Scot's Report

Professor Arnold P. Meiklejohn of Edinburgh University spent last summer in the U.S. studying medical teaching and research, and casting a diagnostic eye over the general U.S. scene. On the whole, he was agreeably surprised. Reports Dr. Meiklejohn in the British journal, Lancet:

"The picture that we sometimes get of a materially prosperous but morally sick society derives, I am sure, from too much emphasis on the abnormal behavior of a tiny fraction of the population . . . The mistaken application of Freud's teaching to the raising of children has produced many spoilt, unhappy adolescents who are only now beginning to find out that the adult world does not automatically give them everything they want. But the influence of the 'Church of Vienna' fortunately does not extend much beyond the cities, nor much further west than Chicago . . ."

The New Frontier. "There is a huge public demand for medical research. The amount of money, new buildings, equipment, and staff now devoted to it is staggering . . . The causes, as so often in the U.S., are partly ruthlessly practical and in part pure idealism. On the practical side, the public is moved by an old instinct--fear: fear of death. Although many Americans still adhere to a traditional religion, many have lost its comforts. They are scared of the thought of their end, and look to medicine to save them ...

"On the idealistic side, it is evident that science is now the new frontier . . . Almost every young doctor of any promise wants to 'do research.' To see his own name, even on the dullest paper, makes him a pioneer . . ." But research can get too big for its breeches. "[A] high-powered scientist said: 'Ten years ago I was happy; I used to go in the morning to my laboratory, wash my own glassware so that I knew that it was clean, do a precise, accurate, satisfying experiment . . . Now a team of girls washes my apparatus, so I am never sure that it is clean. I have to keep my assistants busy, so never have time to do an experiment myself.' "

How to Tell a Harvard Man. "The approach to teaching in most medical schools in America is essentially by emphasis on what is not known rather than what is known in medicine. At Harvard, for example, a student may be shown a case . . . that cannot apparently be explained ... He is asked to go to the library and come back with the answer . . . The teacher, to gain respect, must find the flaw in the student's argument, generally on a point of logic rather than of fact. When teaching at Harvard, it is usually a mistake to be too dogmatic, for a student is all too likely to prove you wrong. It is much better to pursue the Socratic method of posing impossible questions which you cannot answer yourself . . .

"Compared with ours [the U.S. medical student] is older, more mature--having wasted three years in college . . . Life for him has now begun in earnest; he no longer plays any games; he feels himself one of a privileged few, lucky to have got in; and, above all, like all Americans, he is interested in things that are new. It must be admitted that, just now and then, preoccupation with the new leads to too little attention to old and tried principles; nevertheless it is thus that medicine in America is dynamic, not static."

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