I met Bill freshman year. He was a local boy, born and raised in the Boston area, and an outstanding pre-medical student. I did not see much of him during my sophomore year (his junior year). In fact, when I found him sitting in the middle of the hallway on the fourth floor of Barnard Hall at 6:30 a.m. one morning during my junior year, it was the first time I had seen him in at least eight months.
He was sitting on the floor, legs crossed, the latest issue of Psychology Today in his lap, wearing a baggy pair of wrinkled pajamas, desperately fumbling to unlock the hallway phone that he shared with his neighbors. Sweat poured off his brow:
"Hey, Jeff, how's it going? Can you help me unlock the phone? I gotta call someone."
It was pathetic. Bill looked and acted like he had been on dexedrine nonstop for two weeks. He showed me an article about a medical researcher in California. He was so excited by her findings and her particular point of view that he wanted to call her. I tried to explain to him that it was 3:30 a.m. in California, but Bill persisted.
"She's like me, I'm sure she's still up working all night on the project...I'll call her at the lab. She'll probably be so glad that someone cares so much for her research and knows all about it, she'll offer me a job; it's just what I was interested in..."
Bill was almost screaming, his voice echoing up and down Barnard's stark halls, so I tried to quiet him down. I left him there, sitting wild-eyed in the hallway, counting the rings on the other end of the line (I'll let it go to 50 'cause she's probably right at some critical point.").-Bill was flipping out. Within a month he withdrew from school.
By now, tragedies like Bill's are old hat. Everyone knows all about the so-called new mood on campus--grade consciousness, the pre-professional crunch and ruthless competition--and what it drives some students to do. College administrators seek more than ever to downplay the morbid and to be more tolerant of the ethical transgressions (Harvard, for instance, readmitted this year a student who last year forged a series of medical school and scholarship recommendations). The media, on the other hand, has feasted on this emerging spectacle; few major publications have failed to make a big splash out of some variation on the theme. Invariably the focus of attention has been on the "victims" of the pressures; those who have crumbled under the weight and been forced to drop out of the race, or those who have been disqualified for unethical or immoral violations of the rules.
But there is one side of the "new mood" syndrome that has not received that much attention: What impact has the pre-professional crunch (particularly in law and medicine) had on the type of individuals who stick it out and finally emerge as full-fledged professionals?
Besides presenting an indictment of the ruthless process we rely on to choose our future doctors and lawyers, Bill's story also poses chilling questions that have yet to be adequately examined. Bill was a brilliant student. He was a shoe-in for almost any medical school if he could have hung in there for a few more months. But what if he had? How many brilliant Bill's are lasting a little longer and getting out into the world as doctors today? And, going one step further, is this selection process, with performance emphases that often push young students to the brink of sanity or dull their senses of right and wrong, weeding out many of those individuals who could best deliver health care and legal services to those who need it most? The ability to deal adequately and compassionately with human medical problems is surely rooted as much in social and human understanding as in technical knowledge. What, then, does an educational process that dehumanizes and isolates many of the survivors mean for the people in this country who genuinely need good health care and legal assistance?
The roots to understanding this problem may lie in a dichotomy emphasized over 25 years ago by David Reisman, Nathan Glazer and Reuel Denney in The Lonely Crowd. In this study of the changing American social character, the authors identified traits of two opposing social characters: those they called "inner-directed" and those deemed "other directed." The inner-directed person, they said, "tends to think of work in terms of non-human objects," wanting money or power or fame or some other tangible reward for performance, and seeing and experiencing things primarily "in terms of technological and intellectual processes." On the other hand, the other-directed person tends to think of work more "in terms of people--people seen as something more than the sum of their workmanlike skills and qualities."
The Lonely Crowd traced a gradual development from the 19th-century emphasis on inner-direction to what the authors believed was a more other-direction orientation of post-World War II middle-class youth. While finding fault with both extremes, they appeared to be particularly concerned lest the balance shift too far towards other-directional orientation (as they later implied it did in the turmoil of the 1960s).
However, several by-products of the trend towards other-direction that the authors said were healthy developments are the ones that appear to be most lacking in today's pre-professional education circles. The other directed youth, according to Reisman, et al., asks more of a career than conventional status and pecuniary requirements, questions ways of going about things and is not content to follow blindly the ways of the past; and is more attuned to social concerns of people than towards personal illusions of grandeur and reward.
With the "new mood" on campus, though, successful navigation through pre-professional waters seems more to require those traits The Lonely Crowd assigned to the inner-direction of the 19th century: goal and achievement orientation; the urge to outdistance, at all costs, one's competitors; the need always to establish for one's self an isolated and recognizable claim on a new piece of territory.
Even if one grants that a cadre of inner-directed souls--something akin to the innovator class that Joseph Schumpeter said is the driving force behind social and economic progress--is necessary in every profession, something is wrong with a process that is fundamentally geared toward inner direction. An educational system in which the very ground rules act as a powerful deterrent to the other-directed individuals whose interests and motivations are rooted in providing care to the entire population obviously begs for re-examination and re-structuring. All this is one more piece of evidence pointing to an obvious conclusion: that the health care and legal services networks in this country are neither sensitive to nor able to cope with the needs of the nation.
To be sure, Harvard still has many "other-directed" individuals who are genuinely committed to serving rather than attaining and to whom law and medical education means far more than security, status and the chance to rise above the rabble. But the patch is not an easy one to hoe for these individuals, both because of the pressures imposed upon them in specific academic situations and because of the criteria emphasized by professional school admission committees. Many of these other-directed individuals who make it through the pre-professional maze face intermittent disillusionment, many compromises and the knowledge that they can do everything that is expected of them but that they cannot bring themselves to do it.
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