When Stephen Joseph Bergman was a medical intern at Boston’s Beth Israel Hospital in the late 1970s, he came to the institution with youth and grand ideas.

“We came into the hospital internship as idealists,” he says. “We quickly found that our way of wanting to do good medicine ran into the received wisdom of the medical system. There was a tremendous clash. Midway through the internship, a voice in my head said, ‘This is brutal and unfair to both doctors and patients.’ Someone has to tell this story, and it looks like it has to be me.”

And tell it he did.

His book, “The House of God” was published in 1978 under the pen name Samuel Shem and caused quite a ruckus, especially among the older, established faculty. It was a satire about the medical industry, yet it told truths about a system that pushed doctors to make decisions that went against good medicine.

“There’s a group of patients whom we described as GOMERS — Get Out of My Emergency Room,” says Bergman, who now prefers to go just by Shem. “They were chronic visitors with 18 issues who really wanted to die, but we couldn’t let them go because we had to make money. We’d have to take care of them in extreme different ways. Law No. 1 in the book was GOMERS don’t die. We were so overloaded with the GOMERS. It was a little hard to do what we wanted to save other lives.”

It also sold more than 2 million copies, is now published in 30 languages and is widely referred to as one of the most important medical novels of the 20th century. Many doctors read it multiple times over the course of their careers. Shem is currently teaching a seminar on the book in conjunction with its 40th anniversary.

A sequel, “Man’s 4th Best Hospital,” is set to be published in October 2019 from Penguin/Random.