The Patients of God’s Hotel

I came to God’s Hotel to escape.

It was twenty years ago, and the model of medicine we now take for granted, where the doctor is a healthcare provider, and the patient a healthcare consumer, 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. 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 about disease and about medicine, but also about being a true person.

They were always themselves, for better and for worse. I don’t know whether they were born that way—stubborn, clear-sighted, and intractable—or whether they learned to be that way in their difficult lives, but by the time they came to God’s Hotel they simply refused to conform to any one else’s idea of them, and rejected those who did conform. Any gap between the truth of a person and his semblance they would reject: turning their backs and walking or wheeling away; shouting or even throwing things; closing their eyes and refusing 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 my own.