LETTERS
Letters Moral Myopia: “The New York Review” and the New York Intellectuals I am not prone to writing editors and my other habits are good also; however, I have to make an exception in order to...
...The authors may protest that these areas are related-of course they are, but they are also related to many areas never mentioned in the article...
...Thus Barbara Epstein at NYRB is not as important as Jason who is at Random House who is not as important as Jim Silberman who heads Random House, who is not as important as his wife Leona Nevler who is a key taste maker and heiress apparent at Fawcett...
...I. F. Stone is a genius at mining important stories almost exclusively from documents...
...If one trusts the people, there is no reason why they cannot be responsible for allocating their medical dollars, and there is little need for me to subsidize my neighbor’s hypochondria or “luxury expenditures...
...I doubt if any educational experience is so closely studied, tabulated, and correlated as in American medical schools...
...Since both the Enghsh system and Kaiser-Permanente suffer from over-utilization by a segment of their populations and since both have met the problem in makeshift ways (the English by having people wait in GP’s offices, Kaiser by using machines to screen out what its director calls “the worried well”), it is not at all so clear that deductibles and coinsurance are evil...
...The two Senators attending were Senators Bentsen and Baker...
...that there is no evidence of being “fundamentally in collusion...
...Instead they respond to fashion-and headlines and produce shit...
...If ignoring the relationship between various specialties is “perilous” (p...
...would only provoke hilarity, so preposterous is it and so utterly paranoid and ignorant...
...This is hardly a radical suggestion, and many medical school deans have, as we noted, proposed ways to lop off unneeded courses...
...He refers to the secret conferences between the House and Senate members which eventually produced a breakthrough and indicates that the two Senators involved in the conferences were Senators Musle and Baker...
...MICHAEL J. HALBERSTAM, M.D...
...I don’t propose to let anyone cast doubt on my integrity...
...To imply that the situation is static is incorrect...
...And that is what you have done...
...The Mafia is a criminal organization...
...Where...
...JOHN HOLT Boston, Mass...
...One editor in ten is a real editor...
...9, col...
...There is “a powerful center” consisting of five people: Decter, Podhoretz, Epstein, Silvers, and myself...
...What interest does he have in helping my (as he regards them) pallid social democratic books...
...My next book they turned over to a middle echelon New York public school bureaucrat, with predictable results...
...If I review a book I like, I say that I like it and I say why-I don’t pretend that this is some judgement coming down from Olympus...
...If paper buys, then hard gets behind them...
...But they go by rules...
...He complains and has in the past quite often about how hard it is for young writers and writers in general to get published in book form...
...You report Kostelanetz’s charge, without making any specific qualifications about my alleged role, that “an exclusive Mafia-like club exercises monopolistic control over the country’s channels of communication...
...Increasingly books will be signed first through paper and then on to hard...
...These remarks, and especially the comparison with the Mafia, are insulting, without basis in fact, and libelous...
...Three years ago Indians...
...Two years ago Women and Chicanos and Ecology...
...Jason Epstein is a vice president of Random House and a founder of The New York Review of Books...
...8, col...
...Heading the Highway Lobby Off David Martin’s “Heading the Highway Lobby Off’ [November] was both timely and informative...
...If O’Brien did have them, I doubt if he would have commingled them with his financial files...
...CHARLES U. DALY Cambridge, Mass...
...What equivalent can be cited for the five people mentioned...
...Now I ask you: what evidence is there for saying that “the powerful center” functions like an “exclusive Mafia-like club...
...The real danger in the book business is the growing power of the paperback world on the hard cover...
...The authors quote authorities who suggest that students “dispense with considerable course work and training which they never intend to put into practice...
...that the relationships among the other four are hardly more cordial, probably less so...
...Washington, D. C. right dependent on income...
...But I have very often said to friends, or other people who have sent me manuscripts or books, that I don’t think the book is good enough to publish or, if published, for me to review favorably or support...
...and instead the paper people competing with bigger sums for fewer books...
...All publishers do this and thus cheat both the bad books, and in fact the good books which have to support the non-books...
...Diplomaism is not unique to medicine, but its consequences are more expensive there than elsewhere...
...Why send in a group charged with photographing financial documents if the non-financial ITT documents were the object of the search...
...Conflict-of-interest is a very difficult problem in politics...
...that what you call “temporary spats” are actually long-standing (in some instance, at least 7-8 years) breaks over politics...
...Shouldn’t you have read some of their books before presuming to judge their authors...
...MICHAEL D. MALTZ Evanston, ill...
...This leaves strangers if not enemies...
...I am surprised that Blumenthal and Fallows twisted my analogy, since they seem to share q ~ y own suspicion of mass medicine and Answers to December puzzle...
...Instead of measuring competence in a specific field, it measures diplomas...
...An example is Epstein’s argument that “great” writers should not have to answer for apparent conflict-of-interest...
...Your article must stand on its own...
...Personal pique aside, I regret that the authors spread themselves over so many relatively disconnected areas of medical care as death and dying, health financing, specialty certification, and medical education...
...I would have thought that a writer so concerned with corruption as you say you are would have taken the trouble to read The New York Review before trying to write about it...
...This year fuel and Watergate...
...There’s a lot more, too, but I hope my point has been made...
...They would have found that for years their suggestions have been debated, acted upon, discarded, or continued not only in several dozen medical schools, but in almost every one...
...DAVID HALBERSTAM New York, N.Y...
...Put into print, it becomes a significant piece of nastiness...
...Just read your article about literary politics...
...John Holt is the author of several booh on education...
...I have received many bad reviews in my life, a number of them in Cbmmenraiy and The New York Review (apparently the “fundamental collusion” wasn’t working so well then...
...And how can you write about the Literary Situation when you make no effort to understand the writers concerned...
...9, col...
...I disagree with you somewhat on the ethics of people reviewing books written by friends...
...You are guilty of that nastiness...
...What I also wrote, and what the authors’ “. . . .” left out, was: “I appreciate these franchise places for delivering adequate food at low cost...
...is entitled to treat a whole range of illnesses and to use procedures that neither aptitude nor training may suit him for...
...I’m a distinct beneficiary of this but I do not think it is a particularly healthy trend...
...There are times when that’s all I want-especially when my children are along...
...Do you understand how deeply your article insults these writers...
...But I don’t propose to let anyone compare me to the Mafia, with all that implies of criminality...
...The conferences were called by Senator Bentsen of Texas, who believed they constituted the only means of breaking the deadlock...
...If the review is an honest one, I don’t see in the least what is unethical about it...
...AL HILGER New Haven, Conn...
...Much of the article is, as a friend of mine remarked about another Fallows’ piece, “provocative and original,” but too much is superficial...
...This seems to be an important part of my work...
...The authors should have taken a closer look at the monthly Journal of Medical Education before offering their naive ideas about shortening medical training...
...that there are deep, passionatelyheld in t e lle ct ual-political differences splitting these five people into at least three and perhaps more groups...
...Because it is easier to put something on the conveyor belt than to deal honestly with an author...
...All instant books...
...Your dictum, if rigorously applied, might lead to the result that my books, if reviewed at all, would only be reviewed by enemies-people who might claim to be “objective” but who would have very important personal and professional reasons for opposing the point of view I put forward...
...Because having gone through the same bit in my early years and having had earlier books get screwed, I know what is happening to him...
...Don’t forget, that spring the Democrats were playing up their own financial openness as contrasted with the Republicans’ preApril 7th secret money...
...What member of the Nixon reelection campaign staff would believe that the Democrats could survive without secret contributors...
...The editors reply: John Holt is right...
...Where those roots are not perceived, the tendeccy is for the moral critic to lecture the immoral official...
...h an earlier version of this letter, I had written in much d e t d about the relationshipsmore accurately , the non-relationshipsamong the five people you cite...
...I haven’t been overjoyed by them, but like every other writer, I have had to take them...
...The student must be exposed to the rudiments of a lot of specialties-in a way that does not really equip him to practice-before moving up to more intense training in his own field...
...Power is dollars...
...In a wiser profession they would know they have a diamond and would triple the normal budget...
...Ronald Katz is on the staff of Senator Lloyd Ben tsen...
...To repeat slanderous material is to indulge in slander...
...I am no enthusiast for much of medical education, but Blumenthal and Fallows are seriously negligent in their knowledge of medical training...
...Perhaps what is at issue here is the question of “objectivity...
...Health: The Care We Need and Want In commenting on Blumenthal and Fallows’ extensive indictment of American medicine [ “Health: The Care We Need and Want,” October] it is difficult to know where to begin unless, like me, your views have been misinterpreted...
...As a staff member who went through several months of tedious negotiations on the highway bill, I found it to be generally fair and accurate reporting of the events surrounding the emergence of that legislation...
...It makes it harder for editors to find people to review my own books, and it means that most of the people who might otherwise be expected to write a review which was both understanding and sympathetic are ruled out...
...Can’t tell you how much I enjoyed your balanced knock of The New York Review of Books...
...For either this implication, or any charge of “collusion” with the others named, or indeed, for anything else, yo11 offer no evidence whatsoever...
...Almost no editors send books back for serious rewrites...
...And, of course, how ideal it would be not only in medicine, but in the law, business, and life in general, if what one never intended to put into practice coincided with what one never h d to put into practice...
...the press...
...B] ut...
...Halberstam agrees with us that there are two ways to ration medical services-price being one way and “queuing up” the other...
...At some point, helping one’s friends turns into cronyism, nepotism, and corruption...
...The Mafia, one gathers, does have periodic gatherings to iron out relations, divide the spoils etc...
...And one begins to really understand it when one begins to understand the appearances of confict that occur in one’s own life and the real temptations, conscious or unconscious, that they often represent...
...And as for cost, $250,000 is only one-eightieth of $20 million...
...Auden, I. F. Stone, Stephen Spender, V. S. Pritchett, Christopher Lasch and so on (who are all Random House authors and writers for the Review) are involved in a literary fraud manipulated by me, or that their pieces in the Review would suggest as much to a responsible reader...
...But it occurs to me that, since you showed no interest whatever in investigating the truth or falsity of what Kostelanetz says, since you did not trouble to ask any of The Five whether there was any truth to these charges, it would be absurd for me to offer now the relevant details...
...Anyone with an M.D...
...Thus the real power in the literary world goes ever more not to Podhoretz or Epstein, who have little muscle in terms of dollars, but to a handful of people who do the choosing at the paperback houses...
...l), then how exactly and where exactly do we lop off the unneeded “phases of the normal M. D. training” (p...
...What Kostelanetz may or may not say in his book interests me not at all, in this context...
...I specifically mentioned defects in feeforservice care, and was not suggesting that the existing system “offers service like that of the Ritz or Four Seasons,” but instead pointing out that greatness is seldom achieved by a committee...
...I write to express my outrage at what you have put into print about me in your November issue, on page 16...
...The scatter-shot nature of the article produces strange internal paradoxes...
...Faddism...
...an internist needs broader exposure than an orthopedist...
...Particularly such gems as describing Chomsky as a “tedious Johnny-one-note,’’ ’gad how true...
...We also cited studies showing that “coinsurance” and “deductibles” can deter people from getting the care they need...
...like] Mafia capos...
...lTT and Watergate My interpretation of the reason for the Watergate burglary is quite different (and more prosaic) than Timothy Ingram’s [“ITT and Watergate: The Colson Connection,” November...
...And fewer and fewer books bought by paper in the $15,000 paper range...
...Neither is mentioned in the article...
...and that, indeed, if you brought these five people together in one room, something that probably hasn’t occurred for at least a decade, the only possible result would be bitter disputation...
...2) and if specialists should have “a general scientific background and an understanding of the connections between the specialty and other branches of medicine” (p...
...All crap...
...What interest do I have in promoting Epstein’s (as I regard them) radicalchic books at Random House...
...however, I have to make an exception in order to praise your extraordinarily fine review of Richard Kostelanetz’ mediocre book [“Moral Myopia: The New York Review and the New York Intellectuals,” by Suzannah Lessard, November...
...yet the unsuspecting reader, for whom you elsewhere show such solicitude, can only infer that since I am at “the powerful center,” I must somehow be connected with what follows...
...my own first book found a publisher in part because of the efforts of someone who liked it and believed in it-and who was a friend of a friend of a friend of mine...
...his] conspiracy theory has more conspiracy than theory . . . . My own impression is that Kostelanetz wants to be Jason or Podhoretz...
...Is it really only a matter of counting up who reviews whose books...
...We believe that the errors of government will not be properly understood as long as the critics of government fail to see the roots of those errors in themselves...
...So I go over there every day and fight for more advertising space for him...
...Do the authors want our specialists to be more highly trained or less...
...Even if it were suspected that the documents were in O’Brien’s hands, why bug his phone...
...Quoting my analogy between Health Maintenance Organizations and franchised food operations, the authors employ the press agent’s beloved “. . . .” to obscure the force of the actual quotation...
...I would think this would be a very difficult problem in politics, where somebody who never helped his friends would obviously never have any...
...At its core the club is much like self-promoting literary cliques...
...There is, however, one error...
...When did this “club” meet...
...it seems a waste of my time...
...Otherwise we are astounded at the inferences Epstein and Howe have drawn from the article and depressed at the humorlessness with which they have missed its point...
...Thus, when the Sunday Times got around after many years to doing a retrospective review of my first three books, they turned the job over to a notorious educational right winger, and a man who’s famous for a savage tongue-and he did the expected...
...that I have had no connections whatever-I repeat, no connections whatever-with the one specific matter you cite (Random House-New York Review...
...Which is very tricky-it means that certain books which are important but high risk commercially will become ever more orphaned, ever less supported by an already non-supportive book business...
...If it comes in, is well typed, and has 301 pages, it gets printed...
...But he is unique, and even he misses the human dimension in the story of why thtngs go wrong...
...The business would be better if all publishers trimmed their lists 30 per cent...
...This would be lovely had the authors not previously reminded us of the interconnections between various medical disciplines, many of which we cannot even be anticipated when the actual material is taught...
...The profession recognizes a stunning range of specialties, which it seems to view as progressively higher stages on the evolutionary tree...
...Which is far more important than Epstein or Podhoretz...
...We expressed our preference for the queuing system, since that way everyone at least has an equal right to hypochondria instead of a...
...Thus,” Suzannah Lessard states in her article, “we have a lot of Chomsky-like moralizing from library armchairs and practically no trips to the Pentagon or the White House to inquire how real human beings come to create horrors like Vietnam...
...As it happens, I am often asked by friends either to review a book they have written, or in some cases to read manuscripts and, if 1 like them, to push them with publishers...
...Paper is now in the process of taking over hardcover and dominating our taste, which is not necessarily a good thing...
...As for Jason Epstein, a valued friend, and Irving Howe, we respect them both and intended no imputation of bad faith or criminality to either of them...
...Charles Daly is vice president for Government and, Community Affairs of Harvard University...
...Almost no editors sit back and think how they can allocate their resources so that in four years they might be coming up with a real list of real books...
...Suffice it to say that with one of The Five I have not spoken in six years, with another not spoken in four years, and with the other two in almost a year...
...A fine book...
...From the start I’ve found the thing unreadablegray, over-long, academic, etc...
...How is the “collusion” managed...
...It makes many good points...
...Irving Howe is the editor of Dissent...
...a change away from research orientation of students and schools occurred in the mid 1960s...
...JASON EPSTEIN New York, N.Y...
...When we come to specialty training, it is our turn to feel misinterpreted...
...You can count them on the fingers on two hands...
...Much of the curriculum change is, in my opinion, worthless, but the continual reevaluation is absolutely necessary...
...Senator Muskie never attended any secret conference with Congressmen Harsha and Wright...
...HMO’s...
...He takes on their cliquishness without coming to terms with the fact that to the degree that there are cliques in the literary world they are relatively unimportant...
...Considering recent polls showing that half the undergraduates at schools like Harvard plan to apply to medical school, the situation may get worse...
...Unlike the magazine business where the odds are very much against a piece being accepted, there is almost no critical rejection process in books...
...In some cases this long process is necessary...
...One of our points was that medical training takes too long and that American doctors are, in general, far too specialized...
...Which he does not...
...or when they come in and before printed they will go to paper...
...It is too easy to be published in hardback...
...or just Dissent...
...The editors reply: To start from the bottom, Dr...
...My name is brought in...
...most editors publish a majority of books that they do not believe in (and indeed are often contemptuous of...
...Particularly, too, your assessment as basically and mis-fortunately a thing written from private libraries and usually at a second or third remove from experience...
...Mentioned at a cocktail party, the idea that these five people, or any possible combination of them, are “an exclusive Mafia-like club” exercising “monopolistic control over the country’s channels of communication” (which...
...Rather than being in a “lock step through four years of general medical education,” medical students for the past ten years have been exposed to an amazing number of electives, alternatives, “track systems,” shortened curricula, new courses, and multi-media teaching...
...Couple this with the belief that burglaries could be committed with impunity, and you have a task force searching for secret financial transactions in the Democrats’ fies and bugging Lawrence O’Brien’s phone to hear him talking to secret contributors...
...radio...
...There is, on the other hand, good moral and fiscal reason for me to make sure that he is not bankrupted by illness-reason to make subsidized catastrophic illness insurance or Professor Martin Feldstein’s Major Risk Insurance intelligent possibilities for national action...
...He is quite wrong...
...Nor is it true to claim that medical schools “M1 the classes with would-be Nobel laureates” and therefore don’t produce general practitioners...
...The problem of how much do we help our friends is not a simple one, in literary politics or any other kind...
...But carry the opposite principle to an extreme and what do you get-that people should only help their enemies...
...The focused research of David Ignatius’ article on the chummy relationship between deans and drug manufacturers is a happy contrast...
...there follow a series of descriptions of alleged events...
...RONALD L. KATZ Washington, D.C...
...Four years ago War...
...to be compared with the Mafia is to have it suggested that one is a criminal or engaged in criminal-like activities...
...That is incorrect...
...We believe that they have the same obligation as the congressman who takes the campaign contribution from the paving contractor and whose duty to disclose should in no way be diminished by the fact that he is a “great” congressman...
...1 feel that it was committed primarily to find secret Democratic contributors...
...You have done me a grave injustice...
...Our argument was that medical schools choose their students on the same purely academic criteria one would use to choose research chemists, which may not be the best way to choose humane physicians...
...I’ve always felt very strongly that the pose of objectivity, and the claim to objectivity, of most people in our intellectual and academic worlds was at best a self deception and at worst an outright fraud...
...no connection is made between me and them...
...IRVING HOW New York, N.Y...
...This is why we published “Moral Myopia: The New York Review and the New York Intellectuals...
...The number of real books which are published each year is about 25 percent of the total of books...
...Letters Moral Myopia: “The New York Review” and the New York Intellectuals I am not prone to writing editors and my other habits are good also...
...As it happens, I have endorsed, either in reviews or in statements, so many books that I really do believe in that it has created something of a problem for me-or at least it may have...
...My personal policy is never to review books about which I am not enthusiastic...
...And how can you possibly say that the Review was not critical of the New Left or that Stone doesn’t cover the White House or the Pentagon...
...I suspect you are in trouble from the start because you are working off Kostelanetz’ impressions and...
...Our care of the dying relates as much to the loss of religious influence in our lives as it does to what medical students are taught...
...It did, and it is a disservice to medical schools to claim otherwise...
...These people,” you continue, “may have temporary spats with each other but they are fundamentally in collusion, as are competing Mafii capos...
...Though it should take two to three years to do a real book, sometimes four or five, the business is appallingly faddish...
...Ingram’s case for suspecting that the ITT documents were at issue is weak...
...Do you really think that W.H...
...Allocated far too little resources by Random House (because it is not a big book...
...Compare this with the effect of deflating a campaign based on candor and financial openness by rattling a few financial skeletons two weeks before the election...
...An example would be Tim Crouse [The Boys on the Bus...
...Since you strongly imply that they would, shouldn’t you have read their articles, instead of simply counting them, and told your readers just how this fraud reveals itself...
...I grant people the right to say I am stupid, illiterate, reactionary, illinformed, a dangerous radicrfl, or whatever...
...Five years ago blacks...
...About Nobel laureates-it’s true that things have improved since the 1960s, especially in the rise of “family care” as a specialty...
...Our second oint was that-whether the doctors are G!s or specialists-the way we train and certify them has little to do with their competence or their ability to provide the care their patients expect...
...he authors insist that we keep deductibles and coinsurance out of any health plan, but then go on to say-correctly-that the demand for medical care by some people seems limitless and “that extra dollars spent on it must be considered luxury expenditures...
...I cannot imagine a way not to take your imputations of bad faith personally...
...Too often our friends in New York will leap to a conclusion of guilt in the case of the congressman who accepts a campaign contribution from a paving contractor while voting for a highway bill, but will not see even an appearance of impropriety in favorably reviewing another of their own publishers’ books...
...But in other cases it is not, and the medical licensing system is usually too inflexible to adapt to this difference...
...You and your magazine owe me a public statement, in your columns, saying in effect that you have printed or repeated a slander for which there is no evidence...
...David Halberstam is the author of The Best and the Brightest...
...By bloating and impersonalizing primary care we will, I suspect, eliminate both the highs and the lows and obtain a consistent mediocrity...
...We agree with Epstein ,that we were wrong in saying the Review had failed to criticize the New Left...
...Sometimes this makes people very angry...
Vol. 5 • January 1974 • No. 11
