GOMERs and GOMEREs

I just finished reading The House of God by Samuel Shem, MD. The House of God is a medical satire about a group of interns’ experience during their first year of residency. The book follows Dr. Roy Basch, a ‘red-hot’ medical doctor fresh out the the ‘Best Medical School’ and starting his residency at The House of God, a prestigious hospital in Boston affiliated with the Best Medical School (Harvard, I assume). The book was referred to me by a friend in medical school who said it’s the most popular medical novel written to date. Expecting to get some fresh insight into what life is like as an intern, I approached this book with anticipation and excitement. In fact, Mel would tell you I looked at every used-book store in Nepal hoping to find this book. My enthusiasm quickly turned to confusion and even distress as the author paints a very cynical picture of medical education. Roy and his fellow interns are tortured with being on call every third night (and at times every second night), working 100+ hour weeks, being tortured by GOMERs and LOL in NADs, and slowly realizing the idealized physician’s life they all desire is turning out to look more like a nightmare than a dream. As these young doctors become disillusioned they lose their humanness, break down (one jumping to his death from a hospital window), and at one time or another become despicable.

I want to focus on one of the terms this book introduces, the GOMER. This derogatory term is defined by The Fat Man to mean “Get Out of My Emergency Room, a human being who has lost—often through age—what goes into being a human being.” It describes elderly people suffering from diseases such as dementia, whom the interns must care for in unflattering ways such as disimpacting hard stools. They can’t die, and are constantly abused by the medical staff. For example, one the the rules in The House Of God is GOMERS GO TO GROUND, meaning they fall out of bed. The interns use this rule in order to TURF their GOMERs to ORTHO or NEURO by setting the hospital beds up at dangerous heights. The treatment of these people portrayed by this satire is disturbing.

During my undergraduate education, I worked part-time as a certified nursing aide at two different nursing homes. One man for whom I provided care (I will call him James) was a WWII veteran, learned Chinese, and taught Chinese literature at Brigham Young University. In his old age dementia had left him miserable. He relied on CNAs for everything, and many CNAs resented him. James’ dementia made him violent, especially at night and he would punch, kick, spit, and do anything he could to prevent the aides from helping him. I remember one aide who even resorted to hitting James back. She lost her job. Whenever James’ call light went off, the aides would do their best to ignore him, or try and persuade another aide to go see what he wanted. Shem would call James a GOMER.

I became a ‘go-to guy’ when it came to James’ care. James liked me. I think he started to like me the first summer I grew a beard. A gruff man himself, James would say “you and I need a shave” with the biggest grin on his face. I found that James was rarely resistant towards care if I sat down and talked with him for a few moments before attempting anything. An avid reader, James enjoyed showing me what he was reading, and I would occasionally show him what I was reading. I would sometimes greet him with a ‘nee hau’ or begin by throwing his boot, which he hated, across the room to which he would applaud. He loved to tell me about his travels, about his family, and other such things. While his mind was ill, his soul was not. One day when I was struggling with my faith, James bore his testimony to me of the Book of Mormon and of the Restoration. James’ testimony is one of the most powerful spiritual experiences I have had in my life. James became a dear friend of mine.

The purpose in sharing this is to help encourage better understanding. James was treated as less than human because of his dementia. I discovered that James is a beautiful person who enriched my life greatly. People yearn to feel loved and respected. Treating people like GOMERs or GOMEREs (the feminine version of GOMER) is not acceptable. A lot of people have inherited a tough situation in life. I think one of our duties as human beings is to help each other out and encourage better understanding. Let’s think again about how we and others treat people like James.