The medical student.

In primitive societies, those who would become shamans or witch doctors must often undergo curious rites of passage. At an early age, the future shaman is frequently set apart from others by his conviction that he possesses special healing powers, which may be transmitted by virtue of his birth into a healing clan; from the start, his fellow tribesmen endow him with a special mana of one who will confront the ultimate mysteries of life and death. On reaching maturity, and perhaps after enduring ritual ordeals to test his vocation, he is apprenticed to the elders whose ranks he will join. Often he is secluded from his fellows for many years, submitting to painful initiations to establish and consolidate his calling. In these years, the secrets and stigmata of his guild are passed on to him-frequently an arcane language, dating from the distant tribal past, a special manner of relating himself to the sick and the dying, and an elaborate technology of herbs, charms, and incantations to preserve the living or hasten the dead upon their way. Upon emerging from his prolonged initiation, the young shaman may be expected to assume a new name, to don the distinctive garb and amulets of his order, and to accept the ambivalent weight of membership in his feared and powerful guild. The analogy between the training of a shaman and the education of a medical student is of course far from perfect. In most respects, modern medical education is technically justified to a degree that is matched by no primitive initiation system. Yet this analogy at least suggests that those who enter the healing profession may be distinctively motivated to confront actively the issues of suffering, death, and care which most of their fellows anxiously avoid; and further, that their educations may (and indeed should) teach them not only the specific skills of medicine but more general techniques for coping with the vocational anxieties that must inevitably plague the healer. Finally, the analogy points to the fact that in all societies those who care for the sick are set apart from the common run of man-