Quality, Not Quantity
Needed
Daily Observer
Lapius
had warned me that morning that Dean Cator would probably be at the house when
I got home.
“You
don’t mean Edward Ullrich Cator the
famous educator?” I feigned awe.
“Of
course. One and the same, Harry. He is interested in my ideas about medical
education.”
“Really?”
“Not
really,” said Lapius. “That is merely
his approach when he wants to solicit donations to support his three year
course for bright students at the medical school.”
“And
you donate to that folderol?” I asked with astonishment.
“Certainly. I donate my ideas on medical education,” said
S.Q. Lapius.
Dean
Cator was indeed an imposing man. When I
entered he was half defrocked, and already under the influence of some Lapius
imbibements. He sat in vest and
shirtsleeves with a gold chain strung in two neat catenary curves between
pockets on either side of his vest. His
bald head shone even in the dim lighting, like the skin of figures at
was-works.
When
I entered he bestirred himself to grasp my hand in both of his, and fondle it
gently.
“Harry,
so good to see you again. How well I
remember you as one of my best students.”
Since I had graduated somewhere in the middle of the class, the dean’s
memory was mind-boggling and I figured he was trying to hit me up for a
donation too.
“But
why the three year course in medical school?” Lapius inquired.
“Simple,
Simon,” the dean said, while Lapius shuddered at the juxtaposition of those
words. “The country needs more
doctors. Therefore if we turn out a
class every three years instead of every four, ergo, a 25 percent increase in
the number of doctors available.”
“But
aren’t they a little young, Dean?” Lapius asked. “I understand that the medical school
curriculum is combined with only two years of college.”
“Quite
true,” said the dean urbanely. “I spent
a lot of time working out the curriculum.
The nation must be served, Simon, and I take pride in my role of creating
the number of doctors we are going to need.”
“Perhaps
you will increase the number of individuals who have M.D. degrees, dean, but
you won’t necessarily increase the number of doctors.”
“How
so?” the dean appeared bewildered.
“Because
there is an element of maturity required of those asked to assume the
responsibility of a physician. One
purpose of four years in college and then four years in medical school and then
four or five years in training, is to allow time for children to grow up. It seems to me you are pruning the youth
before they ripen enough to bear fruit.”
The
dean didn’t care for the turn in the conversation, and took the moment to
refill his glass with the tacky cherry liqueur that Lapius had served.
“But
surely, Simon, they will have plenty of time to grow up after they have
finished medical school and the prerequisite training, which, incidentally, I
am trying to reduce to two years.”
“Well,
maybe you are right, Dean. Perhaps three
years is all that is needed. The kids
today are so bright. But I must say,
that since I graduated, even since Harry left school, the science of medicine
has grown so fantastically that I would, were I the dean, increase the
requisite years to six instead of reducing them to three. The basic sciences alone should take three
years, which would allow no time for clinical training.”
“Simply
look at the progress that has been made in the study of fluid balance,
electrolytes, blood gases, inhalation therapy, biochemistry; to say nothing of
the literally hundreds of new therapeutic regimens that have been
introduced. Even the expanded use of
aspirin and the biochemical basis of its interactions is probably worth a month
of study alone.”
“How
can all that be compressed into three years, and don’t forget kidney dialysis,
the new advances in cardiology – my goodness, I have had to spend a lifetime
learning things I would have been glad to have learned in medical school. I have often remarked to Harry that I was
sorry to have been born too early and to have missed the marvelous educational
opportunity offered to present day students, haven’t I Harry?”
“Yes
indeed you have, Simon,” I agreed hurriedly.
“So
you see, Dean,” Lapius continued, “there can be no way that the curriculum can
be compressed to three years and still turn out doctors.”
“Ah,
Simon, but you are wrong. We do that by
simply cutting the fat out of the curriculum.”
“What
fat,” Lapius owl-eyed, asked incredulously?
“The
specialties. We exclude studies in ear,
nose and throat, ophthalmology, urology and dermatology, to list a few. That way the student doesn’t have to be
encumbered with information he won’t need unless he decides to go into one of
those specialties. Then he can pick up
the information in his residency training.”
“My
God,” Lapius exclaimed in horror, “You’ve dissected the human body before the
student even gets into the anatomy room--.”
“Oh
yes we have excluded that too. He can
pick anatomy up in surgical residency.”
“The
curriculum at the school for practical nursing is more comprehensive,
Dean. You are graduating a generation of
imposters, not doctors. Medical
education should not be degraded, but uplifted.”
“But
the under privileged have no medical care, Lapius,” the dean said tartly.
“Perhaps,
but that is a condition that will hardly be corrected by your misguided
educational values.”
“Then
I take it you won’t donate.”
“Of
course not. I shan’t participate in a
plan that so diminishes a great profession.”
Cator
flung his coat over his shoulders like a cape and left in a Huff, a small
economy car.
“I
think you made him angry,” I remarked.
“I
hope so,” said Lapius. “If doctors won’t
protect the great profession of medicine, who will?”
“Maybe
the public?”
“Perhaps,”
said Lapius morosely, “but it will take them a generation or two to find out
they have been had.”