Stress Fractures

In 2012, I asked alumni, including readers of this magazine, for any recollections they had of Daniel H. Funkenstein and the stress interview. At that time, I was more than a decade into my exploration of the topic of stress interviews at HMS, a search spurred by my curiosity about the accuracy of such stories and their persistence.

Although Funkenstein stopped interviewing applicants in the early 1970s, stories of his stress interviews are still exchanged, often in the belief that such interviews continue to take place at HMS. During my two decades as a member of the HMS Committee on Admissions, I was repeatedly surprised to learn from applicants that they expected to be subjected to stress interviews. This notoriety contrasted starkly with the prevailing admissions position on interviews—that every effort be made to be warm and welcoming and that deliberately stressing applicants was disrespectful and counterproductive. Each year, at the beginning of admissions season, we would hold workshops on making the interview process a positive experience, one that afforded applicants the opportunity to be at their best; presented the medical school in a welcoming light; and gave applicants the information they would need to decide whether HMS would be a good fit.

Despite our efforts, however, HMS had a reputation, seeded in the middle of the twentieth century, for subjecting interviewees to uncomfortable psychological torment, and that reputation had became lore well beyond HMS.

The Man in the Mirror

How widely the stories of Funkenstein and stress interviews were known became clear during online searches I conducted. One such search highlighted a 2008 Psychology Today blog about stressing presidential candidates. “How do they respond to provocation?” it asked. “Harvard psychiatrist Daniel Funkenstein was famous for his ‘stress interviews.’ He might ask someone to open a window—one that had been nailed shut.”

Most stories of stress interviews cite tactics attributed to Funkenstein during the more than two decades he served as a member of the Committee on Admissions (1952 to 1975). Linking Funkenstein with the topic of stress would not have been unusual; he was a psychiatrist who, as a member of the School’s faculty from 1946 to 1975, studied stress and published about trends in medical school applicants.

Yet, in the summer of 2015 when I contacted Daniel L. Funkenstein ’68 about the stories linking his father with stress interviews, he told me he did not know whether the stories were true. While the younger Funkenstein knew nothing objective about his father’s association with stress interviews, he did remark that, although his father had been dead for more than twenty years, he “would be pleased to know that people are still paying attention to him.”

When Funkenstein senior died in 1994, son Daniel mentioned in a memorial remembrance that his father’s “mastery of the ‘Stress Interview’ was an annual feature of the Second Year Medical School Student Show.” Indeed, in the archives at the Countway Library of Medicine, programs produced for HMS Second Year Shows in the 1960s and 1970s often include a name resembling Funkenstein in the dramatis personae. In December 1961, for example, student Steven Schroeder ’64, currently the Distinguished Professor of Health and Health Care in the Division of General Medicine at the University of California San Francisco, played “Dr. Flunkemclean, who stresses interviews and washes brains.” According to Schroeder, in his skit he pantomimed nailing a window shut and inviting in an applicant. He then declared that “it is hot in here,” and asked the applicant to open the window. After trying in vain to open the window, the applicant turned to the audience exclaiming, “Hey, some [expletive] nailed this window shut,” which Schroeder says elicited a big laugh.

In Harvard Med: The Story behind America’s Premier Medical School and the Making of America’s Doctors, author John Langone addressed stress interviews in a chapter on getting in to HMS.

“There is a wealth of stories, apocryphal and unbelievably true, about the way it was. There was the Harvard faculty member who would invite a trembling candidate to take a seat—in an office bare except for the interviewer’s desk and chair. If the student just stood there looking blank and baffled, he was out.”

Elsewhere in his book, Langone quotes the late Clifford Barger ’43, formerly the Robert Henry Pfeiffer Professor of Physiology and chair of the Department of Physiology at HMS, on the subject of Funkenstein and stress interviews.

“It became obvious that most people on the admissions committees shouldn’t be there. There was the psychiatrist who used to nail down the window. Terrible. I used to argue with him about that.”

Some who recalled Funkenstein had more temperate assessments. Gerald Foster ’51, a Massachusetts General Hospital internist who served as faculty associate dean for admissions from 1982 to 1998, told me that although Funkenstein had an off-putting air, “All the stories are really not true. Every ‘storyteller’ didn’t experience it firsthand, but always knew someone who knew someone that it happened to. When I was in charge, there were stories about his interviews long after he stopped doing interviews.”

On the Record

Some anecdotal data on Funkenstein and his interview style emerged in a transcript from a 2006 University of Wisconsin oral history of one of its faculty members, geneticist Paul Sondel ’76.

“…I had an interview with Dr. Daniel Funkenstein, a faculty member in the Department of Psychiatry. I didn’t know this at the time, but he was famous for stress interviews. I went into his office and sat down. … Then he said, ‘It is a little hot in here. Do you think you could open the window?’

“So I went over to open the window, and I couldn’t get it to open. I fidgeted with it and I unlocked it and I was playing with it. I’m looking at it and said, ‘Dr. Funkenstein, this window looks like it’s painted shut. I’m not sure I can open it.’

“He said, ‘Oh, yeah, you can open it.’

“I said, ‘I’m sorry. I can’t open this window. I apologize, but I just don’t think I’m going to get it.’

“He said, ‘Well, okay, never mind.’ The window was really painted shut. I’d never been through something like that … I left there just devastated. …”

A vivid eyewitness account can be found in Thomas Lee’s book, Eugene Braunwald and the Rise of Modern Medicine. In 2009, as part of his research for the biography, Lee talked with cardiologist Burton Sobel ’62, one of Braunwald’s early trainees. Sobel told Lee that, at Thanksgiving of his senior year at Cornell University, he received a telegram from HMS offering him an interview. He was assigned to Funkenstein.

“I went into the interview, and there was no place to sit,” Sobel later recalled. “He asked me to open a window … and it’s either nailed or glued shut. I couldn’t open it.

“And then he offered me a cigarette. In those days, everyone smoked, including me. I took the cigarette, and there was no ashtray. So I was standing with a window that I couldn’t open and a cigarette that’s dripping ashes all over the guy’s desk.

“I said to him, ‘If you don’t mind, I’d like a chair, and I’d like an ashtray, and then we can continue.’ Sure enough, they materialized, and we continued and everything was very benign. But it was rather stressful, and I went home thinking that Harvard was not going to work out for me.”

Readers’ Panel

When I asked alumni for their stories, forty-six responded, mostly individuals who had been interviewed between 1952 and 1974, including five non-HMS graduates. Although this request, and the analysis that followed, would never pass muster as scientifically valid, my inquiry did elicit a set of rich narratives, including first-person testimonies. And because most respondents reported multiple recollections, the number of incidents far exceeded the number of respondents.

Eleven of the respondents reported that their interviews with Funkenstein were not stressful, with some describing their interviews in glowing terms. Two said they were disappointed they hadn’t had the stressful interviews they’d expected.

Most of the respondents described rumors or a friend’s report of stressful interviews. The most commonly described rumor was of being asked to open a window that had been “nailed shut” (sixteen respondents); one of these included the story of an interviewee who reportedly called Funkenstein’s bluff by raising his shoe to break the window. Other rumored ploys included a phone that rang after the interviewer had exited (three); the interviewer hiding under the desk (three); the offered cigarette but no ashtray (two); the absence of a chair for the interviewee (one); and the interviewer’s sitting in the visitor’s chair, leaving his desk chair for the interviewee (one). One person described a rumor that a coin had been left on the floor to see whether the interviewee would pick it up. Another respondent told of a rumor about an interview interrupted by a telephone call; after the call ended, the interviewee was asked to repeat the conversation. Among the more colorful rumors was one that had it that the interviewee was asked to wear the interviewer’s white coat and sit in the interviewer’s chair and another that said the interviewer cut off the bottom of the interviewee’s necktie!

First-person stories from respondents included six recollections that Funkenstein had told them it was very hot in the room and had asked them to open a window that had been painted shut. Four reported that Funkenstein walked out of the office abruptly in the middle of the interview, another two reported that, when they entered the office, Funkenstein was sitting in the interviewee’s chair, leaving his desk chair as the only free chair in the office.

The “ringing phone” experience was recalled by two respondents, with one reporting that, when he picked up the receiver, Funkenstein upbraided him for answering, and two mentioned that, for their interview with Funkenstein, they were sent to an unoccupied floor in an unoccupied building.

And one applicant, who measured in at 5 feet 6 inches, was treated dismissively by being shown an article indicating that the most predictive variable for leadership was height.

Another category of stress involved personal questions and inappropriate comments, which were recounted by five people. Such statements included “Do you like your father, do you like your mother?” or stigmatizations about background: “I see you were a music major. That must have been easy for an Italian!”

Mea Culpa

To be fair, according to the responses from alumni, Funkenstein was not the only practitioner of stressful interviews. Several respondents described inappropriate comments and questions asked by other interviewers, and one described a particularly stressful tactic used during her interview in 1973.

“When I walked into the office my interviewer was sitting behind a big desk and did not get up to greet me in any way. He handed me a legal-sized pad of lined yellow paper with COCKROACH written at the top of the first page. He told me to write two pages about that. The interview was over when I had finished writing.

“Now, 39 years later, it just sounds silly, but it was very distressing. And I was pretty angry about it, though I thought it was the norm and assumed there was nothing to do about it. However, a short while after that I was at an official Harvard dinner and happened to be seated next to President Derek Bok. So when he asked me how my HMS interviews were, I told him. The next week I got a call from the HMS admissions office asking me for another interview. Somewhere in my files I still have the two-page letter I subsequently got from President Bok apologizing for the interview.”

When such behavior attracts the attention of the president of the University, change is inevitable. No one interviewed after 1974 wrote in with stories of stress interviews.

Lit Crit

I had my own personal experience with Funkenstein. When I interviewed in 1968, Funkenstein looked at my record and pointed out that I was a literature concentrator. He said that the future of medicine was in biochemistry; why, he asked, did we need someone like me?

I was unprepared and insufficiently intellectually dexterous to debate logically. What I did not know that day was that, during that same year, Funkenstein had written about the importance of—and bemoaned the pressures against—a liberal arts education for students aspiring to enter medical school.

Was that a stress interview? Probably not—no gimmicks, no tricks—just a fair, challenging presentation of a hypothesis. It was, however, stressful.

The evidence, albeit anecdotal, that I gathered from alumni and others indicates that at one time HMS deserved its reputation for stress interviews. But the School’s actions since that period show that it now eschews such efforts—and is not proud of that legacy.

The power of story, however, is evidenced by the fact that this reputation has been sustained for the past six and a half decades and, astoundingly, for the four decades since stress interviews were abandoned.

Jules Dienstag is the Carl W. Walter Professor of Medicine at HMS and a physician in the Gastrointestinal Unit of the Department of Medicine at Massachusetts General Hospital. He previously served as a member of the School’s Committee on Admissions, as faculty associate dean for admissions and chair of the Committee on Admissions, as associate dean for academic programs and clinical programs, and as dean for medical education. The author wishes to thank the individuals who shared their stories with him.

Images: iStock (top); Harvard Medical Library in the Francis A. Countway Library of Medicine