Wednesday, December 21, 2011

A Few Thousand Special Snowflakes....

Last week I again had the chance to participate in what is one of my favorite professional duties. It also happens to be one of the most frustrating.  Graduation.  I love graduation ceremonies and I will admit that I tear up at every single one.  What’s not to love?  It’s the one day in an academic career when everyone is happy—parents, students, and faculty. 
Since I started teaching, I have had the chance to participate in roughly 18 graduation ceremonies.  In all that time, I never seen a ceremony disrupted by a student.  This year two students, one male and one female, decided that moment after shaking hands with everyone on stage was the appropriate time for Tebowing.  In both cases, their self-conscious silliness was mostly ignored.

This fall’s ceremony was disrupted several times by parents and family members.  In every ceremony, the attendees are instructed twice to please hold their applause and cheers until after everyone’s name is called.  Families are told that every one present is there to hear the name of one person, and everyone present deserves to be able to hear that one name be read as that student crosses the stage.  It shouldn’t require an advanced degree to understand that if you’re blowing an air horn (and it does happen with dismaying frequency), no one is going to be able to hear the name being read at the same time.  For the first 50 names, more or less, everyone behaves appropriately.  Then one family member decides that their special snowflake is far too special for their family to be held to the same standards as everyone else, so they yell and scream when that snowflake’s name is called.  A few minutes will pass and some other family will decide their snowflake is far MORE special, so they yell and scream and clap.  Sooner or later, someone breaks out the air horn.

This happens at every ceremony.  Most of the time, it’s only half a dozen families or so who think their student is the most special snowflake in the blizzard.  Occasionally, it happens frequently enough that the nomenclature or the provost feels compelled to scold the crowd and again ask that they not prevent other families from hearing the name of their student.  This time, both the nomenclature and provost had to scold the crowd several times, with increasing irritation.  At one point the rest of the crowd was so disgusted with the blatant disregard for the several hundred other graduates that they broke into applause after one scolding.  You have to know you’ve really crossed some social boundary when a few thousand people are applauding you being publicly scolded.

This annoys me every year, but it was particularly galling this year.  Unless you live under a rock or on a deserted island in the Pacific ocean, you have at least some vague notion of the events that have plagued Penn State this fall.  I don’t wish to minimize the trauma to everyone involved by oversimplifying the case, but three men are currently awaiting trial, several more have had their careers either ended or irrevocably disrupted, and an entire community had been turned on its head because at least three people decided the rules did not apply to them.  Apparently, and sadly for all of us, some people in the PSU family have not learned from this lesson.  You would think that any one in any way connected with the university might be particularly sensitive to playing by the rules, doing the right thing, and looking out for the other people around you.  It makes me unspeakably sad and unsettled to discover that it’s largely the parents who chose to do otherwise.  We often wonder why it is that so many young people seem to feel that there are no consequences for their behavior and that the rules don’t apply to them.  We have no business being shocked by this; they are only following the example they have been taught.

In all fairness, even this fall it was only a small percentage of families who behaved badly.  Most smiled and waved quietly as their student crossed the stage and then cheered their hearts out when the last name had been called.  After the last student had crossed the stage, several yelled out from various points “WE ARE…”and everyone—administrators, faculty, students, and families thundered back “PENN STATE!”  It was a fun and proud moment, but not as proud as the one that came at the end of the ceremony.  Just before the administrators and faculty process back out of the hall, the entire crowd is asked to sing the Alma Mater.  In most ceremonies, the students begin singing proudly “For the glory of Old State…” and then peter out from there, humming along and leaving the faculty and the alumni in the crowd to carry the song to its end.  This year, to my surprise and delight, the students sang with earnest through the first three verses.  The real moment of pride, though, came at the beginning of the last verse when the singing from the students swelled considerably.I hope their families noticed, too, and decide to follow their example.

*For the non-PSU folks, the last verse begins with these two lines:
"May no act of ours bring shame,
To one heart that loves thy name..."

Wednesday, November 9, 2011

Raise the song...and your voice

This is the time of year when I see a lot of people who have recently decided to change majors for one reason or another. A huge percentage of them tell me they want to go to medical school or to become a physician assistant—both very noble, honorable professions, to be sure. When I ask them what make them want to become doctors, nurses, or PAs, many of them respond with lengthy explanations about how they’ve always loved science and biology in particular, how they had a pediatrician they loved, how a PA helped diagnose their asthma or a nurse took care of a sibling who had been hospitalized, etc. A good many of them, though, give me the same, vague answer: “I want to help people.”

This is a noble calling, too; don’t get me wrong. I am all in favor of the give-back-pay-it-forward-leave-the-world-better-than-you-found-it philosophy. My problem is with their very, very limited definition of “helping people.”

As I started writing this a week ago, I intended to write about the many ways in which you can help people outside of medicine. Then I saw a documentary on he replications of the original Stanley Milgram studies on authority. Milgram's original studies brought volunteers into the lab and paired them with "learners" who were really research assistants. The "teachers" were told to give increasing electric shocks to the learners sitting in a remote booth when they made mistakes on the task given. Even when the learners screamed in pain and complained of heart trouble, a lab coated investigator asked the teacher to keep going. Milgram found that the vast majority of people were willing to give what they thought might be dangerous shocks to another human being just because someone told them to. In one version of the replications, teachers came in to the lab in pairs. One of the pair was another research assistant who, in half the cases, was told at one point to refuse to administer any more shocks. When that person refused, far more of the subject teachers were willing to also refuse. One person standing up and saying "No. This is wrong." is all it takes to inspire others to do the same.

Shortly after watching this special, news broke about Jerry Sandusky's heinous acts and the horrible cover up that ensued at Penn State. The most shocking, and for some of us most heartbreaking, part is that so many people seemed to have had the chance to stand up and say "No. This is wrong," but no one did. People did what they believed they had to, but no one did what they should have. I have no doubt that their failure to do more than they did will haunt Mike McQueary and Joe Paterno until the day they die.

So here is my charge to all of you, future clinicians or not. Want to help people? It's this simple: Be the one who stands up. Be the voice that says "No. This is wrong. I won't go along with it." Be the one who inspires others to stand up and do the right thing. Be the one who insists that we are all better. Be our pride, not our shame. No matter what you do after that, you will have helped everyone. Not a bad day's work.

Wednesday, October 19, 2011

Only Your Mother Thinks You're THAT Important...

Jon Stewart, among others, took a few minutes to poke fun at Anderson Cooper when it was demonstrated to him that his Blackberry was contaminated with fecal strep.  I wasn’t even a little bit surprised—not because I think Cooper is more unsanitary than the average person; I don’t.  In fact, I’d be far more surprised to find out that it was relatively uncommon to find some kind of fecal contamination on most cell phones.  My hypothesis is based on using the ladies room at work.  Not one day goes by when I don’t encounter someone in the bathroom on their phone.  Mostly, because I work at a university and the largest age demographic is between 18-25, they’re texting but many of them are actually carrying on conversations in the bathroom.  In the stall.

I can see a logical reason why Anderson Cooper’s phone might make the trek with him to the bathroom.  He’s Anderson Cooper.  You can probably envision a scenario in which not getting that phone call right NOW might have an impact on his career, or at least the current story he’s working on.  It wouldn’t take a great deal of imagination to come up with logical reasons for, say, President Obama, Thomas Freiden (director of the CDC), your local police chief, or maybe even Sarah Palin might need to keep their cell phone handy at ALL times (“What’s that?  There’s a pie eating contest in Iowa displaying a cardboard cutout of Mitt Romney and I wasn’t invited???  Get everybody on the bus, quick!!”) but the vast majority of us do not fall into that Need to Know NOW category of life.  This is almost certainly the case if you are 19.  You can wait 5 minutes to get that call or text.  It isn’t going anywhere, I promise.

Anything you take with you into the bathroom risks fecal contamination, and it doesn’t have anything (or much, anyway) to do with washing your hands.  Every time the toilet is flushed, miniscule droplets are propelled into the air by the force of the water entering the bowl and flushing whatever it finds there down the drain.  The force of this water is generally higher in public bathrooms, creating more aerosolized water.  That water is contaminated with whatever has been in the toilet bowl recently and if you can’t foresee fecal matter having been in the average toilet, you probably aren’t old enough to be allowed outside the house unsupervised.  Or to have a cell phone.  It is not in your best interest to take anything you don’t have to into the bathroom stall with you, and this is especially true of anything you repeatedly hold up next to your face throughout the day.

Thursday, July 14, 2011

Things not to say…..

In another week, my Baby Girl and I will be off to her college orientation.  In honor of that occasion, and the millions of teenagers just like her who will be embarking on their college careers this fall, I thought it might be helpful to review a list of things that you should never say to your professor/instructor.  You might think some of these are painfully obvious.  Once upon a time, I did, too.  Then I lost count of how many times I heard these things, just in one semester.  So here’s my Top 10 List of What Not To Say, Part I.

1. I wasn’t here on Monday.  Did I miss anything?
I’m astonished at how this one persists, even though I’m utterly certain that every student has heard admonishments not to say this and the inevitable joke “No, we realized you weren’t here so we all went home” or something to that effect.  First of all, it sounds as though you believe that life doesn’t really go on as usual in your absence.  It takes a special kind of egocentrism to imagine that everything stops when you decide to go elsewhere—the kind usually only awarded to 3 year olds who are cute enough to pull it off.  More importantly, though,  the question is a little offensive.  It implies that at least some percentage of the time what’s going on in class is useless—and that the instructor is well aware that it’s useless and is just doing it to fill time.  You may not see the value of what’s going on in class, but you should at least have the sense to acknowledge that the instructor does.  Frankly, we just don’t have the time or energy to waste on thinking up busy work for you.

2. I wasn’t here on Monday.  Can you tell me what we did?
Better, but still not ok.  This assumes that something of some importance went on in your absence, so that’s a step in the right direction.  It took 50 minutes for the rest of the class to go through whatever it was that happened on Monday; what makes you think I can distill it down to 2 minutes for you right now before class starts?  You might be brighter than everyone else in the room, but I’m guessing you’re not THAT much brighter.  If it were possible to cover the material in 2 minutes, that’s what I’d have done on Monday.

3. My flight leaves on Wednesday afternoon for Spring Break.  Is it okay if I’m not here that Friday?
The short answer, of course, is sure!  Knock yourself out.  In Loco Parentis stopped applying the day you got that high school diploma, Snowflake, and I’m not your mom.  Also, I don’t pay your tuition. You don’t HAVE to be here any day.  You already paid for this class.  What you’re really asking is, can I get credit for being here and still go on vacation early, and the answer to that is an emphatic no.  Here’s why—the dates for spring break are set years, seriously, years in advance and are published.  They’re on the school web site. They’re on your syllabus.  They’re plastered all over campus.  This is a little like saying to your boss “I’ve used up my vacation days, but I REALLY want to go to Cancun with my friends?  Is it ok if I don’t show up for work next week?”  The best answer your likely to get here is “Sure.  It’ll make payroll that much easier this period if we don’t have to pay you for next week.”  The likely answer is “Ok, but if you’re not here next week, don’t bother being here the week after, either.”  You get a week off.  If you want to take more, that’s up to you, but you’re not going to get special allowances to be able to do it.  You’re asking someone else to do more work so you can go play early. That never goes over well.

4. How much do I have to write?/How many pages does this have to be?
Ok, I get that a lot of students ask this question because they’re anxious about doing well and want to make sure they’re putting in the right amount of effort.  What this sounds like, though, if you’re on the receiving end is “This assignment is so far beneath me that I need you to tell me the minimum amount of effort I need to put in to get credit before I can move on to really important things.  Like who Snookie is sleeping with.”  There are a number of students who ask this question who are thinking this very thing (with some variation on the really important thing); you may not be one of them, but you sound like them when you ask this.  There are better ways to get the information that you really want: “I’m trying to gauge the level of detail you’d like in our responses. Do you have a maximum page limit for this assignment?”  or even “Would you mind looking over a draft of my response so I can get some feedback as to whether or not I’m on the right track?”

5. I just figured out my grade and it turns out I’m failing, which is a HUGE shock to me because I only missed the first 2 weeks of class and then those three days before break! I swear I’m a really good student and I NEVER do this badly in class.  What can I do to get more points in the last 3 days before classes end???
Again, there is a short answer to this question and you probably already know what it is: Nothing.  You had 14 weeks to prove to me what a great student you are, and you did.  What you’re really asking here is that someone else do more work to make up for the fact that you did less than what was expected of you for the last 3 months.  If you were truly that conscientious about your grades, I doubt you’d be this shocked, SHOCKED to find out that there’s a failing grade going on here.  You’d have already known after the first test and taken steps to correct the problem then.  How do I know?  Because at least 1 of your classmates did exactly that.  

I do occasionally hear this request for special extra credit from students who are doing very well in the class and want to create a buffer to be sure they get the highest grade attainable.  My response to them is that I don’t report total points or even percentages when I turn in grades. The registrar asks for your assigned letter grade—that’s all.  No one will ever know that you got a 99% instead of 105%.  Honest.

Thursday, April 21, 2011

I Know Where You Went Last Week...

This morning, every morning news show (at least every one that’s ever on in our house, which is most of them since my ADD afflicted husband can’t leave the tv on one station for more than 2 minutes) was screaming about the news that iPhones and 3G enabled iPads collect and record data tracking your whereabouts as you schlep them around town.  This is apparently a crisis even bigger than the narrowly averted government shut down that would have put thousands of people out of work indefinitely.  Who knew?  Ok, so your iPhone/iPad is collecting data on where you are and storing it on your device/synced computer.  Here's why this is a strange thing to panic about:  

1) It's on YOUR computer--as in the one you own-- and the little gadget you’re carrying around in your own hand.  Let’s start with the gadget.  These things are not cheap, so unless you have the common sense of cottage cheese, you’re probably pretty careful about where you leave it lying around. This necessarily limits the number of people who are going to access the information on it.  They’re also very small and light (read: MOBILE), which is likely part of the reason you bought it; meaning you’re probably keeping it pretty close to you most of the time.  As for the computer to which it syncs, you probably have way more sensitive info on there, anyway.  If you’re the kind of person who only uses your computer for word processing, you’re probably not the kind of person who buys an iPad/iPhone.  It’s much more likely that you use your computer for EVERYTHING—taxes, budgeting, personal contacts, stocks, shopping, record keeping…. Hopefully you've taken steps to secure all of your information already.  If not, you've got bigger problems than someone knowing you were at Banana Republic yesterday.  

2) Where you've been is public information by virtue of the fact that OTHER PEOPLE CAN SEE YOU!  Unless you're the Invisible Man, someone else already knows you stopped at Starbucks on your way to work.  Lots of someones.  This is the whole reason private detectives can make a living; they can see you to follow you around and report on where you’ve been.  There is no implication of privacy when you’re out in public.  The fact that you’re in public is not classified information.  Even your home address is public information in most cases, unless you’re completely off the grid…in which case, you’re almost certainly not in possession of an iPad.  Although I would certainly expect some amount of privacy in my own home, the fact that I am home is still not a state secret.  My neighbors and anyone who walks by can probably figure out that I’m home from the fact that my car is in the driveway and the lights are on.  Some of them probably saw me pull in and walk in the door.  This is especially true if you live in my mother's neighborhood.

3) If you’re the kind of person who owns an iPad, you probably also have a cell phone, and maybe even a GPS.  If you own an iPhone, well, I hate to break this to you if you didn’t already know it, but you own a cell phone.  Cell phone companies already track your whereabouts while your cell phone is on (and not to belabor the point, but if you carry an i-gizzmo, you’re not likely to be the sort of person who only turns their phone on in an emergency).  The only difference here is that they have the info, not you.

4) This is not a chip that’s been implanted in your head without your knowledge.  It’s a hand held device, with no discernible means of locomotion on its own.  In other words, you don’t have to take it with you.  You can, in theory, leave it behind.  If you don’t want it to know where you’ve been, don’t take it along.  There are no recorded cases of i-withdrawal being fatal.  I promise.

5) This is perhaps the oddest point.  Folks who use iPads and iPhones are usually the same ones using the internet.  A lot.  Otherwise, there’s not much reason for you to have one of these gadgets.  You’re probably also on Facebook, Twitter, Foursquare (which, btw, is simply a means of letting other people know WHERE YOU ARE), MySpace, etc.  It seems incongruous to log the details of your fight with your son, what you had for dinner last night, where you grocery shop, which team you’re currently rooting for, and your thoughts on, well, everything, but want to keep the fact that you went to work on Thursday a secret.  I’m not sure I follow the logic there.  If you’re already sharing many of the intimate details of your life, why are you worried that your iPhone knows you went to McDonald’s last weekend?

Tuesday, April 12, 2011

You Can't Get There From Here...

 I got to see a remarkable thing the other night.  A crowd of roughly 2500 people, mostly university students, give a standing ovation to an astrophysicist.  That his presentation was worthy of a standing ovation is not so remarkable; this is a brilliant, articulate, charismatic man giving a talk on things that are important and interesting to him.  What was remarkable to me was that it was the students in the crowd who were the first to jump to their feet when his presentation was over.

This is remarkable to me because I teach and advise students in a science field that is not a “basic” science or traditional science field.  Because of this, I am often meeting with students who are fleeing a traditional science curriculum or a basic science major.  Most of them are intent on going to medical school, and I have come to recognize that there are two broad types of students who come to meet with me: those who are looking for more, and those who are looking for less.

The ones who are looking for more are the ones who have discovered that their field of study is not satisfying some desire for knowledge they sense is important to where they want to go.  They feel like something is missing from what they’re studying and they’ve gone in search of another program that might fill that gap.  These are the students who intuitively get what our program is about and they are a joy to work with.  They also are, thankfully, the majority of the students I work with.  Most of my conversations with them go roughly along the same lines as the encounter I had recently with a lovely young woman who wanted out of her biology major.

Lovely young woman (dressed in pink, of course!):  I was in bio, 'cause I wanted to go to med school, but I want to change majors, but I can't get into this class which I know I need and I'm freaking out because I'm not going to get the classes I need to graduate.

Me: What semester are you?

LYW: 1st  (it's always the 1st semester students who are convinced that they won't graduate!)

Me: Ok, well, why do you want to change from Bio?

LYW: I hate plants.

Me (laughing): Fair enough.

LYW: Well, I can still take all the med school requirements in this major and not have to take the bio classes on plant cells and whatnot and I REALLY hate plants and instead I can take psych and stuff that, you know, has to do with people.  Right?

Me: yes, you can take the med school entrance requirements in any major, and yes, we're more about people than plants.

LYW: So, how can I get into this class?

Me: Well...(long uninteresting schpiel about why she really can't this semester)...but the bottom line is that if you take it in the fall, you will NOT be behind.

LYW:  Really?  Cool!  Ok, so what should I take then?

Me: Here's what I would suggest...(blah blah blah) ...Psych 212 will fulfill this requirement...

LYW: I LOVE psych!

Me: That's good; 'cause you're going to see a lot of it.  You can also take this stat class. There are still seats and it fulfills the stat requirement.

LYW:  Really?  SO cool!  Wow, you saved me!  I feel much better!
I should point out that they are not all quite this enthusiastic, but many of them are.  I should also point out that in reality I did nothing but point out information this bright young woman could easily have found on her own, but for the panic about not graduating on time.  The number of bio majors who come and tell me they hate plants is astonishing. I’m not sure where this animosity towards creatures that can neither interrupt you during conversations nor cut you off in traffic comes from.  When I point out to them that there is some basic level of knowledge and skill needed to progress to the upper level biology courses that they will need to be doctors, a few of them have responded that they appreciate that but don’t understand why that basic level of knowledge about the workings of cells can’t be taught using humans, or at least animals, as the platform.  I confess, I don’t have a good answer for them.  Or rather, I do, but my daughter has pointed out to me that my musings on the history of science and the influence of the church and its prohibition on the study of human cadavers on the field of biology is of little interest to people who aren’t me.
The students who come looking for less are far more frustrating and complicated.  These are the students who have either come to the conclusion on their own or been told by someone else, that if they change their major from a traditional premed program, it will somehow be easier to get into medical school.  Unfortunately, it isn’t the plant biology they are hoping to avoid, but usually chemistry and math.  My conversations with them typically go something more like this:
New Advisee: So, I’m thinking about changing majors from biology ‘cause I’m going to medical school and I can’t do the classes in bio.
Me: Ok, well…if you don’t like biology, you probably aren’t going to be very happy in medical school.
NA: I do ok in bio, it’s just the chem and the math I can’t do.
Me: Hmm…well, let’s think about some options for you.  Tell me why you decided you want to be a doctor.
NA: I just do.
Me: Ok, but why? What do you like about the idea of being a doctor?
NA: I just wanna, you know, help people. And do something in health.
Me: There are a lot of careers in health that would allow you to work with people and do something that would be helping them without going to medical school…
NA: I’m going to medical school.
Me: that may be true, but I think we should talk about some alternate plans for you and see if there might be a career that appeals to you that might not necessitate going to medical school.
NA: No.  I’m going to med school.
Me: Ok, well then you’re going to need to take 2 semesters of inorganic chemistry and 2 semesters of organic…
NA: See, that’s why I’m changing out of bio.  I can’t do that much chemistry.  It says on the academic plan that I don’t need all that chemistry.
Me: You don’t to graduate, but you will for medical school.
NA: I can’t take all those chemistrys.  I can’t do chemistry.

At this point, I know very well that the best thing for both of us would be for me to look her dead in the eye and respond like this:
Me: (in my fantasy conversation) Look, here’s the deal.  No one in last 90 years has gone to medical school without taking chemistry.  You will not be the first.  You have two choices here: pass chemistry or choose another option.  You’re telling me choice #1 isn’t working for you, so I’m trying to help you with choice #2.  You are welcome to continue with your degree and apply to medical school without the additional semesters of chemistry; you will only be wasting your own time and money.
It isn’t always chemistry that’s the problem; sometimes this conversation is about calculus or math in general.  I’m more sympathetic to these students who truly don’t see the connection between math and medicine, mostly because they haven’t thought much about it.  Occasionally, though, I have a student come in who has a problem with biology. These are the students who utterly mystify me.
New Advisee 2: I want to change out of biology but I still want to go to medical school.
Me: Ok, what brings you here?
NA2:  I hate biology.
Me: (brief pause while I ponder this, blinking) You do realize that you’re still going to have to take a substantial amount of biology in this major, right?
NA2: Well yeah.  I mean, I can take a few classes if I have to…
Me: Well, passing the required bio classes will get you your degree, but once you get to medical school it’s going to be a lot more bio…
NA2: Well it’ll be different in medical school.
Me: How so?
NA2: ‘Cause then it will be doing what I want to do.
Me: (fantasy conversation in my head) Exactly what magical transformation do you believe is going to take place so that, on the day you are admitted into medical school, the heavens will part and the angels will sing and suddenly biology will be more fun than playing Farmville?  I have to tell you that I have known a lot of students who have gone on to medical school and this has not been the experience of any single one of them.  You might be the first, but I’m not sure I would stake the next 8 years of your life on it.
Me: (out loud) I think if you really dislike biology, you’re going to be very unhappy in a major with bio in the title, and that’s probably going to be reflected in your GPA, so let’s talk about some options that might be better suited to you.  What classes have been your favorite so far?
NA2: I really loved my econ classes.
Me: Ok, good.  So maybe you might want to consider a major in economics…
NA2: But I’m going to medical school.

At this point I’m reminded of a quote from Steven Wright: “Anywhere is within walking distance if you have the time.”