Honestly, I had never thought too much about our professional cynicism before. In truth, managed care is only a small part of the equation. My realization was disappointing, really. But my only solution now was to go straight into practice, skipping medical school entirely. In short, it's the expectation that medicine should infiltrate every possible aspect of one's life without exception.
Medical school manages to take the fun out of everything.
At the time, I was certain that they couldn't possibly take the fun out of sex. But they did. A major theme of the educational experience was that anyone can have sex. Regardless age or disability, anyone can do it. You might not have the energy or function to make it up a single flight of stairs, but damned if you can't still get it on.