Just Like Someone Without Mental Illness Only More So

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Authors: M.D. Mark Vonnegut
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antibiotics then. Surgery had to be very quick and was as likely to kill you as cure you. Keeping germs out of the surgical field was a novel idea. There were 155 medical schools in the United States, most of which were run for profit by one or two doctors, like trade schools. There were no admission requirements. If your family could pay, you could be a doctor. Doctors were taught and trained without being exposed to patients or science. The chances of any given patient being helped by any given doctorwere slim. Most were peddling snake oil of one sort or another. The Flexner report, published in 1910, sought to improve medical care by making sure medical schools had reasonable admission requirements and were associated with universities and that medical education stressed the scientific method and empirical observation of patients. One of the things that stressing science and empiricism did was to democratize medical care and make innovation possible. In European medicine, medical students didn’t have any exposure to patients; things were done a certain way because they had always been done that way, and all the various committees and academies and practice guidelines said they should be done that way. So the forces of innovation won, and American medicine became the best in the world, and all that white marble was trying to get us to be the best we could be.
    After you’ve promised to “do no harm” and to honestly do your best to ascertain what is true, the rest is just details.
    Science was the only way we could avoid fooling ourselves about what helped and what didn’t. Doctors were supposed to act like battlefield medics, identifying and addressing pain, suffering, and disability. I believed that once you had a medical school education, especially a Harvard Medical School education, doing
good
was just a matter of showing up.
    I liked all the white marble, but it can be hard to live with. The five buildings facing the quad appear to be not quite part of this world. They have wings that stretch and branch out into labs and foundations and institutes and hospitals and on and on into the so-called
real world
, but it’s all connected to the white-marble hole.
    My Harvard Medical School advisor had a recurring nightmare.He’d wake up in a cold sweat saying to himself, “This really is the best place.”
    There was and always will be a million miles between what my classmates and I wanted to do and what we would end up doing. We at Harvard and Harvard’s teaching hospitals were the light and the way. All you had to do was ask us. It has always amazed me how much quackery and bad medicine goes on. The temptation of being worshipped and pushing snake oil and making a ton of money at it turns out to be more than most people can withstand.
    After being rejected by fourteen publishers, my book
The Eden Express
was published the same year I started medical school. My favorite rejection comment was “This book is good but with your last name it would have to be better.”
    I took the paperback advance and bought a substantial serious adult-type Victorian house a ten-minute walk from the medical school. When a classmate came over for something, he said that it was the kind of house we weren’t supposed to have until we were older.
    “I am older,” I pointed out. Right before getting the book published and right after getting into medical school, I got married.
    The book ended up doing well enough to pay most of my way through medical school—no
Slaughterhouse-Five
, but not bad for a beginner.
    Harvard took some flack for admitting me, which probably had something to do with why I shut up and didn’t write much for thirty years. There were letters from outraged alumni who knew deserving applicants. With so many earnest wholesomeapplicants, why was Harvard out dredging for bottom-feeders like me?
    My mother, my cousins, and my sisters weren’t doing so great. We had eating disorders, co-dependency, outstanding

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