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Samuel Shem
Samuel Shem
Samuel Shem
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Samuel Shem is the pen name of the American psychiatrist Stephen Joseph Bergman (born 1944). His main works are The House of God and Mount Misery, both fictional but close-to-real first-hand descriptions of the training of doctors in the United States.

Of Jewish descent,[1] Bergman was a Rhodes Scholar at Balliol College, Oxford in 1966, and was tutored by Denis Noble FRS, cardiac physiologist and later head of the Oxford Cardiac Electrophysiology Group. In an address to Noble's retirement party at Balliol, he related that Noble's response to Bergman's attempt to become a writer was to ply him with copious sherry. He graduated from Harvard College and Harvard Medical School.[2]

He was an intern at Beth Israel Hospital (subsequently renamed Beth Israel Deaconess Medical Center), an experience that inspired his book The House of God.

As of 2017, Bergman is a member of the faculty of the New York University School of Medicine at NYU Langone Medical Center.

Shem's play Bill W. and Dr. Bob had an Off Broadway run at New World Stage in New York City. It ran for 132 performances and closed on June 10, 2007. The New York Times called it "an insightful new play."

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Samuel Shem

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Samuel Shem is the pen name of Stephen J. Bergman (born December 27, 1944), an American psychiatrist, novelist, playwright, and professor of medical humanities renowned for his satirical depictions of the medical profession and human relationships. Bergman grew up in , and attended , where he graduated magna cum laude and in 1966 with a degree in social relations. He then pursued a at University, earning a PhD in , before completing his MD at in 1973. Following his residency at Beth Israel Medical Center in New York, Bergman joined the faculty at , serving as a professor of for over 35 years until his retirement from clinical practice in 2005. In 2014, he transitioned to Grossman School of Medicine as a clinical professor in the departments of medicine and , where he teaches on maintaining humanity in healthcare. Shem's breakthrough came with his debut novel, The House of God (1978), a semi-autobiographical satire based on his internship experiences that critiques the dehumanizing aspects of medical training and has sold over two million copies worldwide in more than 30 languages. The book introduced iconic phrases like "gomers" (elderly patients seen as burdens) and remains influential, with a 30th-anniversary symposium held at the Cleveland Clinic in 2008. His subsequent works form a "healing quartet" exploring medicine and connection: Mount Misery (1997), a sequel focusing on psychiatric residency; Man's 4th Best Hospital (2019), depicting a return to corporate-dominated healthcare; and Our Hospital (2023), which addresses COVID-19's impact on a small-town facility. Beyond novels, Shem has written plays such as the Off-Broadway hit Bill W. and Dr. Bob (2007), co-authored with his wife Janet Surrey about the founders of Alcoholics Anonymous, which ran for 148 performances and has been staged internationally. In nonfiction, Shem co-authored We Have to Talk: Healing Dialogues Between Women and Men (1998) and Making Connections: Building Gender Dialogue and Community in (2007) with Janet Surrey, emphasizing relational therapy and gender dynamics. He has delivered commencement addresses at over 50 medical schools and spoken globally on "Staying in ," earning honors like the Boston Public Library's Literary Light award and Vanderbilt University's Medal of Honor. Married to clinical Janet Surrey since 1973, with whom he has an adopted daughter, Shem continues to influence and literature by highlighting amid systemic pressures.

Early life and education

Family background

Stephen Bergman, who writes under the pen name Samuel Shem, was born in 1944 and grew up in , to Jewish parents. His father, Sigmund "Sig" Bergman, was a dentist born in New York in 1914, who aspired to become a physician but was barred from in the 1930s due to antisemitic quotas and against . His mother, Rose Fuchs Bergman (1913–2007), was a community activist who co-founded the Hudson Area Library in 1959, reflecting the family's commitment to education and public service. The Bergman household emphasized intellectual achievement, with Sig Bergman encouraging his son to apply to prestigious universities like Harvard rather than more conventional paths such as West Point. This focus on academics and professional success was shaped by the family's Jewish heritage and encounters with societal prejudice, instilling values of that later informed Shem's explorations of and ethical challenges in . Despite the household's preference for practical professions, Bergman pursued his interest in literature.

Academic pursuits

Stephen Bergman, who later adopted the pen name Samuel Shem, graduated from in 1966 with a concentration in social relations, while fulfilling pre-medical requirements. He was elected to , recognizing his academic excellence. That same year, Bergman received a , enabling him to attend University. There, he pursued a DPhil in . This period marked a pivotal intellectual development, blending rigorous scientific inquiry with Bergman's emerging literary inclinations, as he began exploring writing amid his laboratory work. Following , Bergman enrolled at , graduating in 1973 with an . Throughout his medical studies, he balanced the demands of clinical training with his passion for literature, drafting early creative works that reflected his philosophical interests in human experience and societal structures. This dual pursuit laid the foundation for his later integration of medical knowledge and narrative storytelling.

Medical career

Training and residency

After graduating from Harvard Medical School in 1973, Samuel Shem, whose real name is Stephen Bergman, commenced his medical internship at Beth Israel Hospital in , a teaching affiliate of Harvard. This one-year program, spanning 1973 to 1974, immersed him in the intense demands of clinical medicine, where interns managed demanding schedules, complex patient cases, and a steep dominated by senior physicians. Bergman later described these experiences as revealing the often dehumanizing pressures of hospital life, including relentless on-call duties and ethical dilemmas in patient care that tested personal resilience. The internship's high-stress environment and rigid power dynamics profoundly shaped Bergman's perspective on medical training, serving as the direct inspiration for his satirical novel (1978), which fictionalizes an intern's year at a modeled after Beth Israel. In the book, these elements are portrayed through exaggerated vignettes of overworked staff navigating futile treatments and institutional absurdities, highlighting systemic flaws in how new doctors are forged. Bergman's observations during this period underscored the emotional toll of prioritizing efficiency over empathy, themes that resonated widely among medical professionals. Following the internship, Bergman completed his residency in at in , a Harvard-affiliated institution renowned for its programs. This training, undertaken in the mid-1970s, focused on the diagnosis and treatment of psychiatric disorders, building on his earlier DPhil in from Oxford University, which had equipped him with insights into the biological bases of . While less publicly chronicled than his internship, the residency deepened his understanding of interpersonal dynamics in healing, influencing his later explorations of therapy and human connection in .

Clinical practice

After completing his residency, Stephen Bergman, writing as Samuel Shem, established his clinical practice in at , where he worked from the late 1970s until 2005. His residency experiences there provided the foundation for his expertise in patient-centered care. Specializing in the treatment of alcoholics and drug addicts, Bergman integrated practical interventions such as requiring attendance at meetings as part of , observing dramatic improvements in patients upon achieving sobriety. Bergman's therapeutic approach centered on relational therapy, drawing from relational-cultural theory to foster mutuality and emotional connections in treatment. He emphasized emotional advocacy, encouraging patients to express vulnerabilities within a supportive framework that prioritized over rigid institutional protocols. This method highlighted the importance of genuine interpersonal bonds in recovery, influencing his advocacy for more compassionate psychiatric practices. Throughout his tenure, Bergman's interactions with patients at revealed deep insights into the flaws of institutional , including bureaucratic hurdles and dehumanizing routines that hindered effective care. These observations directly informed his critiques in works like Mount Misery, where he portrayed the emotional toll on both patients and clinicians in such settings. His commitment to relational and humanistic principles contributed to broader discussions on improving care by centering human connection.

Academic appointments

Samuel Shem, whose real name is Stephen J. Bergman, served as an instructor in at from 1977 until 2005, spanning nearly three decades of teaching focused on psychiatric education and the human elements of medical practice. During this period, he drew on his clinical experiences at to illustrate principles of in psychiatry training. In 2014, Bergman transitioned to New York University Grossman School of Medicine, where he was appointed Clinical Professor of Medical Humanities in the Department of Medicine, a role he continues to hold as of 2025. In this capacity, he contributes to curricula that integrate literature, narrative medicine, and ethical considerations into medical education, emphasizing the preservation of empathy amid clinical demands. Throughout his career, Bergman has delivered lectures and commencement addresses on "Staying Human in Medicine" at over 50 medical schools worldwide, using insights from his psychiatric background to advocate for connection and resilience in healthcare professionals. These talks, often drawing from his experiences in residency and practice, have influenced discussions on burnout prevention and the cultivation of compassionate care in medical training.

Literary career

Debut novel

Samuel Shem's debut novel, , was published in 1978 by under his pen name, drawing directly from his experiences as a medical intern at Beth Israel Hospital in . The book fictionalizes the grueling realities of internship training, transforming Shem's real-life residency challenges into a satirical narrative that critiques the dehumanizing aspects of and culture. The novel centers on Dr. Roy Basch, a young intern navigating the chaotic "House of God," a thinly veiled stand-in for Beth Israel, where he and his peers endure relentless shifts and ethical dilemmas under the guidance of the eccentric senior resident known as "the Fat Man." This mentor figure imparts the infamous "Laws of the House of God," a set of cynical maxims—such as "Gomers don't die" (referring to elderly patients with multiple ailments) and "The delivery of good medical care is to do as much of nothing as possible"—that encapsulate the survival strategies interns adopt amid institutional pressures and patient suffering. Through these elements, Shem employs dark humor and raw dialogue to expose the emotional toll on new doctors, highlighting themes of burnout, power imbalances, and the commodification of care. Upon release, The House of God sparked immediate controversy within the medical community, with critics decrying its profane language, portrayal of patient neglect, and unflattering depiction of physicians as either incompetent or callous, while others praised its unflinching honesty about internship horrors. Despite the backlash—or perhaps because of it—the book quickly became a bestseller, selling over 2 million copies worldwide and earning acclaim from outlets like The Lancet as one of the twentieth century's most notable medical novels. It has since been translated into more than 30 languages, cementing its status as a seminal work in medical satire.

Subsequent works

Following the success of his debut novel The House of God, which established Samuel Shem as a sharp satirist of medical training, Shem continued to explore the human and institutional frailties of healthcare in his subsequent works, evolving from focused critiques of residency to broader examinations of corporate influences and personal healing. His 1997 novel Mount Misery serves as a direct sequel to The House of God, shifting the satire to psychiatric residency at the fictional Mount Misery hospital, where protagonist Dr. Roy Basch navigates a chaotic array of competing therapeutic theories, ego-driven mentors, and the emotional toll of mental health care. The book critiques the pseudoscientific fads and power imbalances in psychiatry during the late 20th century, portraying residency as a "misery" that mirrors the patients' struggles while highlighting Basch's growth toward authentic empathy. Shem's novels featuring Roy Basch form his "Healing Quartet," which critiques the medical profession over decades: (1978), Mount Misery (1997), Man's 4th Best Hospital (2019), and Our Hospital (2023). In Man's 4th Best Hospital, Basch and his former colleagues reunite decades after their to combat the takeover of their hospital by profit-driven conglomerates, lampooning electronic health records, administrative bloat, and physician burnout as erosions of patient-centered care. This work illustrates how economic pressures have transformed hospitals into "fourth-best" entities, prioritizing metrics over medicine. The 2023 novel Our Hospital concludes the quartet, with Basch returning to a pandemic-ravaged during , exposing the exhaustion of frontline workers and the clash between compassionate practice and resource-starved systems. Through this lens, Shem underscores the quartet's overarching evolution: from the raw survival of to a call for relational healing amid systemic collapse. In The Spirit of the Place (2008), Shem departs from the Basch series to depict a doctor's reconnection with his rural roots, following Dr. Orville Rose's return to his hometown after his mother's death, where he confronts personal history and the challenges of solo amid community "breakage." The novel emphasizes themes of healing through place and relationships, contrasting the alienation of modern urban medicine with the intimate, holistic demands of small-town care, drawing on Shem's own reflections on medicine's spiritual dimensions. Departing from medical themes, At the Heart of the Universe (2015) is a non-satirical epic set in rural , inspired by Shem's experiences adopting his daughter, and follows two mothers and a father entangled in love and loss under the . The novel shifts focus to universal themes of , identity, and cultural displacement, using the personal to probe broader human connections beyond professional critique.

Collaborative projects

Samuel Shem has collaborated extensively with his wife, clinical psychologist Janet Surrey, on theatrical and literary works that explore themes of recovery, relationships, and personal growth. Their most prominent joint project is the play Bill W. and Dr. Bob, which premiered in 2007 and chronicles the lives of founders Bill Wilson and Dr. Robert Smith, as well as the pivotal roles of their wives Lois Wilson and Anne Smith in establishing Al-Anon. The production ran for 132 performances at in before closing on June 10, 2007, earning the 2007 Performing Arts Award from the National Council on Alcohol and Drug Dependence for its inspirational portrayal of addiction and mutual support. In addition to this full-length play, Shem has authored shorter dramatic works that have been anthologized and performed, reflecting his interest in interpersonal dynamics and societal pressures. His Room for One Woman (1981), which depicts an elderly disabled woman's struggle to retain her independence in a single-room occupancy hotel amid eviction threats, was produced alongside Napoleon's Dinner at the Impossible Ragtime Theatre in New York and later included in The Best Short Plays of 1982. Napoleon's Dinner (1981), a comedic piece about a pompous academic preparing for a formal dinner while grappling with family tensions and his own pretensions, was also featured in the same anthology and staged in the same 1979 Off-Off-Broadway double bill. These short plays, while primarily Shem's solo efforts, align with the relational humanism evident in his collaborations with Surrey. Shem and Surrey's co-authored non-fiction books further extend their shared focus on healing through dialogue and partnership. In We Have to Talk: Healing Dialogues Between Women and Men (1998), the pair draws from their workshops—beginning with a 1986 experimental group in —to offer practical guidance on improving communication in heterosexual relationships, emphasizing empathy and mutual vulnerability as antidotes to common relational breakdowns. Their later work, The Buddha's Wife: The Path of Awakening Together (2015), reimagines the life of Yasodhara, the historical Buddha's wife, as a of relational , blending psychological insights with Buddhist principles to advocate for awakening through intimate rather than solitary enlightenment. These books, informed by Surrey's expertise in relational and Shem's style, underscore a collaborative that transforms personal and therapeutic experiences into accessible, transformative texts.

Personal life

Marriage and family

Samuel Shem, whose real name is Stephen Bergman, met Janet Surrey during their college years at a Dartmouth football game in late October 1963, marking the beginning of a . The couple planned to marry after graduation, but their relationship faced a temporary breakup when Bergman, as a Rhodes Scholar, moved to Oxford University in in 1966, leading to a period of separation during which he experienced depression and heavy drinking. They reconciled after Bergman's return from Oxford, marrying in 1973 and building a lasting partnership based on shared interests in relational and , which deepened in the 1980s. Janet Surrey is a clinical who has practiced extensively and served as a founding scholar of the Jean Baker Miller Training Institute at the Wellesley Centers for Women, where she has contributed to work on issues, , and relational . Her expertise as a has influenced their joint professional endeavors, including explorations of interpersonal dynamics and healing dialogues. In 1992, Shem and Surrey adopted their daughter, Katie Chun Surrey-Bergman, a four-month-old from , joining a community of adoptive families and raising her in a bicultural household that emphasized her Chinese heritage. In 2001, they returned to when Katie was nine, an experience that profoundly inspired Shem's 2015 novel At the Heart of the Universe, which weaves themes of , loss, and reunion around a similar story of a daughter connecting adoptive and birth parents in rural .

Activism and interests

Shem has advocated for reform by critiquing the flaws in psychiatric training and practice through his writings and public engagements. In his 1997 novel Mount Misery, he portrays the emotional toll and ethical lapses in a prestigious , drawing on his own residency experiences to expose dehumanizing elements and call for more compassionate care in settings. Similarly, Shem has used speeches to address physician burnout and the need for relational approaches in , emphasizing resistance to systemic inhumanities as a form of professional . He has also campaigned against corporate influences in , highlighting how profit motives erode patient-centered care. His 2019 novel Man's 4th Best satirizes the takeover of healthcare by corporate entities, portraying billing and efficiency metrics as barriers to healing, and has been praised for its timely critique of commercialization. In a 2015 New York Times , Shem argued for reducing unnecessary medical interventions to preserve the humanity of care, linking over-treatment to corporate pressures. These themes recur in his global lectures on , such as the ongoing series "Staying Human in ," delivered at institutions worldwide to promote ethical resistance and connection in healthcare. Shem's personal interests include and relational therapy, areas he has co-developed with his wife, clinical psychologist Janet L. Surrey. Their 2015 book The Buddha's Wife: The Path of Awakening Together reimagines the life of Yasodhara, the Buddha's wife, to explore relational spirituality and mutual awakening through community bonds, integrating Buddhist principles with psychological insights. This work builds on Surrey's foundational contributions to relational-cultural theory, which posits that growth occurs through empathetic connections rather than isolation, a perspective Shem applies to therapeutic and medical practices. Of Jewish descent, Shem's advocacy for is informed by his heritage, as seen in his emphasis on moral values and equity in healthcare ethics lectures. His experiences adopting a daughter from have further motivated his focus on and global interconnectedness in personal and professional pursuits.

Legacy and influence

Impact on

Samuel Shem's debut novel, (1978), served as a pivotal catalyst for broader discussions within the medical community regarding intern burnout, the dehumanizing effects of grueling training schedules, and rigid hierarchies. The satirical portrayal of experiences at a fictional exposed the psychological toll of 36-hour shifts and authoritarian structures, prompting reflections on the need for more humane training environments. This work contributed to eventual reforms, including the Accreditation Council for Graduate Medical Education's (ACGME) 2003 duty-hour restrictions that limited resident workweeks to 80 hours and consecutive shifts to 24 hours, addressing the exhaustion and errors highlighted in the novel. Through his extensive lectures on "staying human in ," Shem has advocated for maintaining and relational connections amid professional isolation, drawing from themes in his writings to emphasize the healing power of mutual doctor-patient bonds. Delivered at over 50 commencements worldwide, these talks underscore the risks of burnout and the importance of in preserving clinicians' well-being. His ideas have been integrated into curricula, notably at NYU Grossman School of Medicine, where Shem teaches six-week seminars analyzing to explore patient-care dynamics and ethical challenges. In later works like Man's 4th Best Hospital (2019), Shem critiques the rise of corporate healthcare, depicting electronic medical records as profit-driven tools that prioritize billing over patient interaction and treat physicians as expendable in privatized systems. The novel illustrates how such structures exacerbate burnout— with studies showing physicians spend up to 60% of patient visit time on screens— and fuel ethical dilemmas in for-profit hospitals. These portrayals have sparked ongoing debates about privatization's impact on care quality, influencing conversations in and policy discussions on decoupling clinical data from insurance incentives.

Recognition and awards

Samuel Shem has received numerous honors recognizing his contributions to , including selection as one of the Boston Public Library's "Literary Lights" honorees. He was also named one of "Boston's Best Authors" in recognition of his literary impact. These accolades build on the success of his debut novel, , which became a and established his reputation as a satirical voice in . Shem's novel The Spirit of the Place (2008) earned two national awards for best , affirming his prowess as a . Specifically, it won the National Best Book Award in General and from USA Book News in 2008. In 2009, it received the Independent Publisher Book Awards (IPPY) Silver Medal in . Shem's expertise in has led to invitations as a at over 50 commencements across the . He also delivered a keynote address at the Hemingway Centennial Celebration in in 1999, highlighting his literary stature. His collaborative play Bill W. and Dr. Bob, co-authored with , received praise from as a "satisfying revival" with a "purpose-driven script [that] never forgets the humor of the human experience." This recognition underscores the play's effective portrayal of founders Bill Wilson and Dr. Robert Smith. Shem received the Vanderbilt University Medal of Merit for his contributions to .

References

  1. https://www.thecrimson.com/article/2016/5/23/stephen-bergman-profile/
  2. https://www.harvardmagazine.com/2024/03/feature-steve-bergman-samuel-shem
  3. https://www.robinstrausagency.com/samuel-shem
  4. https://journalofethics.ama-assn.org/article/house-god-it-pertinent-30-years-later/2011-07
  5. https://pmc.ncbi.nlm.nih.gov/articles/PMC5537593/
  6. http://www.samuelshem.com/v2/about/
  7. https://medicine.buffalo.edu/news_and_events/lectures/golden-lecture/archive/2005.html
  8. https://smhs.gwu.edu/news/human-side-medicine
  9. https://www.theguardian.com/theguardian/1999/feb/08/features11.g29
  10. https://www.findagrave.com/memorial/218115056/sigmund-bergman
  11. https://journalofethics.ama-assn.org/article/selecting-medical-students-then-and-now/2012-12
  12. https://www.thecrimson.com/article/1966/1/3/harvard-breaks-rhodes-record-committee-selects/
  13. https://hms.harvard.edu/news/commencement-2009
  14. https://www.brandeis.edu/now/2009/may/pbkceremony.html
  15. https://med.nyu.edu/departments-institutes/medicine/divisions/medical-humanities/faculty
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  17. https://www.icmi.com.au/samuel-shem/
  18. https://med.virginia.edu/biomedical-ethics/wp-content/uploads/sites/129/2021/03/MCH-24March21-handout.pdf
  19. https://nypost.com/2019/01/19/how-a-1970s-satire-changed-the-medical-profession/
  20. https://www.newyorker.com/books/under-review/the-house-of-god-a-book-as-sexist-as-it-was-influential-gets-a-sequel
  21. https://www.thenation.com/article/culture/samuel-shem-man-fourth-best-hospital-book-review/
  22. https://www.mdlinx.com/article/house-of-god-author-discusses-new-sequel-in-exclusive-interview/6btdHvC7wrZp5UlstqV3HA
  23. https://www.theatlantic.com/health/archive/2012/11/samuel-shem-34-years-after-the-house-of-god/265675/
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  27. https://www.penguinrandomhouse.com/books/606772/mans-4th-best-hospital-by-samuel-shem/
  28. https://www.penguinrandomhouse.com/books/696833/our-hospital-by-samuel-shem/
  29. https://kevinmd.com/post-author/samuel-shem
  30. https://www.kentstateuniversitypress.com/2011/the-spirit-of-the-place/
  31. https://www.goodreads.com/book/show/3180195-the-spirit-of-the-place
  32. https://www.goodreads.com/en/book/show/24683765-at-the-heart-of-the-universe
  33. https://www.publishersweekly.com/9781609806415
  34. https://billwanddrbob.com/learnmore.htm
  35. https://www.broadway.com/buzz/168081/alcoholics-anonymous-play-bill-w-and-dr-bob-to-return-off-broadway/
  36. https://www.concordtheatricals.com/p/1135/bill-w-and-dr-bob
  37. https://www.concordtheatricals.com/p/8391/room-for-one-woman
  38. https://www.samuelshem.com/v2/body-of-work/plays/
  39. https://www.concordtheatricals.com/p/9309/napoleons-dinner
  40. https://www.nytimes.com/1979/11/25/archives/stage-shem-plays-at-the-ragtime.html
  41. https://www.basicbooks.com/titles/samuel-shem/we-have-to-talk/9780465032525/
  42. https://wipfandstock.com/author/janet-l-surrey/
  43. https://samuelshem.wordpress.com/
  44. https://www.wcwonline.org/JBMTI-Site/Founding-Scholars/janet-surrey
  45. https://www.jewishboston.com/read/samuel-shem-on-the-joys-of-adoption/
  46. https://www.sevenstories.com/books/3914-at-the-heart-of-the-universe
  47. https://beingfullyhuman.com/2020/11/16/medical-activism-a-foundational-element-of-professional-identity/
  48. https://www.nytimes.com/2015/02/21/opinion/for-doctors-less-is-more.html
  49. http://www.samuelshem.com/v2/
  50. https://meditationandpsychotherapy.org/members/jansurrey/
  51. https://www.bostonglobe.com/2020/02/05/magazine/why-burned-out-doctors-despise-electronic-health-records/
  52. https://www.forbes.com/sites/judystone/2019/11/12/electronic-medical-records-burnout-and-mans-4th-best-hospital/
  53. https://med.uth.edu/blog/2023/03/01/arts-resilience-welcomes-author-samuel-shem/
  54. https://www.theatlantic.com/author/samuel-shem/
  55. https://www.nytimes.com/2013/07/18/theater/reviews/bill-w-and-dr-bob-at-soho-playhouse-about-aa.html
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