What Doctors Don’t Know

Becoming a Doctor: A Journey of Initiation in Medical School

by Melvin Konner MD.
Viking/Elisabeth Sifton Books, 390 pp., $19.95

Doctors, dressed up in one professional costume or another, have been in busy practice since the earliest records of every culture on earth. It is hard to think of a more dependable or enduring occupation, harder still to imagine any future events leading to its extinction. Other trades—goldsmithing, embalming, cathedral architecture, hexing, even philosophy—have had their ups and downs and times of vanishing, but doctoring has been with us since we stumbled into language and society, and will likely last forever, or for as long as we become ill and die, which is to say forever.

What is it that we expected from our shamans, millennia ago, and still require from the contemporary masters of the profession? To do something, that’s what.

The earliest sensation at the onset of illness, often preceding the recognition of identifiable symptoms, is apprehension. Something has gone wrong, and a glimpse of mortality shifts somewhere deep in the mind. It is the most ancient of our fears. Something must be done, and quickly. Come, please, and help, or go, please, and find help. Hence, the profession of medicine.

You might expect that such a calling, with origins in deepest antiquity, would by this time have at hand an immense store of traditional dogma, volumes and volumes of it, filled with piece after piece of old wisdom, tested through the ages. It is not so. Books do exist, of course, but all of them are shiny new, and nearly all the usable knowledge came in a few months ago. Medical information does not, it seems, build on itself; it simply replaces structures already set in place, like the New York skyline. Medical knowledge and technical savvy are biodegradable. The sort of medicine that was practiced in Boston or New York or Atlanta fifty years ago would be as strange to a medical student or intern today as the ceremonial dance of a !Kung San tribe would seem to a rock festival audience in Hackensack.

Into this jumpy, always revising profession there strolled, several years ago, an inquisitive anthropologist, not totally an innocent, fresh from two years of living with a !Kung San tribe in Kalahari, with another possible book on his mind. Melvin Konner, Ph.D., a professor at Harvard, had hankered in boyhood to be a physician but had given up the idea in his undergraduate Harvard years and gone on to graduate school instead. After establishing himself as an academic expert in comparative behavior, his curiosity about medicine returned in force, and he arranged for admission to Harvard Medical School at the age of thirty-five. He does not entirely explain the move; in part, maybe large part, he did so out of professional anthropological interest: What was the tribe of medical doctors really like when viewed closely from the inside? The thought of becoming a physician, looking after sick people, was near the top of his mind, but not, as with his classmates, the only thought.

His book deals almost exclusively with the third…


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