Mark, a senior from West Virginia who is graduating today with high honors in Anthropology, is one such other-directed person who has finally (and barely) achieved his goal of being admitted to medical school. His commitment to medicine, particularly rural medicine in his home state, is unimpeachable. He spent last summer researching a summa cum laude anthropology thesis on rural health care delivery in Clay County, W. Va. For another summer, he worked in a clinic in Morgantown, W. Va.
Although most of his anthropology work was done under the tutelage of a medical anthropologist with a Ph. D. and an M.D. and his science grades were high, Mark was rejected at every medical school to which he applied. Finally, at the beginning of this month, he was notified that West Virginia University had reevaluated his application and accepted him.
No one can claim that Mark should have, under any criteria, been accepted at all the med schools. Yet, when his pre-medical advisor began late this spring to make inquiries about Mark's weaknesses, the responses were illuminating. In his applications, Mark explicitly stated his desire to become involved in grass roots health care, treating the medical problems of people as social as well as medical phenomenon. This data and his undergraduate degree in anthropology, in spite of his good medical and science grades and several research projects he participated in at Harvard, led admissions officers to question seriously his commitment to medical science.
With West Virginia, the problem was even more appalling. In August 1974, after a summer of Chem 20 at Harvard, Mark wrote a letter to his hometown newspaper decrying the pressures of pre-medical studies and questioning whether such a system could effectively prepare individuals to deal with the human beings experiencing the medical problems. In its first look, the West Virginia admissions committee saw the letter as an indication that Mark could not make a good, technical doctor, that he was more concerned with social problems than medical ones.
The sympathies expressed by Mark were indeed as social as they were medical, but they sprang from a fundamental belief on his part that getting along with and understanding people and their social problems is a primary part of the healing process, particularly in rural health care.
The letter itself was prompted by a series of frustrating events that culminated on the evening Richard Nixon resigned. As all the students in his Tuesday/Thursday five-hour Chem 20 lab were filing downstairs to watch Nixon give his resignation speech, a water hose broke loose and wetted every lab sample except Mark's. Since he was one of the last to leave the room, Mark says he felt immediately that everyone, including the section leader, suspected that he had purposely sabotaged the lab.
"That sort of suspicion and the fact that it always had to exist between all the students really got me thinking," Mark says. "It drowns out the importance of conscientiously trying to be good to other people...people who are in there busting ass to be the best and only worried about their own status don't realize that they need other people and that coming across as a decent person is a vital part of medicine."
For many who resist the rigorous pressures of conformity that pervade the pre-professional scene, the difficulties begin long before they attempt to take their case to professional school admissions committees. At no point in any pre-professional curriculum or course at Harvard are students encouraged, let alone required, to address broader questions of ideology, orientation and ethical and moral dilemmas. Those who seek to structure their education to examine such issues often find themselves left in the wake of students who abide by the pre-professional rules.
Steve was among the group of Harvard students that senior professor John Finley '25 classifies as the class-president type. Steve came to Harvard as a real politico, interested in law school and "into being president of everything." But by the end of freshman year the whole game seemed perverted to him.
"I began to see that overachieving wasn't the be-all and end-all. The whole drive for power, the insatiable desire to get to a name law school and a name firm, seemed to be grabbing people all around me. And yet no one really knew why: there they were grubbing for grades, their goals in a course set by their teachers, kissing ass, making connections, working like crazy, not because that's what they really wanted, but because that's the only way they could stay on top."
What upset Steve the most was that all around him he saw extremely bright individuals who permitted themselves to focus more and more narrowly on their own worlds and become further and further removed from social reality: "To me," he says, "the major thing about a Harvard education is the chance it could give to people to sit back and become concerned with far-reaching questions about our society. Harvard should be breeding people who are going to help this society look at how the pie is divided, not how to get a bigger slice for themselves. Life is more than a buck, and I felt that all these people with a golden opportunity to do something for others were just slipping into a slot where it was easy for them to make it; they are cheating themselves, allowing themselves to be less than they could be, fitting the mold when they're the ones who don't have to."
After graduation last year, Steve went to Washington to work for Sen. Frank Church (D.-Idaho), but he found the same difficulty there: no one really seemed concerned with "Joe Farmer or Joe Factory Worker back home bustin' ass in the fields or the saw mill all day so a bunch of guys could live high in Washington." After a year back in an Idaho sawmill, Steve now says that he is "de-Harvardized" enough to try school again. He wants to become a labor lawyer and return to Idaho: "A good lawyer out here could really help the little guy; do a big service and earn a decent living. It's the personal satisfaction of helping someone who needs it that I think I need now, not the money or enough status to hold my head high at the country club."
Given that there must be some process for selecting students who will go on to over-subscribed law and medical schools, there is no doubt that the present pre-professional structure is an effective market device. But the problem is that the "invisible hand" that drives some along the treadmill faster than others deters many of the other-directed individuals like Mark and Steve, who see the professions as a means of serving people, not as a pathway to security, wealth and status. The upshot is that more and more of those who emerge from the obstacle course have no conception of the basic human needs and values that underlie the service-delivery professions and instead allocate their skills according to the market: that is, to the big corporate law firms and lucrative medical practices that bring the big buck.
In the meantime, besides imposing inner-directed orientations on those who climb aboard the pre-professional train, this structure will continue to drive countless Bills over the fine line it draws between unreality and insanity. The new mood on campus and the pre-professional crunch are symptoms of a malady much wider in scope than the pre-professional education structure. But perhaps it is about time that Harvard came more to grips with the question of whether those it sends on to the professional schools are these most qualified for and concerned about providing health care and legal services to society, or those who happen to survive the undergraduate contest.