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Langone Examines Medical Education

BOOK

Harvard Med

by John Langone

Crown Publishers, Inc.

400 pp., $25.00

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For pre-med students in Cabot Science Library burning the midnight oil, the white marble buildings of Harvard Medical School (HMS) represent something of a holy shrine--and institution to be fantasized about over problem sets and lab reports.

The typical dream? To have achieved, what John Langone, Kennedy fellow in medical ethics, calls "Preparation H"--graduating from Harvard College and Harvard Medical School, and then securing a residency in a Harvard hospital.

In his latest book, Harvard Med, Langone illustrates how the nation's top medical school has hand-picked and educated the country's premier doctors since the American Revolution, using anecdotes, case studies and first-hand experiences.

The author of many works, including Bombed, Buzzed, Smashed or...Sober: A Book about Alcohol and Like, Love, Lust: A view of Sex & Sexuality, Langone has exposed the human drama behind the gleaming facade of the "marble white palace" of Harvard's Longwood campus. In doing so, he is perhaps the first writer to enliven the medical profession in such a potent, entertaining and realistic manner.

Of interest to undergraduates, Langone talks about HMS admission requirements and standards and describes some of the students who are accepted.

More importantly though, he focuses on the widening gap between patients and care-givers in medicine today, using colorful interviews and descriptions to demonstrate how students and faculty at HMS are both contributing to this gap and trying to narrow it.

He does not set this issue up as a thesis and then argue each side to reach a conclusion. Instead, he uses a rather unconventional structure--interweaving the school's history with a loosely chronological narrative following the progress of a class of medical students from orientation to graduation.

While the structure may be a little disorienting at times, it does add some unpredictability that medical historical texts often lack. And Langone effectively ties together past and present, discussing the consistent lower status of women in the profession while romanticizing the "coarse" general-care, small-town practitioner who knew how to be kind, understanding and available.

Throughout the narrative, Langone drives home the message that patient care should ideally be both scientifically sound and socially conscious.

According to Langone, the Medical School is a research-oriented institution, not the place to study geriatrics of primary care, nor the place where one goes "to train to work with Indians in Fargo or set up a dermatology practice in Biloxi." Instead, HMS produces mostly specialist and surgeons making six-figure salaries.

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