LEARNING TO PLAY GOD

Marion, pediatrician and author (The Boy Who Felt No Pain, 1990; The Intern Blues, 1989; the novel Born Too Soon, 1985) tells tales out of school—and out of internship and residency- -dramatizing his thesis that the education of doctors is virtually guaranteed to produce competent but insensitive physicians. According to Marion, most students entering medical school are idealistic and eager to help others. As third-year students, however, they serve as clinical clerks to overworked, burned-out, and callous interns. And once they become interns themselves they too become sleep-deprived and psychologically damaged, often blaming patients for their situation. As residents, young doctors have even more power and responsibility, and the uncaring attitude they developed as interns can have even greater impact on patient care. That this attitude may well remain once their training is finished is clear from Marion's portraits of various older physicians who figure in his stories. Occasionally a story seems designed more to hold a flattering light up to the author than to shed light on the problems inherent in our present system for training doctors, but all are engrossing. Marion knows how to spin a tale, including enough medical detail to lend veracity to his account yet not overwhelm the lay reader. In an epilogue, he makes his own brief recommendations for revamping the education of doctors; after exposure to the medical mind-set presented in his stories, a question remains as to whether his recommendations go far enough. Absorbing stories that reveal the need for major reforms in how doctors are trained.