Faculty Bibliography

The rigors of pulling a thirty-hour shift as part of a medical student's education are enough to make the student envy bedridden patients

Many persons come into hospitals expecting to find a cure for various disorders, only to be disappointed that there is treatment, but no cure available. Some commonly incurable ailments are reviewed

In [Alice Hoffman]'s last novel, ''White Horses,'' a legend of exciting outlaw men was part of the young heroine's upbringing; she had to fight free of its seductive magic, personified by her no-good brother, before she could set out toward her own future. The novel is explicitly concerned with this legend, with its power and importance. In ''Fortune's Daughter'' there is no such explicit myth. Instead, the sense of magic and elemental force arises from the central mystery of childbirth. This novel's great strength lies in its two heroines, who both find themselves drawn, without plans, hopes or full understanding, into the inevitably mythological process of pregnancy and childbirth. In this, the men are sometimes reminiscent of those in the novels of Anne Tyler, some of whom have this same quality of watching the women around them with bewilderment - occasionally awed, occasionally resentful. ''Fortune's Daughter'' calls up other comparisons with Miss Tyler, who has at times combined folk tale and contemporary detail in ways that are not so different from Miss Hoffman's; think of the fortuneteller at the beginning of ''Searching for Caleb,'' going from city to city in search of a long-lost man - and taking Amtrak, and munching Cheez Doodles. Other aspects of ''Fortune's Daughter'' - the wild dogs in the streets of Hollywood and the impending earthquake - are reminiscent of Nathanael West's ''Day of the Locust.'' But Miss Hoffman never sinks completely into California grotesque, though she is capable of touches of it: ''OnSweetzer Avenue, in a backyard where birds of paradise grew, the dogs had attacked a six-year-old boy in a fight for his wading pool. By the time the police had arrived the boy's neck was broken. They had managed to shoot a collie, and when an autopsy was performed the oddest things were found in its stomach: a silk scarf; small bones, which had not yet been identified; blue water the color of sapphires; three gold rings.'' THE writing is confident, powerful and essentially laconic, but it is also lush; description is limited but rich, vivid and sharp. ''What frightened [Rae] was not being pregnant, but having to tell [Jessup] about it. Jessup didn't even like to be in the same room with a child. He referred to children as midgets, and he had often suggested that orphans be put out on ice floes and left to drift into the cold, blue sea.'' The peculiar offbeat humor keeps the narrative from drifting into melodrama; for example, when Rae calls up the mother she has run away from, early in her wanderings, what she says is, ''I'm in a garden apartment in Maryland,'' and her mother replies, ''I love it. . . . Your father always insists you're in California. He's convinced that people like Jessup always wind up on the West Coast.''

[Bernard Virshup], a doctor who teaches at the University of Southern California, wisely does not focus on how to handle the academic burden of medical school or conduct oneself with those terrifying first few patients. Instead, he offers what he calls ''coping attitudes'' for obtaining long-term satisfaction and enjoyment from the practice of medicine

MY journal from last summer when I worked in the hospital: history sheets meant for patients' records covered instead with disjointed fragments in my most minuscule cramped handwriting. My journal, surrounded by the stern hospital injunctions printed on history sheets: ''Enter name and unit number on both sides of Every sheet.'' ''Please do not waste space.'' My journal, written in lectures and conferences, a page of diary hidden beneath a page of conscientious lecture notes - a habit I developed in high school. My journal: endless complaints of fatigue (''worst night in a while, home after no sleep on call and then baby up from 2 to 3 A.M.''). Analysis of depression (''The sad truth is, I really want to be doing something I'm good at, and I am just not good at this''). Resolutions (''I have to (1) get more efficient about writing up patients, (2) stop eating potato chips in the middle of the night on call''). Quotes and anecdotes, attempts to record the flavor of the place so I would be able to recall it (''People dying with the TV on, Mr. P. with lung cancer, L.A. Olympics in background, swimming races''). And above all, a steady sense of stress, stress so constant and unyielding that I sometimes have trouble recognizing my own familiar voice in my journal. Sometimes in my mind, I say to my children, the one who is born and the others I hope to have, ''Your mother will be a doctor.'' And mostly, I feel at least tentatively proud and pleased by that thought. I am still a long way from practicing medicine, but I look through my journal and find the occasional note of jubilation (''Mrs. L. told me she thought I would be a good doctor because I explained her drugs to her so well'') and look ahead to a future when the satisfaction, the competence, will come to dominate over the fatigue, the anxiety, the sense of my own ignorance. ''But one has to make some sort of choice,'' said Harriet. ''And between one desire and another, how is one to know which things are really of overmastering importance?'' ''We can only know that,'' said Miss de Vine, ''when they have overmastered us.''

Perri Klass is a third-year student at the Harvard Medical School. Her fiction appeared in ''Prize Stories 1984: The O. Henry Awards.'' Her novel, ''Recombinations,'' will appear next year. ONE DAY LAST year, I sat with my classmates in our reproductive medicine course in Amphitheater E at the Harvard Medical School, listening to a lecture on the disorders of pregnancy. The professor discussed ectopic pregnancy, toxemia, spontaneous abortion and major birth defects. I was eight months pregnant. I sat there, rubbing my belly, telling my baby: ''Don't worry, you're O.K., you're healthy.'' I sat there wishing that this course would tell us more about normal pregnancy, that after memorizing all the possible disasters, we would be allowed to conclude that pregnancy itself is not a state of disease. But I think most of us, including me, came away from the course with a sense that pregnancy is a deeply dangerous medical condition, that one walks a fine line, avoiding one serious problem after another, to reach the statistically unlikely outcome of a healthy baby and a healthy mother. ''Yeah, I know,'' he said, ''but if there's even a one in a zillion chance. . .'' MY CLASS IN MEDIcal school was absorbing the idea that when it comes to tests, technology and interventions, more is better. No one in reproductive medicine ever talked about the negative aspects of intervention, and the one time a student asked about the ''appropriateness'' of fetal monitoring, the question was cut off with a remark that there was no time to discuss issues of ''appropriateness.'' There was also no time to discuss techniques for attending women in labor - except as they related to labor emergencies. So, in the end, I find myself hoping most of all that expectant parents and others will continue to pressure the medical profession to change, to relinquish some of its control over childbirth, to take a more fair-minded attitude toward the risks of intervention versus the risks of nonintervention, to provide more options and more information and, above all, to stop regarding pregnancy and childbirth as exclusively ''medical'' events. OUR SON, BENJAMIN Orlando, was born on Jan. 28. Naturally, I would like to be able to say that all our planning and preparing was rewarded with a perfectly smooth labor and delivery. But, of course, biology doesn't work that way. The experience did provide me with a rather ironic new wrinkle on the whole idea of interventions. Most of the labor was quite ordinary. ''You're demonstrating a perfect Friedman labor curve,'' the doctor said to me at one point. ''You must have been studying!''

Ideally, status is the patient's own decision. If the patient is not mentally intact, the decision may be made by the family. People choose to be DNR, understanding, for example that their medical situation is such that once on a mechanical ventilator, they are unlikely ever to come off it. They choose to be DNR because they feel that because of age, or severity of sickness, or level of pain, if death should come they would like it to come peacefully. No room crowded with doctors and nurses and medical students and technicians. No technological ''miracles' bringing them back from the dead. As one patient said: ''If you could cure what ails me, that would be a miracle worth having. Bringing me back so I can die of this same thing a little way down the line, that isn't even a favor.'' ''I know what you guys like, you like people to be DNR, the more the better,'' I heard a senior doctor tell a group of interns and residents, trying to get a rise out of them. ''It means less trouble for you at night if something happens.'' ''I don't make my patients DNR if I expect them to leave the hospital alive,'' said that same senior doctor, taking an extreme position. Most doctors would argue that there are different kinds of DNR. There is the person who stands a good chance of walking out of the hospital, but wants to die peacefully if his heart stops. And then there is the person who will be dead in a matter of days and is in constant pain. In the one case you may want to proceed with all sorts of aggressive therapies, and in the other you may even stop taking the patient's temperature, because you don't want to know if an infection develops.