Just Like Someone Without Mental Illness Only More So_ A Memoir - Mark Vonnegut [54]
The process whereby one gets to be a doctor is one where you pretty much have to be a grade-and-approval junky. This eventually has unfortunate consequences—all a hospital or insurer or pharmaceutical company has to do to get doctors to jump through hoops is set up a grading system and put some doctors in tier one and others in tier two or three or four. The courage to do the right thing in the face of disapproval is often lacking.
There is a dangerous point in the deliberation process of the admissions committee where the application has been formally presented and one of the people who interviewed the candidate briefly defends why he gave the candidate a 9.5 or 10.0. There’s a pause where anyone on the committee can say anything. If the next thing that’s said is strongly positive, the application will sail on to the next level, but if someone says, “A bit thin on the extras,” or “Were they involved in the community?” or, worst of all, “It’s a strong application, but is this applicant really right for here?” the fate of the otherwise strong applicant twists in the wind. Trying to defend someone at this point almost seems to make it worse. If the application needs your help, how good could it be?
People don’t apply to Harvard Medical School lightly. They are all standing on a lot of shoulders. We were passing judgment on some of the most absurdly intelligent, accomplished, highly motivated men and women the world had ever produced.
The curse of having to be important dooms a lot of us. Living up to all that white marble and the tree Hippocrates taught under and the admissions process is not easy. If you become a doctor to make a difference, it turns out that no difference you can make is enough. Unambitious people aren’t going to be applying to or getting into medical school, but once an ambitious person gets in, she has to either win a Nobel Prize or learn how to be of service to ordinary people with unglamorous problems.
If it wasn’t for questions like “How high’s the fever?” “How many days has he been sick?” or “Diarrhea?” I wouldn’t know what to say to people. Whether or not children eat vegetables has consumed a significant part of my professional life. Nobody I’ve interviewed for medical school has said they want to get really good at treating diaper rashes and quieting crying babies and frightened children. Life-or-death comes up less often than you might imagine and when it does the doctor’s power to change the outcome is limited. If you’re saving your energy for the big important moments, you’re going to be saving a lot of energy. People who are trying to die are trying to tell us something.
——
“What problems are young people having today?” I was asked at a harmless social get-together at the home of the dean of admissions.
The problem for young people today is the Harvard Medical School admissions committee. People this bright and accomplished shouldn’t have to be begging for a job in medicine. It shouldn’t be so hard. There should be more clearly defined, simple paths for people to be of use. That so many young people want to be doctors speaks well for the families producing intact applicants and for medicine for attracting them, but I can’t help feeling that there should be a broader array of choices. People that intelligent who have worked that hard should be able to be doctors if they want to. What exactly is the point of producing an abundance of amazingly capable people if we don’t have more things for them to do? Two hundred years ago being able to read and write a little, being healthy and having a work ethic, meant you could do well at just about anything.
It shouldn’t be so hard for people to figure out what to do with their lives.
“What the hell are we going to do with Timmy?”
“I don’t know. Do you think we could get him into med school?”
Every Nobel laureate was once a goofy sixteen- or