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REVIEW: The Spirit of the Place

February 11, 2013
Don't even look at the cover. Read the book.

Don’t even look at the cover. Read the book.

Samuel Shem (Stephen Bergman), best known for the iconic House of God, is back. A few novels later, he’s got a gem: The Spirit of the Place (, kindle version).

In The Spirit of the Place, Shem keeps some of the blunt honesty and humour of his former work but provides a more intimate look at the life of a physician. And, it’s not really about medicine at all, it just happens that a physician is the perfect specimen for the kind of intensity and vulnerability that the protagonist needs to have. Instead of ‘buffing and turfing’ patients, Dr. Orville Rose (Orvy) is focused on, well, he doesn’t really know what. He struggles to accept the caustic embrace of family and is forced to confront it head-on.

With the news of his mother’s death, Dr. Rose returns to Columbia, the inexplicably whale-themed town where everything breaks and his past – and mother – haunt him. She has willed him the house, car, and half her savings on the condition that he stay in Columbia for 1 year and 13 days. He knows immediately what to do: flee back to Italy and his esoteric girlfriend, Celestina. Surprisingly, she suggests that Orvy obey the spirits and, since she’s already left him for a Swiss banker, he has little else to do. He joins his old mentor’s practice and is soon stuck piecing together fragmented Columbians at all hours of the night. His misery continues thanks to scathing posthumous letters from his mother delivered at regular intervals. It doesn’t help that his childhood-bully, now an American Hero, is living across the street and much to his chagrin, Henry Schooner seems desperate to befriend Orville.

The work gets harder when the good Dr Rose finds himself abandoned by his colleague, cleaning up the mess that the Columbians made of themselves. I think every health care provider, at some point in their career, has felt this way:

‘I’m the guy at the bad end of it all!’ he cried out, standing there on the icy street. “I am the one they call to sew them up, cast their bones, pronounce them dead. I’m the one called in for a dose of reality and I am sick of it! Do you know how much effort it takes just to sew up a wound, let alone try to repair a blown-off leg? How many years – hard, disciplined years – it takes to learn it? I put out enormous effort, superhuman effort on a daily basis, and they put out none! The Colombians eat crap and lie around like pigs and smoke so the nicotine makes them feel a little jazzed up while the carcinogenic tars mix with the PCBs from the river and the cement dust to destroy their lungs or livers, and they say to themselves, “gosh, I think I’ll go to the doctor!” – page 115

Just as that sounds familiar, most physicians can identify an old codger who mentored them and whose practice late in life was charming if sketchy. In this book, Bill Starbuck is that old doc. He prescribes his own remedy, Starbusol, for every ailment possible.

Another strike against Bill was his increasing reliance on his own special medicine, Starbusol. For decades, he had made the stuff himself. It came in bottles, smelled of pine, and tasted like a cross between cherry cough medicine Coca-Cola. In extreme cases, it could could be injected. No one, not even Orville, knew what was in it. – page 56

His wisdom is more convincing than his cure-all is effective:

‘Well, that makes sense.’ He smiled. ‘One thing I learned is, is that whenever you think you are choosin’ things based on the facts, ten years later you look back and see you didn’t know shit from Shinola about what was really going on in the world and in your life to push you to think you were choosing things one way or another.’ – Bill Starbuck, page 47

Through Bill, Shem provides relaxed wisdom, and through Orville he gives reassurance that we are all a little weird and fractured. I admire any writing that humanizes physicians, and the foolishness and cowardice that result in a faltering journey for Orville make him real and relatable.

From that first afternoon as a child in the field looking up at the clouds passing across when he had discovered the ‘something else’ and when, on bringing it back to his mother he’d been told he was crazy because ‘there’s nothing else but this,’ Orville had lived in the deep, secret, abiding sense that he was abnormal . . . Alternative to the culture, always. Even, years ago in college at Syracuse and medical school in Dublin, alternative to the alternative 60s – talking the talk but not walking the walk. – page 270

Women in The Spirit of the Place are less subjects of fantasy and more complicated challenges, compared to those in The House of God. Orville finds himself captivated by Miranda and her son Cray, whose slow-to-warm-up temperament provides great and endearing reward. Shem has traded in juvenile sexuality for a more mature and intimate strain; lust becomes love and though broken, like everything in Columbia, Orvy recognizes it.

While there is no list of rules to live by, The Spirit of the Place offers a more aged humour; wisdom in place of wit. House of God fans who rely on quick jokes might be disappointed but those who have also grown up themselves will appreciate Shem’s evolution. It’s still cynical, it’s just a little more honest and bare, forcing us to confront the fact that we are all – or have once been – as lost as Orvy.

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