multiple nights on call). Gilheeny and Quick are in awe of Cohen and spend hours discussing psychology and philosophy with him.
Roy enjoys the erotic feelings he experiences when examining young, attractive female patients and believes that some of them return his sexual feelings. Although he’s still with Berry, he continues to have sex with Molly, and she gives him a tiepin engraved with the letters “MVI.”
Chapter 13 Summary
Right around Christmas and the New Year, which marks the end of Roy’s ER rotation, his time there takes a turn for the worse. He examines a young woman raped on her way home from a friend’s house and sees that her trauma at the hands of another man has already begun to drive a wedge between her and her husband. Gilheeny is shot in a robbery attempt and seriously wounded. Roy also examines a young girl who is the victim of child abuse and a woman with advanced cancer.
Roy’s emotional life gets worse as well. He tells Berry about Molly, and Berry says that she already knew that Roy was sleeping with other women. Again, she accepts his infidelity, still wants to be with him, and demands the same freedom to be with other people as well. Berry is also worried about both Roy and Chuck’s well-being and is appalled at the higher-ups in the House of God when she attends a holiday party with Roy. The chapter ends with Roy’s question, “How could I survive?” (214).
Chapters 9-13 Analysis
Roy’s emotional health continues a downward trajectory during these chapters. He sees incidents of malpractice, patients’ best interests ignored for the sake of trying to “cure” them and to make the hospital money, and the suffering these actions cause. He’s still resistant to Berry’s attempts to help him understand and process his emotional difficulties, though, showing that he’s in denial about the deep flaws in the medical system. The long hours and frequent on-call shifts take their toll as well. The introduction of Cohen, the psychiatrist, and Roy’s initial impressions of him are significant because Roy will eventually become a psychiatrist rather than a more “traditional” medical doctor.
The gendered hierarchy of The House of God, typical of the American medical system in the 1970s, is apparent in these chapters. Lower-paid nursing positions that require less education tended to be held by women, while doctors were usually men. Jo is a notable exception, but the book generally depicts female nurses and male doctors. This gender split introduces the potential for sexual relationships between professionally subordinate nurses and the doctors they work for, as described in The House of God. Young, attractive nurses are generally portrayed as sexually willing and promiscuous, and Roy also experiences mutual sexual attraction with some female patients. These sexual dynamics are generally unchallenged and not commented on in the text, but in the Afterword, Shem praises the increase in female medical school graduates in the decades since the 1970s, a trend that made these asymmetrical sexual relationships less common.
