Harvard Med: The Story Behind America's Premier Medical School and the Making of America's Doctors.

John Langone has spent much time at Harvard's temple of medical education and returns with a notebook full of impressions of how the high priests of the healing profession are trained. We are right there among the cadavers as students learn anatomy and hone the black humor that shields against their revulsion over slicing body parts. Langone also takes us to the hospital bedsides as would--be doctors stumble through their first patient interviews and later as they struggle to tell people they are dying of cancer. These are pgwerful, well-drawn scenes.

But Langone, a veteran medical journalist, hopes to do more. He aims to illuminate the causes and possible cures of "the gap between caregivers and patients, a gap that is ever-widening because of the intrusion of technology and market forces in medicine." A worthy goal. Unfortunately, Harvard Med reads mostly like a reporter's notebook: It is full of mini-profiles and anecdotes, but lacks the sort of narrative that could show the reader how an institution like Harvard shapes students.

We should care about medical education because it affects the quality of the treatment we get. Langone reiterates the common lament that this treatment has grown increasingly impersonal and expensive as the medical profession has splintered into specialties and subspecialties. He mourns the passing of the old-fashioned family doc, who mixed preventive counseling with compassionate attention to his patients' emotional, as well as physical, health.

In fact, the problems with doctors today have their roots in pre-medical education, and Langone gives this subject insufficient attention. Colleges and medical schools collaborate to shrink the pool of applicants by means of killer science courses like organic chemistry. Naturally, doctors need to know a lot of science, but Harvard Med and other schools place too great an emphasis on applicants' grades in certain undergraduate classes. The supercompetitive science geeks are experts at acing written exams, but don't necessarily have talent for the delicate task of caring for the sick.

Langone does identify the "pre-med syndrome," but explores the phenomenon primarily by quoting professors and students who deplore it. Harvard, he asserts, has tried to move away from its fixation on college science grades. He profiles med students who write poetry and think big thoughts about the relationship between behavior and health. But the author doesn't offer a substantial portrait of a representative geek or of one of the old-line professors who still defend the narrow grade fixation.

This becomes a frustrating pattern: Langone mostly focuses on reformers and idealists, whom he quotes at great length about the weaknesses of medical education. Harvard wants to produce prize-winning researchers. Debt-burdened students find irresistible the big bucks of cardiology, as opposed to the merely comfortable income of a primary care physician.

But what's missing from the book is a sustained storyline that follows a student's evolution from the vague notion of serving ordinary patients with ordinary problems to the conviction that being a top-dollar specialist is the only way to go.

Langone says in an introductory note that he avoided depicting the routine of a typical medical student or the drama of the emergency room because these are hackneyed genres. He's right that we have had enough of hyped ER heroes. But the author errs when he steers away from a detailed documentary of one or a handful of medical students, whose maturation and changing attitudes would have provided far more insight into the workings of Harvard Med than this sporadically entertaining volume.

Paul M. Barrett is a reporter with The Wall Street Journal.