The Astronaut Model

“What problems are young people having today?” I was asked at a harmless social get-together at the home of the dean of admissions.

  The problem for young people today is the Harvard Medical School admissions committee. People this bright and accomplished shouldn’t have to be begging for a job in medicine. It shouldn’t be so hard. There should be more clearly defined, simple paths for people to be of use. That so many young people want to be doctors speaks well for the families producing intact applicant and for medicine for attracting them, but I can’t help feeling that there should be a broader array of choices. People that intelligent who have worked that hard should be able to be doctors if they want to. What exactly is the point of producing an abundance of amazingly capable people if we don’t have things for them to do? Two hundred years ago being able to read and write a little, being healthy and having a work ethic, meant you could do well at just about anything.

  It shouldn’t be so hard for people to figure out what to do with their lives.

  “What the hell are we going to do with Timmy?”

  “I don’t know. Do you think we could get him into med school?”

  Every Nobel laureate was once a goofy sixteen- or twenty-two-year-old whose family worried about what the hell or she was going to end up doing.

  I have had heartbreakingly accomplished patients kill themselves or become heroin addicts. It’s not enough to play an instrument perfectly or to get a full scholarship.

  As soon as a new hurdle is set on the path to getting into medical school (organic chemistry, higher and higher GPAs, higher and higher board scores, extracurriculars, community service, moving personal stories, et cetera), the ability to clear the hurdle spreads through the applicant pool like the ability to resist penicillin spreads through a petri dish. Everybody is throwing a lot of pasta up against the wall hoping that it will stick. Any essay that works will be reworked and reworked and reworked some more.

  Some applicants were accused of trophy collecting. It wasn’t enough to be a concert pianist, work in a first-rate research lab, or save a small South American village. It had to come from the heart.

  After watching so many candidates I liked go up in flames I suggested to the dean that each committee member be allowed to advance one applicant a year to the final pool without the usual debate. He thought it was a good idea and would bring it up to the committee.

  Is a doctor really that special a thing to be, or are we making too big a deal of this? It’s like we’re all scrambling to get to a place a little higher up on some slippery pyramid because we don’t know how high the water will be when the tide comes back in.

Mark Vonnegut M.D.

Just Like Someone Without Mental Illness Only More So