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Book Reviews   |    
What I Learned in Medical School: Personal Stories of Young Doctors
Reviewed by Benjamin Spinner
Psychiatric Services 2005; doi: 10.1176/appi.ps.56.5.615
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edited by Kevin M. Takakuwa, Nick Rubashkin, and Karen E. Herzig; Berkeley, California, University of California Press, 2004, 207 pages, $24.95

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A distinguished psychiatrist visited a hospital and was hosted by the director of the psychiatry residency program. The director was clearly pleased with his new class of residents and told the visitor, "We have a cellist, a former journalist, a physicist, two athletes, and a poet." The guest replied, "That's nice, but what you need are doctors."

The system of medical education confronts the tension of balancing the unique characteristics of its students with the common requirements of its training. As with any reaction under heat, it is the case also with medical education that what goes into the crucible is not necessarily what comes out. And if the elemental ingredients are the same later in the reaction as they were earlier, the shape of the product is inevitably different. A rigid formulation of a diverse experience? Perhaps. Yet it is likely that rigidity is a more familiar influence on medical education than diversity.

What I Learned in Medical School: Personal Stories of Young Doctors is a collection of 22 autobiographical stories by medical students and recent medical graduates who attempt to share their experiences in medical school. Several of the stories follow the structure of a personal reflection that leads quickly and simply to a quick and simple lesson. Others are more complex. Linda Palafox, a pseudonymous writer, discusses, in "My Secret Life," her struggle with alcoholism. Hers is a deeply humble story, and a generous reminder that the conditions of life that clinicians treat are also those that clinicians live. In another story, "Parasympathizing," one of the book's editors, Kevin M. Takakuwa, writes about his difficult confrontation in medical school with an academic arena that seems to him impersonal and competitive. He writes, "I was caught between a desperate urge to escape and a stubborn refusal to quit." Emotional incentives exist for both. David Marcus, in his contribution, comes close to having the decision made for him by his school administrators, who nearly expel him for poor performance and whose insensitivity to Marcus's disabilities clarifies that the absence of compassion leads consequently to the expression of cruelty. His story teaches that more empathy is needed, not only in the clinic but also in the classroom.

In medical school, even those who start as cellists must end as doctors. The best of the stories in this book illuminate the personal struggles of people involved in the attempt to remain individual in a general system, a system whose shape is sometimes too rigid to fit the diverse contents it aims to mold.

Mr. Spinner is a fourth-year medical student at Mount Sinai School of Medicine in New York City. He plans to pursue a residency in psychiatry.

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