Becoming a Doctor

(Critical Survey of Contemporary Fiction)

Melvin Konner was in his thirties, with a well-established academic career, when he decided to become a doctor. By the time his training was complete, he had shifted goals again, choosing not to practice medicine, but the experience was not wasted. BECOMING A DOCTOR focuses on the third year of medical school, when classroom instruction is over and the student is thrown into hands-on contact with a bewildering assortment of patients. The glamour of medicine quickly wears off as Konner finds himself up to his elbows in blood, diseased tissue, and body wastes. At first the callous attitude of his mentors shocks him, but he sheds his idealism and grows his own protective shell as he comes to realize the limitations of medical knowledge, the self-destructiveness of many patients, and the nearly infinite depths of human sufferings.

The following excerpts from the book’s “Glossary of Slang” provide eloquent evidence of the attitude of the typical resident and intern at a big hospital: Crispy Critters -- children chronically hospitalized due to third-degree burns over most of their body surface; among the saddest cases in medicine; also known as “toasted toddlers.” Dirtball--A chronic alcoholic, drug abuser, bag lady, or other street person who rarely bathes, has frequent infectious contacts, and is likely to be a walking colony of dangerous microorganisms.

What gives this book its value is the fact that Konner writes from the perspective of a mature and highly educated man who, as an anthropologist, has been trained to observe human behavior. His book is nontechnical and charmingly self-revealing. It consists of a continuous stream of anecdotes, suggesting that it was based on a fairly comprehensive daily journal. Konner’s four years of medical school served a dual purpose: an education as a doctor and an anthropological investigation of a medical teaching facility as a human institution. He deplores the dehumanization of doctor and patient that he observed. “In the cool realms of technology,” he concludes, “we may have succeeded beyond our fondest dreams; now we can afford to, and must, turn our attention to the relatively neglected realms of humanistic medicine.”

Becoming a Doctor

(Literary Masterpieces, Volume 8)

Although Melvin Konner gives passing mention to other phases of medical school—the admissions hurdles, the first two years of intensive book learning, dissecting, and physical examinations, and the fourth year of “consolidation, exploration, and thought”—Becoming a Doctor: A Journey of Initiation in Medical School concentrates on the student’s third year. Konner’s reasons for such a concentration are that “the third year is the first of total clinical immersion” and “the year in which the most important phase of socialization is largely completed, when the adoption of the values of physicians is effected.” During the third year, the medical student must begin to apply all of his or her previous learning, under the supervision of attending physicians, and to develop a doctor’s lifelong skills. This initiation occurs amid the frequently bloody hurly-burly of the clinical setting in a teaching hospital, with the student often suffering from sleep deprivation, poor food, and the pressure of life-and-death situations. The initiation consists of “rotations,” stays of from two to eight weeks in each of the main medical specialties—emergency care, anesthesiology, surgery, neurosurgery and neurology, psychiatry, pediatrics, obstetrics, gynecology, pathology, internal medicine, and so forth—corresponding to the hospital’s various wards and taking on some of the aspects of Dante’s journey through the circles of Hell, Purgatory, and Heaven.

The opening of Dante’s The Divine Comedy, with its reference to the midpoint of the path of life, is evoked to help explain Konner’s motives in undertaking the study of medicine in his mid-thirties, after he had conducted research among the !Kung San (Bushmen) of Africa’s Kalahari Desert, taught at Harvard University, and established himself as an anthropologist. How far Konner means the parallel to Dante to apply is uncertain. Dante was lost in a dark wood and threatened by allegorical beasts; although Konner writes vaguely about “having in some important manner lost one’s way,” he says he was beset only by “an appetite for experience that exceeds the normal restraints of pride.” Yet there might be more beasts around than Konner will admit. The word pride is important here, and important to Konner. A few pages later, he confesses that his study of medicine fulfilled a quaint childhood fantasy induced by the cultural environs of his lower-middle-class Jewish neighborhood in Brooklyn, and his book is dedicated to his parents, Hannah Levin Konner and Irving Konner, both of whom “were handicapped by severe hearing impairment.”

Konner’s justifiable pride here might be touching if it did not possibly reveal a fearsome dybbuk compelling his life. One can also tolerate his bragging about how many top medical schools interviewed him and how his earlier book, The Tangled Wing: Biological Constraints on the Human Spirit (1983, published during his third year of medical school), was nominated for a National Book Award. Less...

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Becoming a Doctor Bibliography

(Literary Masterpieces, Volume 8)

Booklist. LXXXIII, July, 1987, p. 1636.

Chicago Tribune. September 7, 1987, IV, p. 3.

Library Journal. CXII, September 1, 1987, p. 171.

New England Journal of Medicine. CCCXVIII, January 14, 1988, p. 125.

The New York Review of Books. XXXIV, September 24, 1987, p. 6.

The New York Times Book Review. XCII, July 26, 1987, p. 1.

Publishers Weekly. CCXXXI, June 12, 1987, p. 79.

The Washington Post Book World. XVII, October 25, 1987, p. 8.

Wilson Library Bulletin. LXII, November, 1987, p. 83.