Roy is The House of God’s protagonist, a 30-year-old Jewish doctor who grew up in upstate New York. He spent time in England under a Rhodes Scholarship before enrolling in medical school. His father, barred from attending medical school because of his ethnicity, became a dentist instead. This family history suggests that perhaps Roy is acting under family pressure or a sense of fulfilling his father’s dream of becoming a doctor rather than really wanting to. His father is portrayed as naïve and clueless about Roy’s experiences or inner life, suggesting that Roy finds him inadequate as an authority figure. Roy may be especially open to the Fat Man’s guidance because of this void, though at first he dismisses the Fat Man just as he has learned to dismiss his father.   

Roy experiences compassion and grief over the suffering he sees during his internship year but, until late in the book, doesn’t know how to articulate or handle those feelings in a productive way. Although seeming to recognize them as coping mechanisms, he welcomes the erotic connections between himself and female patients and hospital workers in the course of his work. He also drinks heavily in his internship year, another coping mechanism.