George E. Vaillant
Psychiatry 700A. (Behavioral Science in Medicine) is a course at Harvard Medical School designed to sensitize medical students to the importance of self-awareness, and to decrease the distance between them and the patients they see. The concluding lecture in this course was given by George E. Vaillant, who outlines defense mechanisms used by physicians, as well as the risks of those mechanisms.
Today, to pull together the six sections of this course, I need to synthesize aggression, drinking, drug abuse, anxiety, inheritance, and attachment. I'm going to do it the way a lot of teaching and learning is done in medical school: each upon each--as our laboratory diagnosis teacher used to say. That's how you pass your first nasogastric tube, and how you draw your first blood. So today I'm going to demonstrate the relevance to doctors, to you, of what you've been learning.
One purpose of a psychiatry course in medical school is to teach you to be wise and to have as much sense about human affairs as your grandparents: to grow old before your time. What you're really trying to learn from psychiatry, then, is to be rational in the face of irrational feelings and behavior--in the face of unreason.
I'd like to introduce you to the relevance of such unreason with two recent letters from members of the Harvard Medical School class of '67 to the Alumni Bulletin:
It is an immensely sobering and painful thought to realize that out of my medical school class--a cohort of people in their late thirties--we have already lost six of our members, two through acts of God, one uncertain, and three quite definitely by their own hands. I fear that this is no more than one of the painful realities of life in an unbelievably demanding profession. Yet, I feel that we do not--as a group or profession--pay sufficient attention to this