Application to Harvard Medical School
When I applied to Harvard Medical School, I was interviewed by a man (let’s call him Grumpy) who had several tough questions. A few months after my interview, I heard that Grumpy was fired, and people told stories about him.
One story was that Grumpy told an applicant to open his window (unknown to the applicant, a nail held the window shut). The applicant attempted to do so. If the student could not open the window, Grumpy confronted him about his weakness, and how that would negatively affect his connection with patients. If instead the student pushed the window so hard as to break the window, then Grumpy would confront the student as being too aggressive. A variation on that story is that Grumpy nailed the window shut when the applicant was sitting there. When asked to open the window, the student tossed his shoe through the window. Another story was that when interviewing an applicant, Grumpy excused himself from the room for a couple of minutes. Then he would have his secretary call the room, and Grumpy would strongly criticize the applicant either for ignoring a crucial phone call, or else for answering someone else’s phone.
My story involved my father (William, MD). Unknown to me, Grumpy had a powerful disagreement with my father (I learned about this conflict some time later). Grumpy had published an article in The New England Journal in which he recommended that internists ought not to have one or two years of general medical training prior to specializing (such as specializing in infectious disease or cardiology). My father published a strong disagreement, and said that all doctors first needed general residency prior to training in their specialty. My father pointed out that patients with complex disabilities usually had complex problems beyond the narrowness of a specialty. Over time, my father’s recommendation was correct, and was put into practice nationally.
At the time, I was ignorant of the confrontation between Grumpy and my father. He asked me where my father worked. At that time, Marquette University School of Medicine (my dad’s place of work) was in the process of merging with the University of Wisconsin. I stumbled, as I was unsure whether or not Marquette was still independent from the University of Wisconsin. Grumpy pushed me hard to give an answer, and pushed his face right into mine. “Is it Marquette or the University of Wisconsin where your father works?” When his face was a couple of inches from my face, I stumbled badly to provide a thoughtful answer. After the interview I assumed that I would not be accepted to Harvard. Weeks later, I got a call from someone else and was told that I was on the waiting list, but by then I had decided not to attend Harvard. I chose to attend the University of Rochester Medical School.
My Incompetence
Near the end of the second year of medical school (or beginning of the third year), medical students started to practice real medicine. We learned how to draw a tube of blood. We initially pulled blood from ourselves and each other, and then were expected to draw blood from inpatients. I was assigned to work with a young male patient, and three times I was not able to draw blood. At that point I apologized, and said that I would stop trying. However, he insisted that I keep trying, since he liked me, and he was paralyzed on that part of the body, and it did not hurt. So, I attempted 17 times to draw blood from him before I finally stopped completely.
Surgeon: Dark Humor
Surgeons looked down on students. They referred to medical students as “Rhoids.” That was a version of hemorrhoid.
During my six-week surgical rotation (in medical school), I was sitting with the Chief Resident. He was called to the Emergency Department. We raced there. A young man had attempted suicide by using a sharp knife to cut deeply into his neck, cutting both major arteries. We madly attempted to help him, but he was clearly dead. As we walked away, with blood over ourselves and throughout the room, the Resident, who did not discuss the hopeless attempt to save the patient, calmly spoke to me. “You are going into psychiatry. Tell me, would you call that a suicide gesture or a suicide attempt?”
My Knowledge of Anatomy
In 2005 I called a former medical school pharmacology teacher of mine. He was a fantastic person, and later became the president of Tufts University School of Medicine. I asked him to teach a one-hour conference (over the telephone) to the psychiatrists at the Brattleboro Retreat. Before we discussed my request, he asked, “At the beginning of medical school, didn’t you believe that the liver was on the left side of the abdomen?” I admitted that was true, and we had a good laugh. He then kindly gave the presentation to my staff.
Summer Medical Work
Between junior and senior year of medical school (1973) I got a summer job at a local hospital in Rochester. Another medical student and I took care of inpatients on a general medical unit, and were taught and supervised by a Chief Resident. I was assigned to cover a woman in her 20’s who had severe abdominal pain. We evaluated her in every way possible, with various physical evaluations and X-Rays. A surgeon, internist, radiologist and others all tried (and also failed) to find a cause. One evening I had an idea. I put her urine sample into a clear glass, and placed it on her windowsill. The next morning the urine had turned bright red. Several months previously, in a brief conversation, someone had mentioned porphyria disease, which was rare. She had it, and she responded well to treatment.
The Chief Resident was astonished and excited, and reported the case to Grand Rounds. For many years I continued to look for that disease, and never found it again.
Medical Committee
In my senior year of medical school, the faculty asked me to join one of their committees. The purpose was to change the medical school to improve our educational experience. I was astonished for two reasons. First, I had no idea that they wanted to listen to me. Second, they clearly thought that our biochemistry and anatomy faculty (with whom I had poor relationships) were bad teachers. This was an early sense of being trusted and competent.
