This is a House of Cultured Doctors

One long enduring pop cultural stereotype of the medical doctor is their presentation as connoisseurs of "higher culture"--the doctor as one with great time for the symphony and opera and wine-tasting, for example, exemplified by that TV doctor whose presence on our screens is now extending into its fifth decade, Kelsey Grammer's Frasier Crane.

In pointing out that it is a stereotype I certainly do not mean to suggest that doctors are cultureless, that no one who wears a white coat has ever had any interest outside of medicine, etc.. Yet it should seem strange to anyone with the least understanding of what a doctor's life is likely to be like that the hacks who slap together the crapola smeared on our screens insist on portraying doctors as so much able to enjoy these particular examples of "the finer things." After all, we all know the long, hard, road to becoming a doctor--the often gratuitous brutality of a med school education and a residency, and then when they are in their late twenties' the struggle to get properly started in a career as they try to dig themselves out from under the mountain of debt they are likely to have amassed in getting to that point, and maybe the beginnings of a life generally.

Moreover, a doctor's life doesn't necessarily get easier after that, with some long-ago remarks of an acquaintance of mine whose parents were both doctors seeming relevant. Granted, some doctors do much better than others financially, but all the same, they were well-established in their jobs at a hospital that has been listed as among the "best" in the entire United States, and so likely far from the bottom of their high-status, high-income profession. Discussing some of his parents' stresses with a lack of discretion I suspect they would not have appreciated, he spoke of their combined household income, which a check of the statistical tables showed put them not far outside the top "one percent," still left them struggling, maybe overwhelmed, as they wondered how they were going to put two sons through school as they took care of their aging parents--very commonplace concerns that still left these relatively "successful" people badly strained. I don't remember what I thought of the picture he drew of their situation at the time, but I have thought of it often since as the kind of story that Vautrin could well have used as an illustration in his "offer no one would refuse" speech of the hard trials, uncertainty and limited rewards of the conventional bourgeois path--which leave one with very little of the disposable time, income, security, comfort, necessary for the pleasures of connoisseurship, while one would imagine the gap between even doctors' situations and the costs of access to such pleasures to have widened since. (Consider just how much more expensive the requisites of a middle class life have become relative to wages--ownership of a house and car, tuition for school, health insurance, etc.. If doctors do better than most it seems plausible that many doctors have seen their positions erode as well, all as those doctors who make the most tend to live in areas where the cost of living is the highest, like those cost-of-living nightmares that are California's Bay Area and New York.)

Given such realities, where does the image of the "cultured" doctor come from? I suspect it is partly a matter of the hacks who slap together the aforementioned crapola being prone to equate intelligence and education with "the leisure class" to which such pleasures are most accessible--often, without realizing it. It seems partly, too, a matter of their outrageous flattery and glamorization of the professional classes, among which medicine stands near the top, to the point that even if a doctor, whatever their origin, is by virtue of being a doctor a working person rather than a gentleman of leisure, all this is rather confused together in the minds of these people, the practitioner of medicine somehow being effectively leisure class after they go home for the day, the disposable time and money there. As a practical matter "success" in the professions does tend to bring one a higher standard of consumption than the work force at large, but rarely so high as that, while again time and ease and security are not simply purchasable with money so long as they go on working (all as very few have much hope of "early" retirement"). The result is that in the end it comes down to Hollywood hacks flogging clichés describable as the "stupid person's smart person," all as, as to some extent they do with characters of all backgrounds, they endow them with an exaggerated amount of time and money on their hands so that, in contrast with the viewers at home leading their stiflingly limited lives, they can have a wacky adventure each week.