Inside today’s academic medical centers, the talk is about generational differences. Work-life balance or fiduciary responsibility. Medicine is a job or a calling. Physicians should band together as union members or in professional guilds. Trainees should have stricter duty hours or live within the hospital. The crisis in medical education is existential, but often narrated along generational lines. Nobody explores generational and existential simultaneously as well as Ivan Turgenev, whose Fathers and Sons is the great novel of a society coming undone around existential and generational differences. It is a novel about materialists versus artists, liberals versus radicals. It is also a novel about doctoring; too many lines to call out but here are a few– “In actual fact doctors have got to be paid… As you know yourself, doctors are a mercenary lot,” and “It’ll be a comfort to you to know … that nowadays in general we laugh at medicine and worship nobody.” That last one could be the sign over the door.