The ministry of bodies

Doctors looking at heroic shadows

One of my favourite novels is The House of God by Samuel Shem. Published back in 1978, it covers the first year of work in a hospital of a doctor who has just graduated from medical school. A lot of medical students read it at some point during medical school, and think it’s a satire of what goes on in a hospital. Then they start to work and realize it’s actually an autobiography.

A new book by Seamus O’Mahony, The Ministry of Bodies, is a fitting counterpart to The House of God. In fact, it’s so fitting that I find it hard to believe that the way the title of the new book juxtaposes so well with the name of the old one is just an accident.

While House of God covered the first year of work of a new doctor, The Ministry of Bodies covers the last year or so of work of a doctor who is about to retire. And while House of God was written as a novel and published under a pseudonym, The Ministry of Bodies is written more as a sort of diary and is openly autobiographical. I guess when you’re at the end of your career you don’t have to worry so much about personal consequences from telling the truth.

The author, Seamus O’Mahony, graduated from medical school in 1984, and has spent his career working as a gastroenterologist (a specialist in diseases of the stomach and intestines), partly in the UK, and partly in Ireland. Over the course of his career, O’Mahony has become increasingly disillusioned with much of what happens in medicine, and he has previously written the excellent Can medicine be cured?: the corruption of a profession, which should in my view be required reading for medical students and doctors, and which outlines much of what is wrong with the modern practice of medicine.

That book is a serious book. So is this one in a way, although the tone is much lighter. There are numerous absurd anecdotes. For example, we get to meet the elderly nun who wants “all measures taken” to prevent her from dying, and the man who wakes up after a suicide attempt and immediately asks to see a cardiologist, because he’s been having some chest pain recently and he’s concerned he might have angina.

While The House of God introduced the term “gomer”, to refer to the oldest, frailest patients, who frequently fill up emergency rooms and hospitals, but whom doctors are usually powerless to do anything for, The Ministry of Bodies introduces its own new term, “super-tanker”, to refer to patients so demanding, and so difficult to “steer”, that all decisions relating to their care need to be made by a single physician, who is willing to act as their “captain”.

Through a large number of short and often amusing vignettes, O’Mahony showcases much of what is wrong about modern medicine. As an example, he shows how the subconscious belief in immortality that seems to grip much of the population drives decision making in the health care system, resulting in absurd overtreatment of people at the end of life.

He also points his finger damningly at what is perhaps the biggest problem there is in health care in many western countries at the moment – the chronic shortage of hospital beds, and how this, when combined with an ever increasing “management by metrics”, has resulted in a gaming of the system that often leads to those with the least need getting care ahead of those with the greatest need.

The book is both hilarious and depressing, and should be read by anyone with an interest in what happens in hospitals and in what doctors do. That probably means it should be read by everyone.

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36 thoughts on “The ministry of bodies”

    1. Appreciate the link! It is not easy shedding and upgrading the groupthink of mainstream programming. Too often we do not realize the answer is not uncritically jumping into the alt-right echo chamber filled with just as much self-serving ideology. You really have to walk the Earth alone, and that’s not easy, given our evolved need for socialization. Hats off to those with the courage to think different and persist. It’s rather like staying on a diet – few can do it.

  1. You are such a great guy, Sebastian! It seems as a lot is wrong as far as medical treatment goes. The doctors work for Big Pharma many times. I think doctors should read Bruce Lipton as well. His book The Biology of Beliefs….(longer title)…might make some people realize what he did find out working with stem cells and epigenetic. His knowledge doesn’t seem to be what doctors learn in med. school….

    1. That one I will read. Thankyou for reminding me of him.

      “Cells, tissues, and organs do not question information sent by the nervous system. Rather, they respond with equal fervor to accurate life-affirming perceptions and to self-destructive misperceptions. Consequently, the nature of our perceptions greatly influences the fate of our lives.”

      /Bruce H. Lipton

  2. Thanks Sebastian, I read House of God as a young doctor and identified with all of it. I retired 10 years ago utterly disillusioned. Now I have cured my diseases of the Western world by diet.
    I preach to all who will listen, which isn’t many. Samuel Shem’s Mount Misery says it all about psychiatry which was my profession.

    1. ‘Now I have cured my diseases of the Western world by diet.’

      Would you be so kind as to elaborate?

      1. I weighed 21 stone 7 years ago with T2 diabetes and proliferative retinopathy. I looked on the internet and tied a low carb diet. It magically reduced my weight by 10 stone. Diabetes and retinopathy is in complete remission. Lately I have gone even further with a full ketogenic diet with intermittent fasting. Weight is down further, sleep better, mood better, brain acuity better, joints free of pain, don’t need to get up in the night to pee. In fact, I feel 44 instead of my 64 years.
        It is not Covid that is killing us, it is our diet of processed carbs, seed oils, sugar and constant snacking on empty carbs. i.e. the standard western diet.

    2. I totally agree with Liz. A low carb diet is the best treatment for almost every disease. In my experience (i’m a very elderly man) I fixed overweight, acid reflux, insomnia, chronic fatigue syndrome and avoided an incipient diabetes and several other small pathologies like back pain, ankle pain, acquiring a physical and mental efficiency never experienced. Almost a million of Italian people are attending the life 120 style, which is promoted by the journalist Adriano Panzironi in his divulgative book “Vivere 120 anni-Le verità che nessuno vuole raccontarti”, an impressive best seller with great impact in Italy.

  3. The title “Ministry of Bodies” hoovers somewhere between Monty Python and 1984. Very clever.

  4. It seems to me that the bulk of the negative developments in modern medicine arise from socialized medicine. Patients want to get everything they believe that their taxes have paid for. On the other hand, the Governments have instilled the public a view that it is omnipotent and omniscient (along with a lie, Governments do not have infinite money). Add to the mix a medical personnel’s agency problem and you will have a pretty nice mess. The only thing that saves us from total disaster is doctors and nurses’ decency, in most cases.

    Congratulations for your writings.

    1. ‘The only thing that saves us from total disaster is doctors and nurses’ decency, in most cases. ‘

      I think that idea has been thoroughly exposed as a lie in the UK.
      The NHS/government threw out the elderly at the start of the ‘pandemic’ and left them to die in their care homes, not a peep of protest from the medical professionals.
      The NHS/government then forced DNR orders on the elderly and disabled, again not a peep of protest from the medical professionals.
      The NHS was essentially shut down for anything but covid for at least six months with the nurses and doctors being so idle many had time to make tik tok dance videos.

      1. Also, no protest against the repeated sidelining or banning of apparently effective low-cost prophylactics and treatments with known safety profiles which could have brought the pandemic to an end a long time ago and saved hundreds of thousands of lives, in favour of expensive proprietary prophylactics that are (as we keep being told) very fragile to new variants and still have a long way to go in their phase III trials.

  5. ‘the chronic shortage of hospital beds’
    The UK has slashed the number of hospital beds whilst simultaneously ramping up the size of the population with relentless barely controlled mass immigration.
    Sometimes I wonder if the UK political class want to ruin the nation state, only kidding, I don’t wonder about this I know it to be a fact.

    1. As the recently departed defence minister described the current UK government, it is “a cesspit”. With master shoveler being Johnson.

  6. Thank you I’ve just bought your book, kindle edition. Well I hope I have, modern I.T. confuses me.
    I’m only writing this comment so I will receive others in my email. See what I mean by being confused!

  7. Thanks for the tip on the new book. After thirty years as a vascular surgeon, I have a lot of bedtime stories. A great book by James Stewart is a must read. It’s called “The Blind Eye”. It reads like a novel but is a facinating account of a deranged surgical resident who over the course of his surgical training diabolically murders patients in the Ohio State University Hospital in the mid to late 1980s as the surgical administration ignored and sometimes even gaslighting the evidence.

  8. Readers who liked “Ministry of Bodies” might like “Mad Medicine: Myths, Maxims and Mayhem in the National Health Service” – also written by a retired hospital consultant (me) who is beyond the reach of punishment for heresy etc (I think). It has many lessons for doctors new and old, as well as for the public. Jeremy Hunt liked it! It predates the pandemic so you will have to wait a little for my take on that – unless you have a look at my blog.

  9. Without gomers, vascular surgery would disappear. I would imagine that that specialty is also known as “hackers” because they amputate so much. Lots of gallows humor in that specialty. More than the “gropers” (OBGYN) or the “pushers” (anaesth.).

    Vascular surgeons also experiment a lot on patients. By design. Most of their devices aren’t thoroughly tested because they are used rarely. They have a large toolkit of various knicknacks and could hardly function without device manufacturers. (Perhaps I exaggerate a bit.)

  10. I wish that you will read this little book published in 1987:
    Kill as Few Patients as Possible, by Oscar London.
    ISBN 0-89815-197-X.
    I trust it as the best book about practical Internal Medicine.
    You can find it at the usual vendors by the Net.

  11. It’s not just that modern medicine is badly broken. The real problem is that we’ve lost sight of the goal, which is to lead healthy lives with minimal or no medical care required.

    Along these lines, read the book Nutrition and Physical Degeneration by Weston Price. He was a dentist wanted to understand why tooth decay was rampant in our society. He travelled the world in 1929-30 to visit places still living unchanged, and those transitioning to more modern lifestyles/food. The changes in jaw structure and overall health are striking. In traditional cultures, heart attacks, cancer, and massive physical degeneration were extremely rare.

    I think we’ve been poisoning ourselves. What makes it hard to see is that our culture seems so clean, so advanced, the food looks and tastes great. But modern chemicals create toxicity, modern farming produces food that doesn’t nourish, food processing creates toxic foods never eaten before, EMFs create metabolic stress, modern lighting affects circadian rhythm.

    We need to find a way to restore health.

    1. Weston Price’s book is brilliant. My grandchildren live in a house with plenty of normal activity. No anti-microbial “sanitisers”. They have had no pharma drugs or needles. They have real food, (as so far as that is is possible), and plenty of vitamin C. They are as healthy as anyone could wish.

  12. Dr. Rushworth:

    So glad to see that Amazon eventually published an English language version of your book. I bought it immediately after reading the first three sample pages and will continue reading it after writing this comment. Thanks for this particular post reviewing “The Ministry of Bodies” and mentioning other works in a similar vein. Also thanks to your sharp readers for similar links.

    When you are the spouse of a health care professional, you do learn certain bits information. Most of it should not be shared publicly due to various privacy laws and employee restrictions. But among the bits I have learned, I have surmised that it is quite difficult and stressful for practicing medical professionals to be burdened with a novel virus with unpredictable behaviors and also a disease lacking in treatment protocols. Many doctors and health professionals are akin to very highly educated, conscientious mechanics. The seem to pride themselves on “fixing things”. If you bring them your sick vehicle, they will actually do whatever they can to try to fix or save your vehicle . Some of these ‘mechanics’ (e.g. in America Pierre Kory, Peter McCullough and others) have academic skillsets and will invent, test, persevere until they find solutions rather than let their patients die. It’s simply not in their nature to give up on their patients or wait for big pharma to hand them a solution months on while they are witnessing death and disease. I find that heroic. I am sure such physicians pay some kind of career price for their well-intentioned risks and efforts. Thanks again for this post.

    Ryan M. Ferris
    Bellingham, WA, USA

  13. This is by far one of the best blogs that you have written, Sebastian. I will order both books immediately. Thank you.

  14. Well as a burned out family practitioner i already feel a keen kinship with Seamus. Disillusioned? More like cast adrift at sea in a raft with sharks circling. I will read it!

  15. Thank you Sebastian, I got both books, started with The House of God and can’t stop reading it. Very well written, funny and serious where it needs to be and on top of that not even a trace of Woke of Feminism 😊

  16. Read ‘House of God’ at your recommendation. I am a fairly new nurse at 5 years, and much of the book rings true. I try to be kind to our residents, seeing how much stress they are under.

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