A MEDICAL SCHOOL DROPOUT

A MEDICAL SCHOOL DROPOUT

Aronson, Stanley M

A career in medicine is eagerly sought by many of todays college graduates. The exalted popularity of medicine continues despite recently expressed doubts about medicine’s capacity to remain autonomous in an increasingly aggressive and commercialized health care industry. Indeed, the continuing luster of medicine, as a career, is such that fewer than one-third of all applicants seeking entry to the United States medical schools will be granted admission.

In centuries past, however, the admission process to the medical schools of western Europe had been substantially less confrontational or competitive. Admission was determined, principally, by the fulfillment of certain academic prerequisites [such as a working knowledge of the Classical languages], by the capacity to pay the university fees, and whether one’s father was a physician. The relative ease of medical school admission, in past centuries, inevitably meant that some matriculants were less than enthusiastic about a career in bedside medicine. It was not rare to hear of an established physician insisting that his son enter medical school And once in medical school it was not uncommon to see this ambivalent scholar find laboratory exercises such as human dissection to be distasteful, if not revolting, experiences. The less assertive sons might continue as sullen students eventually graduating but rarely practicing medicine with any zealous sense of commitment. Others, however, affirming their inner beliefs more assertively, might quit their medical classes to seek a career elsewhere.

Charles Darwin [1809-1882], son and grandson of eminent British physicians, found his medical education in Edinburgh so dismaying, so distressful, that he fled medical school in horror, eventually establishing himself as a creative biologist. And then there was the gifted, exquisitely sensitive son of a noted French physician, born in Cote-Saint-Andre, near Grenoble, in the year 1803.

From early childhood Hector Berlioz was a phenomenal human: extravagant in emotions, demanding, irreverent, uncompromising, petulant in behavior, abrasively articulate, polemical and intolerantly opinionated. he lived, in the judgment of others, in a state of perpetual hyperbole. While the Berlioz family could easily pay for his elementary education, it was decided that his instruction be provided solely by his parents. His curriculum was heavily reliant upon Latin and Greek instruction, Classical literature, rhetoric and mathematics. His mother added lessons in the guitar and the flute. It was the oftdeclared intention of the Berlioz family that young Hector eventually study medicine and ultimately join his father in his clinical practice.

The France of the post-Napoleonic era still expected its sons to pursue careers dictated by their fathers. Church teaching reinforced the societal tradition of the son entering his fathers trade or profession. And the French Revolution, with all of its rhetoric condemning the social covenants of the medieval era, still honored this custom.

So, 18 year-old Hector was shipped off to Paris in 1822 to commence his formal training in the art of medicine. Contemporaries described him as possessing a strikingly animated face, glaring eyes and a bold aquiline nose projecting beneath an abundant mass or red hair.

Berlioz found lodging near the university. His new roommate took Berlioz to a public mortuary in order to purchase “a specimen” [an unclaimed body to be taken back to the anatomy dissection laboratory at the university]. In his memoir, Berlioz describes his emotional reactions upon entering this place of the dead.

“When I entered that fearful human charnel house, littered with fragments of limbs, and saw the ghastly cloven heads, the bloody cesspool in which we stood, with its reeking atmosphere, the swarms of sparrows fighting for scraps, and the rats in the corners gnawing on bleeding vertebrae, such a feeling of horror possessed me that I leaped out of the window and fled home as though Death and all his hideous crew were at my heels. It was twenty-four hours before I recovered from the shock of this first impression, utterly refusing to hear those words anatomy, dissection or medicine. I firmly resolved to the rather than enter the career that had been forced upon me.”

As with so many of Berlioz’ declamations, this was a gross exaggeration. In actuality, he continued in his medical studies for two academic years before he finally declared his full independence from his family. [And sparrows, while consumers of insects, are not known as scavengers of flesh.] Yet there was some truth to his recollections. Until the 20th Century, medical students were required to obtain, from whatever sources, a human cadaver so that they may learn the inner structure of the human body. Indeed, a covert profession called body-snatching had been developed expressly in response to the insatiable need of medical students for human bodies.

The Berlioz family was finally reconciled to the notion of young Hector becoming a musician and composer. he entered the Paris Conservatory and rose gradually to become one of France’s greatest composers and its forerunner in the Romantic Movement: creator of three great operas, two innovate symphonies, and a variety of magnificent choral works. The Paris of the 183Os, where Berlioz found his creative soul, was a congenial haven for many artists in exile. Chopin, Liszt, Wagner, Mendelssohn and even the poet Heinrich Heine found refuge in the City of Light.

The genius of Berlioz was recognized during his lifetime. His orchestral works were widely played and acclaimed; and his skill as a writer was evident in his many newspaper columns on the current musical scene. But nowhere in his prolific writings or commentaries to his music is there a hint of his medical education or his childhood when he was tutored by his physicianfather.

It is worth noting, in passing, that a handful of enduring writers, including Oscar Wilde, Ernest Hemingway, Marcel Proust and Oliver Wendell Holmes, were sons of prominent physicians. But, with so many physicians in so many lands, and over so many centuries, it would be surprising if at least a handful of physicians’ offspring, by random chance alone, did not exhibit some writing talent. No prominent composers other than Berlioz, on the other hand, are the offspring of physicians.

STANLEY M. ARONSON, MD, MPH

Copyright Rhode Island Medical Society Aug 2004

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