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More on M.D.'s to Be

How ironic that you should publish Nancy Knoblock Hunton's article on managed care ("Who Calls the Shots?" New England Regional Edition, March-April, page 32A) in the same issue that features Ellen Rothman's description of how human beings become patients and doctors ("M.D. to Be," page 66).

In nearly 10 years of asking, I have yet to find anyone who can explain how managing care differs from practicing medicine (aside from who does each). Hunton's piece provides no enlightenment. Her conclusion could have been written by the marketing division of U.S. Healthcare. It presumes that the "right" treatment can be prospectively, uniformly determined, obviating the need for the very art of medicine which Rothman is so sensitively acquiring.

Hunton devotes little attention to the fact that managed care asks individuals to surrender not only their choice of doctors but also sovereignty over their treatment, which heretofore has resided with patient and physician collaboratively. In the new configuration, doctors become agents of the insurer, and one's ability to trust one's doctor falls commensurately. Is this really what society wants?

Jonathan L. Weker '76, M.D. Montpelier, Vt.

The word that comes to mind in reading the current writings of medical students like Rothman is "self-absorption." I suppose that if 80 percent of one's emotional experience has come from watching shadows on a screen, one tends to see life as mostly a matter of one's own emotional reaction to it. And if one's "role models" are mostly actors, one tends to absorb actors' priorities, the highest of which is looking good at what you do. Rothman's concern for patients seems too heavily weighted with concern for the quality of her own experience.

The medical student passes from the late-adolescent subculture directly into the medical subculture-two of the most isolated and inward-looking subcultures of our society. With all Rothman's concern for the "personhood" of her patients, few of her peers-or, apparently, her preceptors-could point out to her that a 74-year-old woman surrounded by strangers who call her "Betty" instead of "Mrs. Smith" is constantly reminded of her loss of standing and respect.

C. Dennis Thron, M.D. '59 Professor of pharmacology and toxicology Dartmouth Medical School Hanover, N.H.

The Holocaust, Continued

Christopher Reed's report on Daniel Goldhagen's Hitler's Willing Executioners ("Ordinary German Killers," March-April, page 23) requires comment. If Reed's opening paragraph correctly summarizes Goldhagen's conclusions, it is difficult to imagine the book as a product of "impeccable scholarship." For how could a summary judgment such as "The vast majority [sic!] of Germans would have agreed to take part in the extermination of Jews if asked to do so" be the result of serious scholarly research? What kind of sampling or other research method is at the basis of such a statement? The same question mark applies to other astounding remarks.

Who is to deny that there was anti-Semitism in Germany not decades, but centuries before Hitler came to power? I leave it to historians of high professional standard to judge whether it has been more virulent in Germany than in other European nations. Anti-Semitism has been the curse and shame of our Christian civilization. It has not spared America (see James O. Freedman, "Becoming an Educator," January-February, page 45). The fact that Germany under Nazi rule carried this heresy to its horrific extremes and that far too many ordinary Germans were passive or even consenting bystanders to the Holocaust constitutes the nadir of the history of this nation and will stigmatize it forever. Nevertheless, I wonder how anyone could qualify Goldhagen's wholesale conclusions as the outcome of an earnest quest for truth. Such writing should not have gone unquestioned in a Harvard publication.

Klaus A. Heiliger, M.B.A. '66 Berlin

A clarification needs to be made about the photo shown with "Ordinary German Killers" (see "Letters," May-June, page 98). Dr. Jonathan Webber of the Hebraic studies department at Oxford University says that there is a strong possibility that this particular photo, which is on display at the Auschwitz Museum in Poland, has been changed and superimposed by the former Communist administration that oversaw the museum previously.

It is a shame that this propaganda photo has become part of the iconography of Holocaust remembrance. Not that it matters anyway; we all know countless similar tragedies occurred, whether a camera was present or not. Goldhagen raises points that others have been afraid to address. He states that other theorists created their ideas in an empirical vacuum. But perhaps that is too unforgiving in studying such an inexplicable event. If anything was in a vacuum, it was the Holocaust itself: a mass-mobilized, systematic destruction of people in a way that the world had never seen and hasn't seen since.

Stefanie Rudnicki Linden, N.J.

Kudos and Brickbats

The current issue, May-June, is just marvelous. Congratulations to you and your team.

Stanley D. Hopper, Ph.D. '71 Palmdale, Cal.

The dismay of your former poetry editor, Donald Hall, who complained in your May-June letters section (page 5) about the dropping of what he referred to as poetry, is understandable, but I doubt if very many of your other readers will join in his distress.

For many years I tried, without success, to extract some meaning from the random words that were presented [in the magazine's pages] as representing "musical thought" or "the harmonious unison of man with nature" (Carlyle), or "the spontaneous overflow of powerful feelings recollected in tranquillity" (Wordsworth), or "the rhythmical creation of beauty" (Poe), or "the emotion of life rhythmically remembering beauty" (Fiona MacLeod), or even simply "the best words in the best order" (Coleridge), to cite some definitions of "poetry" from Roget's Thesaurus.

Keep up the good work.

Calvin Evans Hardin Jr., J.D. '30 Baton Rouge

These days, there's little poetry in my busy life, so I rather looked forward to that section. Now you've taken it away! C'mon, admit it: you goofed. Bring it back!

Peggy J. Pickle Austin

Editor's Note: Harvard Magazine continues to run poetry on an occasional basis; in this issue, see Villanelle for a Lesbian Mom.

More M.M.

The excerpt from the memoir of Paul Tillich ("Open Book," May-June, page 30) mentioned how oblivious he was to Marilyn Monroe until the connection was made with Arthur Miller. About 10 years ago I was visiting San Francisco with a number of prominent businessmen, educators, and politicians from Lyon, France, just before the Super Bowl. I was standing in the lobby of our hotel with two of them when Joe DiMaggio arrived. I said to my friends, "There's Joe DiMaggio." They said, "Who's he?" Searching for some way to identify him, I said, "He used to be married to Marilyn Monroe." This brought instant recognition and sounds of approval, illustrating the interesting way in which different groups may allocate priorities.

Don Friedkin '42 New York City

Cells and Classrooms

"Out of Work in Jail" (May-June, page 15) omits a critical urban problem: decades of high school drop-out rates in the 30 to 50 percent range. Any solution to jobs also has to encompass a solution to underclass decay. The land of opportunity and pursuit of happiness has been subverted.

Charles J. Hamm '59 Brooklyn, N.Y.

Marathon Man

"The Boston Marathon" (March-April, page 81) was unfortunately incomplete in an important way. No mention was made of William T. Cloney Jr. '33, current secretary of his class, who directed the Marathon from 1946 to 1982. During his stewardship, Cloney guided the race from several hundred participants to 10,000; he successfully worked with the AAU to allow women athletes to participate as equals in the event, introduced the wheelchair section of the race, initiated the computerized finish line, and reluctantly introduced time qualifications to keep the race manageable as it grew exponentially in popularity among recreational runners.

Will Cloney, as the volunteer director, took this race from Boston oddity to world preeminence, second in prestige among marathons only to the Olympics.

N. P. Dodge Jr. '59 Omaha

Erratum
"Front-door Policy" (May-June, page 76) erroneously reported that some businesses outside Holyoke Center's retail arcade would be forced to vacate their premises as Harvard Planning and Real Estate undertakes a planned redesign of "The Shops by Harvard Yard." In fact, the only businesses affected are those located within the arcade, surrounding the building's elevator lobby. The Ma Soba and Au Bon Pain restaurants, on Mt. Auburn Street and Massachusetts Avenue, respectively, and the retailers along Dunster Street are staying put. We regret the error.

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