Through the telling of stories, I have had the good fortune to visit more than 40 training programs. Prompted by questions from housestaff at earlier visits, I began to hold private sessions at later visits with housestaff only-faculty excluded-sessions I called "Forbidden Topics," where nothing discussed leaves the room. We talk about money medical malpractice, and medical marriages.

Soon, they tell me what they cannot tell their faculty: of the absolute lack of mentoring, the dearth of role models, the paucity of wise counsel. Reluctantly, they admit to an attitude of patient as onus. They learn that attitude from each other, they tell me, and from their immediate superiors. Faculty are seldom around these days, after all, forced as they are to forgo teaching to earn money for the institution.

I hear, too, of sexual harassment from their superiors, of how many young women and some men are victims of it and horrified by it, but how a few learn to exploit it to get a leg up on the rest, as did Cass in the story. I come away from these sessions feeling as you do. Dr. Sirridge, that this is not a description of medicine as the caring profession I have known either. And that these young people are being cheated.

Cass's story, while wholly fiction, is nevertheless of reality. It is, I agree, offensive. Reality sometimes is. If there is to be change, it will be up to you and your colleagues, Dr. Sirridge. But it will not be through denial. Nor do I have any easy answers for a medical faculty under siege itself. But you could start with the examples of Fitzgerald at UC Davis, Rubenstein at Chicago, Kreisberg at Birmingham, and Khan at Nassau County. They seem to know how to nurture their housestaffs.