Norman Cousinsand Responding Physicians
For the past two years, I have been privileged to visit medical schools and hospitals in various parts of the country. I have been able to meet with medical students and physicians at various stages in their training and their careers. The weakest link in the entire chain of physician training, it seems to me, is the ordeal known as the internship. More specifically, I refer to the theory that it is necessary to put medical school graduates through a human meat grinder before they can qualify as full-fledged physicians. Putting it more delicately, the theory holds that anyone who wants to go into the medical profession must be given a rigorous and systematic exposure to the realities of the physician's life.
How does the internship prepare the physician for the "realities?" What if the "preparation" has the effect of dulling the sensitivities of the physician, or fostering feelings of resentment by an intern toward a patient who has a propensity for feeling his sharpest pains at 3 a.m.? What kind of judgment or scientific competence is it reasonable to expect of a physician who hasn't had any sleep for 32 hours? Is the workload at times not so much a sampling of later challenges as it is an exercise in what I can describe only as disguised hazing at best and systematic desensitization at worst? Is it a good policy to subject seriously ill patients to treatment by physicians who are physically and emotionally exhausted? It was interesting and significant to me that the defense of the practice came from those who, having survived the experience, seemed deter-