By Steve Love
The Spirit of the Place contains everything – and more – that author Samuel Shem became (in)famous for delivering in The House of God, his hilarious (unless you’ve ever had to visit a doctor), iconic novel about medical education and the healthcare it underpins.
There is sex and love, disease and death, laughs and exploding bodies (yes, they go together), doctor-patient-neighbor relationships among complex characters with coexisting streaks of good and evil. Unlike The House, however, there is a universality that pulses beyond the hospital and into the community to rage at small-town and big-time issues of the day (guns, medical insurance, historical preservation, the 1980s Reagan Revolution). Appealingly troubled protagonist Dr. Orville Rose is haunted by a blackmailing mother – dead, but not departed – who forces him to return to his hated hometown in order to gain his inheritance, find equilibrium and overcome what she believes is a greater capacity for selfishness and hatred than for love.
The Spirit soars in the supernatural guise of mother Selma Rose but is no ghost story. Rather, it is a connecting journey between life and death, seismically registered in head and heart.
In his new novel, published by The Kent State University Press in its literature and medicine series, Shem, pen name of Dr. Stephen Bergman, answers forevermore the question of whether he is first and foremost a writer or a physician. As a physician trained in psychiatry, Bergman may be able to dissect a human body or explore the depths of the mind, but it is as Shem the writer that he plumbs the human spirit with an instrument sharper than any scalpel.
Bergman always had in mind being a writer. He explained as much in an afterword to a later edition of his 1978 The House of God and revealed details of his life that foreshadow the characters of The Spirit of the Place and its setting – Columbia, a small town in New York’s Hudson River Valley. Here, Orvy learns, as Bergman once did, the Chekhovian differentiations of life as it should be and life as it is. There are many things, he finds, that a doctor cannot cure.
Life’s contradictions, medical and otherwise, inspire Shem’s work. They are expected to be a part of the discussion during a two-day Return to The House of God Symposium in Cleveland October 22 and 23 in which Shem will participate. While the symposium, sponsored by The Center for Literature, Medicine and Biomedical Humanities at Hiram College and the Cleveland Clinic Department of Academic Medicine, will concentrate on the impact of The House of God on medical education and physicians during the past 30 years, it is in The Spirit of the Place that Shem broadens his story to family, professional and community relationships.
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Life’s contradictions, medical and otherwise, inspire Shem’s work. In The House of God, Shem laid medical training as bare as a corpse on a pathology table, cut out its diseased heart and held its failed humanity in his hands for all to see, physician and patient alike. Teaching physicians treated their protégés with so little regard it is no wonder bonds between new physicians and their patients were too often weak or nonexistent. Shem exposed medicine as more than technique and technology. It is about caring connections, human to human, about listening not only to the story of disease on the patient’s chart but also to his entire life story. In The Spirit of the Place, these relationships move beyond professional to family and community.
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Life’s fullness and flaws create the spirit of this place that is Columbia, a place that is, as damaged but undaunted town historian Miranda Braak tells it, one of “breakage and resilience.” Whatever can go wrong in Columbia will go wrong, including its people. It is the town joke, and, until Orvy comes to better understand the phenomenon that is the shared human journey, he mistakenly believes it makes a joke of the town to which he has been compelled to return.
There are echoes of previous Shem characters, themes and techniques, including pointed and poignant letters from a parent, in this case Orvy’s dead mother, who has found the perfect posting co-conspirator in Miranda. But Shem also has forged ahead into new terrain of the spirit that includes but goes beyond the medicine practiced by the sometimes bumbling but beloved town doctor who is Orvy’s inspiration, example and nominal partner in a small-town practice.
Though Shem’s characters in The Spirit of the Place are less singularly memorable than the Fat Man, House of God residentwhose rules and caring saved not only patients but also interns, these Columbians are richer, fuller and deeper, particularly Miranda, Selma and her granddaughter Amy and Henry Schooner, childhood bully with a grown-up golden veneer that only Orvy sees through. Even a clichéd, cinematic conclusion cannot diminish the connection a readers will feel with Shem’s characters – especially his surprisingly strong women.
In Return to The House of God: Medical Resident Education 1978-2008 (The Kent State University Press), Amy Haddad and other essayists addressing Shem’s work take him to task for treating women as dim, sexual objects. Their accusation fails to persuade. Even if The House were once a sign of the sexual times, Shem is no serial sexist. The strong women of The Spirit of the Place demonstrate with their lives (and deaths) that “maybe love is just not giving up on people.” Sam Shem never does.
Steve Love, a Hiram College graduate student, is a retired Beacon Journal chief editorial writer and columnist.