With God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine, Victoria Sweet describes a unique style of patient care at Laguna Honda, the nation’s last almshouse.

Your book is laced with stories of your studies of the history of medicine, particularly Hildegard of Bingen’s Medicine. What’s the most important lesson history teaches us about treating patients today?

In the past, they really focused on the environment of the patient. We tend to see the patient as if there was no background, just a patient with a disease. Hildegard would be looking at what the patient ate, what they drank, the climate, their job. And because of the nature of their medications, they took time to work. So they would do this very slow kind of medicine. On some diseases today, like high blood pressure, that approach would work quite well.

You describe Laguna Honda as “the almshouse of yore... the last resort.” What is its legacy, and why isn’t there any place for such a hospital in today’s medical world?

The patients are fantastic, and the doctors can spend hours with them. But what’s happening today [is that] we’ve become “providers.” There’s this whole dehumanization. That’s wrong. In a computerized world, I still have great hopes that the pendulum will swing back—it only works when it’s human to human. We need an alternative universe of medical care, where we try the Laguna Honda way.

You’ve said you wish for a free hospital and a free almshouse [for extended care and rehabilitation] in every U.S. county. What’s the biggest hurdle to that?

There are two hurdles, one from the left and one from the right. We used to have this system where every county had a hospital almshouse, where once a patient gets out of a county hospital, there’d be someplace else to send them if needed. The left wanted to close these almshouses because they didn’t provide equal care. And the right was thrilled to hear that because a county system costs money.

One particularly heartbreaking story is that of Jimmy, an untreated schizophrenic who just days after his discharge was found dead in a park. Are hospitals getting any better at treating these patients?

In California, even getting somebody [who is mentally ill] admitted is difficult. Most are admitted to the psych ER, then as soon as they’re not completely crazy, they’re discharged. At Laguna Honda, we had a lot of psych patients, but we would admit them for other reasons. We had a very good psychiatric group, so we would have them for months and years. With the requirement [now] that we can only keep these patients for 72 hours, we get the most medicine we can into them and then have to discharge them—it’s a real Catch-22. We wouldn’t do that with diabetics.