“And I knew now that the sex in the House of God had been sad and sick and cynical and sick, for like all our doings in the House, it had been done without love, for all of us had become deaf to the murmurs of love.”

This quote, from the flash-forward scene at the end of Roy’s internship year, shows how isolated the hospital is from the outside world and that having sex there is a coping mechanism. Roy has also come to view his work at the House of God as being done “without love,” the opposite of what he intended or believed it should be.

“These fingers do not touch bodies unless they have to. You want to see bodies, go see bodies. I’ve seen enough bodies, and especially bodies of gomers, to last me the rest of my life.”

This quote, spoken by the Fat Man, summarizes his non-interfering philosophy of medicine. It also upends the expectation that a medical professional doesn’t get tired of examining patients or doesn’t experience disgust when doing so. As the Fat Man’s character does throughout the book, this statement undermines and implicitly questions expectations.

“Why didn’t they want you to meet me, your first day as a doctor? Because I tell things as they are—no bullshitology—and the Fish and the Leggo don’t want you to get discouraged too soon. They’re right—if you start to get as depressed now as you’ll be in February, in February you’ll jump off a bridge like Jo’s pop. The Leggo and the Fish want you to cuddle with your illusions, so you don’t give in to your panic.”

The Fat Man acknowledges that the higher-ups do not want the interns to understand or suspect the difficulties they’ll be up against during their internship year. Roy loves that the Fat Man acknowledges the interns’ fear (“panic”) and that he wants to be honest with them despite the dark nature of what they may undergo.