While reading Victoria Sweet’s fascinating new memoir, “God’s Hotel,” I felt compelled to Google “Laguna Honda.” That’s the name of the charity hospital — what the French call an “Hôtel Dieu” — at the center of Sweet’s narrative. Surely Sweet invented this place, I kept thinking. A hospital where patients lie in rows of beds on open wards, sometimes for months? A hospital with its own greenhouse, barnyard, and aviary? A hospital whose nurses and doctors spend hours at their patients’ bedsides and write leisurely notes in longhand? It sounded more likely to have existed in medieval Europe than in 21st century San Francisco.
But a visit to lagunahonda.org confirms that the unusual hospital where Sweet practiced medicine for more than 20 years and which she describes so enchantingly is, indeed, real — or was.
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As a young physician, Sweet arrived at Laguna Honda intending to work part-time just until she completed her PhD in the history of medicine. As the years passed, though, she found herself mesmerized by the place and struck by the relevance of her historical studies to her medical work.
Sweet’s dissertation topic was Hildegard of Bingen, a 12th century Benedictine nun and physician. Rather than simply poring over illuminated manuscripts in the library, Sweet decided to apply Hildegard’s pre-modern medicine to her patients at Laguna Honda.
Medieval medicine, as Sweet explains, was not limited to leeches and exorcism. Rather, it involved a complex philosophical system in which a person’s diet, environment, relationships, and attitude, not to mention the passage of time, were all believed to contribute to health — what we might call, today, a holistic approach. It was, Sweet asserts, “real medicine for real patients with real diseases.”
In a regular modern hospital, a doctor would feel too rushed, too pressured by insurance companies, too fearful of a malpractice suit to try some of Hildegard’s “slow medicine.” But at Laguna Honda, where the sick and dying paid nothing and often had nowhere else to go, the usual rules were suspended — often to the patients’ great benefit.
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Take the patient Sweet calls “Terry Becker,” for example. Terry was a heroin addict who became paralyzed from the waist down and developed deep skin ulcers that threatened to expose her spine and kill her. Meticulous nursing care and even skin grafts didn’t heal her wounds. Out of options, Sweet used Hildegard’s concept of viriditas, or “greenness,” treating Terry as if she were a fragile plant, in need of nurture and protection. Sweet fed Terry nutritious food, wheeled her into the sunshine, encouraged her to stop smoking and to dump an abusive, drug-pushing boyfriend. Over two-and-a half years, the ulcer — and Terry’s life — mended. Slow medicine, indeed.
In “God’s Hotel,” Sweet weaves several interrelated narratives gracefully: her experiences as a physician at Laguna Honda; her pilgrimage by foot from France to Santiago de Campostela in northwest Spain, which she undertook in sections during a series of vacations; the world of Hildegard and medieval medicine; the (alas!) inevitable succumbing of Laguna Honda to “progress.” The old open wards in which patients tended to their more infirm neighbors, we learn, have been replaced by a sleek facility that touts “wellness” programs, “health care data” systems, and flat screen TVs.
Sweet’s tone, in “God’s Hotel,” nicely matches her subject. Her writing has a lovely, antique quality. For example, she almost never refers to Laguna Honda’s exact location. Instead, she calls San Francisco “The City,” as opposed to “The County” — the acute care hospital from which so many Laguna Honda residents arrive. The vagueness of location also conveys a distance in time, as if Sweet were writing from both far away and long ago. She reinforces this impression by launching into anecdotes with the word “now,” as in “Now Mr. Conley was a nice man…,” as if we readers were fellow pilgrims, resting by the side of the road, listening to Sweet tell her story.
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Sweet would likely be pleased to have left this impression, because she comes to consider all of life, including medicine, as a kind of pilgrimage. After one of her treks in Europe, she returns to Laguna Honda with a pilgrim’s eye for allegory, seeing those around her as “characters…patients, nurses, delivery men, doctors — with spiritual and moral messages, if I chose to decipher them.” Sweet invites us to view the modernization of Laguna Honda as an allegory, a cautionary tale about what is lost when healers and their patients are replaced by bureaucrats and “clients.”
When Victoria Sweet arrived at Laguna Honda as a young doctor, a senior colleague told her that this hospital, with its chronically ill patients, crumbling buildings, and never-ending budget woes, was “a gift.” In this beautiful and unique book, she shares that gift with us generously.
Suzanne Koven is a primary care internist at Massachusetts General Hospital and writes the monthly “In Practice’’ column for the Globe. She can be reached at inpracticemd@gmail.com and her website is www.suzannekovenmd.com.
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