Harvard Med as Verdun

EVERBODY'S got an inside story... Rita Jenrette revealed the lewdnes of the Congressional social scene, Woodward and Armstrong blitzed the justices of the Supreme Court, John Dean sold his mea culpa to the networks for a million dollars. Such books usually break down into one of three types: gripes, boasts or confessions. Few are flexible enough to encompass all of these forms, but those that do can evoke sympathy for the writer and emnity for his oppressors. Charles LeBaron's Gentle Vengeance--An Account of the First Year at Harvard Medical' School is this protean type; complaining and bragging, it is an autobiography in institutional clothing.

LeBaron has a lot of company on the inside. Harvard circuit. Love Story reduced the life of the undergrad to sports and sex. One L demonstrated the collective ego of the Harvard Law School, and The House of God wildly captured the spirit of interns at Beth Israel Hospital. Paper Chase even scamed its way onto TV. There was little territory left for a writer to snatch, so LeBaron now moves us into the classrooms and anatomy labs of Harvard Medical School or, as Samuel Shem called it in House of God. BMS--Best Medical School.

LeBaron is not your typical medical student. At 34 he's the oldest in his class, and a man with a career already behind him. After working 13 years in health service as a social worker and an orderly, he knows the medical establishment from the bottom up. When he tells of the doctors who won't take time to speak with anyone but other doctors, on of the administrators who never make it into the trenches to observe what they're administering, he does so with a working-class sensibility. They've never had to subdue a raging schizophrenic night after night. LeBaron has. This, he makes clear, leads to humanitarian credentials.

He also knows his writing. As the author of a published novel, LeBaron is a talented narrator with a gift for fluid glibness. Thus, he seems like the perfect person to write an expose on the training of doctors--the most criticized profession in this country besides politics.

AND IN MANY ways his book is the best of these inside-Harvard Jobs because of his sense of humor and eye for detail. But still there are problems here that preclude a truly serious reading. Gentle Vengeance is not a book you'd recommend to the Dean of HMS for Careful consideration.

The main problem is that LeBaron is more than an observer. He is the star--in fact, he is the only intelligent being in his book. Sometimes he's open with his conceit: "But I had guts, all right. Better to act modest though." More often he simply takes to demeaning all those around him. His professors are generally insulting, harsh, sexist, and self-satisfied. His fellow students are completely absorbed in their books, frustrated, awed, and for the most part heartless cowards. According to LeBaron, they aren't even interested in what they study.

Of course, LeBaron wasn't always a here. He arrived without knowing much about science: "Myknowledgy of neuroanatomy," he confesses, "stops with an idea that the brain is located somewhere in the head." But he learned quickly even with all his complaints. And there are a lot of them. The administration is conservative and hirarchical Basic science courses don't integrate the clinical material. There is too much memorization and not enough reasoning. Even his signs of generosity are grudging: "On the whole, I was willing to give Harvard the benefit of the doubt," he writes. Not really.

It's hard to take his gripes too seriously considering his outstanding objection is that classes are held on Saturday mornings. It will ruin my weekends, he moans. I can't stay out Friday nights. Of-course, if everyone is working as hard as he claims, they don't have time to go away anyway. And if they really have to leave, they can always cut a class.

But most confusing is the book's inconsistent tone. LeBaron, with his nonscientist credentials as his trump, mixes complete naivete with brutal cynicism. This is the insider who still considers himself on the outside. By the end you can't tell whether he hated his first year, or if he would recommend Harvard Medical School to someone else. He can't seem to understand why anyone beside himself would ever even want to go to Medical School.

But what is most surprising is LeBaron's complete lack of introspection. He spends little, time questioning anyone's motivations--he never asks why students in their teens decide to give up their twenties for the grind of endless school and the care of dying patients. The psychology of his classmates is entirely absent. Conversations are included only to post straw men or to make points; they rarely give insight into the speakers. As far as LeBaron can tell, his classmates are there only because they are fourth generation HMS or the children of the faculty.

The best inside stories always show some balance. Unfortunately you can't often write a fair account and sell books too. The wholesale attack on the Establishment, then, is probably your best shot. But when this gets carried too far, as ha0pens here, all useful observations lose their force. LeBaron gets caught in too many superficial analyses and cliches and he rather than his school comes off as bloated.