Travels by Michael Crichton

people.
    And the trend toward the physician-scientist had brought to the medical school a kind of student with whom I had little in common. My classmates tended to think that literature, music, and art were irrelevant distractions. They held these “cultural” matters in the same intellectual contempt that a physicist holds astrology. Everything outside medicine was just a waste of time.
    In those days Harvard had built a new medical library. One day a pale, ethereal-looking man wandered in and looked around. It took me a moment to realize it was Louis Kahn, who was one of my heroes. I was very excited and reported the news at lunch: “Louis Kahn was in the library today!”
    “Who?”
    “Louis Kahn.”
    Frowns. “The new professor of medicine?”
    “No, the architect.”
    “Oh …” And the conversation turned away.
    Louis Kahn was not only a famous architect, he was arguably the most influential
medical
architect in the world, as a result of the building he had done at the University of Pennsylvania some years before. Harvard was putting up a lot of new hospital buildings at this time, and there was much discussion of their merits and faults. How could you have informed discussions if you had never heard of Louis Kahn?
    This single-mindedness led to some bizarre medical episodes. Once I heard a group of residents plan the surgical treatment of a middle-aged businessman. The best thing for his intestinal problems, they agreed, was to schedule five separate surgical procedures. The first would clean up his bowel. The second would cut a hole in his stomach so he could defecate into a bag. The third would do something else. The fourth would repair the hole in his stomach and reconnect his intestines. The fifth would do something else again. All together, the man would be out of the hospital, good as new, in nine months.
    The alternative was a two-stage procedure that would require only three weeks and no colostomy bag, but it was obviously inferior to the five-stage treatment.
    I suggested that the man might not agree to the five-stage treatment. Everyone listened to this view with astonishment. Why on earth wouldn’t he agree?
    I said perhaps the man didn’t want to spend nine months of his lifein a hospital, undergoing one operation after another. I suggested that a busy corporate executive was worried about many things besides his health. He was worried about his family, about his income, about his rank in the company. A nine-month hiatus from daily life was going to give him a lot of problems.
    I also said that to live with a colostomy bag was a major body alteration and it would not be lightly accepted by anyone, even temporarily.
    No, no, they said. When we explain it to him, he’ll certainly agree to the five-stage treatment.
    Of course the man didn’t agree to it. He wanted the fastest possible treatment, and he thought their elaborate plan was crazy. He reacted to the idea of a colostomy bag with horror. The residents came away shaking their heads: What can you do with somebody who doesn’t care about his health?
    Yet the fact that the patients were complex human beings with a rich life beyond the hospital never really sank into the consciousness of the residents. Because they had no rich lives beyond the hospital, they assumed no one else did, either. In the end, what they lacked was not medical knowledge but ordinary life experience.
    Nor did the attitude of practicing physicians encourage me. I liked them much better as people; they often had a breadth of interest missing from the current crop of students. But, all too often, the senior physicians were dissatisfied with their work. Even if they loved medicine—and most did—they came to dislike the life style. In those days, when group practices were less common and doctors had a more direct one-to-one relationship with their patients, clinical practice was enervating in a way that seemed to catch up with physicians after a decade or two. These men