Tuesday, September 25, 2012

Lemon Lectures

We just took our first cardio exam. We are now well into the body systems which means we are past the potpourri of random questions we had in anatomy (what do you call this thing/where is this thing?), biochemistry (how is this production process regulated?), and the other introductory classes. Now we have a potpourri of random questions specifically on the system we are studying and the exams all have the same format. How the thing works grossly, microscopically, and molecularly; what can go wrong, how it went wrong, and pictures of what went wrong; drugs to fix what went wrong, side-effects of the drugs, and interactions with other drugs or disease states.

Somewhere along the way (or perhaps I'm only now becoming aware of it) the professors aren't that interested in teaching for student understanding. Instead, I've formulated a hypothesis that the school wants to cover all the material we'll be exposed to during the next few years so that when we hit rotations they can tell the doctors they send us to how great it is that we have 'been taught' everything we need to know. At that point, when we don't know the answer to something, "the fault...lies not with the [school], but with us."

I'm not saying this is necessarily a bad thing. A system like this rewards self-motivated learners who can make lemonade. I'm not saying that a cardiologist shouldn't teach cardiology or that a biochemist shouldn't teach biochemistry. In fact, the best chemistry teacher I've ever had was an analytical chemist. What I would like to point out is that, hour for hour, navigating textbooks and lecture slides is not nearly as efficient for understanding as a good presentation.

Bad

Good

Sunday, September 9, 2012

How Deep Does the Rabbit Hole Go?

How deep does the rabbit hole go?

This week a classmate invited me to access some study materials on dropbox. So I went to the Student Government Association sponsored site and I found pdf files of quite a few of our textbooks. Now, I'm not an ethicist or lawyer by trade, but I'm pretty sure it's illegal and immoral to download or distribute digital files to avoid paying for them, especially because the copyright notice printed on the inside cover states- 

All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a data base or retrieval system, without the prior written permission of the publisher.

Some of the titles I found there include the following:

First Aid - $45
BRS Physiology - $25
Bates Guide to Physical Exam - $100
Rapid Interpretation of EKGs - $30
Katzung Pharmacology - $45
Netter's Atlas of Human Anatomy - $55
Purve's Neuroscience - $150
Thieme Atlas of Anatomy - $180
BRS Gross Anatomy - $33
BRS Microbiology and Immunology - $25
Gray's Anatomy - $100
Lippincott's Biochemistry - $50
Lippincott's Immunology - $50
Practical Guide to the Care of the Medical Patient - $40
Review of Medical Microbiology and Immunology - $45
The Developing Human - $65
Current Medical Diagnosis and Treatment - $65
Andreoli and Carpenter - Essentials of Medicine - $70
Basic and Clinical Biostatistics - $55
Grant's Dissector - $35
Harrison's Principles of Internal Medicine - $180
Medical Physiology - $105
Robbins and Cotran Pathologic Basis of Disease - $105

I believe that people are basically good and that we know what is right and what is wrong. In an effort to stimulate thought and discussion I posted on the class facebook page a question: Is there an ethically defensible reason to have copyrighted material on the dropbox? The responses I got ranged from a link to the tuition payment schedule to "I want a unicorn" to  "Everything should be free and there should be no money" to "Utilitarianism - I would never buy these books since they are too expensive but the knowledge contained in them might help me save a life one day. 1 life > 135.99$ to a publisher." 

One guy even posted, "In Plato's Republic, Socrates tells a story about a guy named Gyges who finds a magic ring of invisibility (yes, LOTR is based off of this). Gyges murders the king to marry the queen while being praised as a hero, and he believes it's the most rational way to live--if you can do bad and get away with it, why not? While we could 'share' books without the authorities being none the wiser, Socrates would say that doing so would plant malevolence in the soul which would catch up to us in this life or the next, as lack of virtue is essentially akin to weakness, a chink in the city wall of the spirit! If you don't believe it will catch up to you in this life and deny the existence of Tartarus as the delusional ramblings of some guy Socrates calls Er, why not put on the power ring by clandestinely sharing copyrighted materials?"

Sunday, September 2, 2012

Student Affairs

If you ever want to spice up your life, try making an unpopular stand to your friends just to see what happens.

This week at the end of a study session with my study group of about eight, I told them what I felt about downloading and distributing illegally acquired study materials. My words went something like, "Because I believe that tolerating a behavior is just as bad as participating in it, I will no longer by tolerating illegal file sharing. I have an appointment with the head of student affairs right after this meeting and I will tell him what's going on. I don't think it's fair to you to name names this time but if I see or hear of it happening again, I will." This was followed by a stunned silence as everyone shuffled out.

In my meeting with student affairs, I expected to be stretched on the wrack or at least bribed in exchange for the names of the offenders. On the contrary, we spent our time discussing the art of motivational conversing - having difficult conversations with people you care about. They seemed to be less than enthused with the hammer approach I used. I thought it was pretty neat that their goal was to provide me with the tools to police my profession. They suggested that I try again and think about what it is I want to have happen. I decided that in the short term, I wanted my friends to delete the files. In the long term I want to protect their careers from culminating in fraud and embezzlement, but mostly I wanted them to do the right thing because it's the right thing to do.

Luckily, I had my chance a short time later when one of the offenders approached me and initiated the conversation.

"Hey, I just want to know where you are coming from."

"Well, I want you to know I'm on your side. We both know it's wrong to use something without paying for it. In fact, it's indefensible. I want to ask you all what you thought and where you were coming from, but it seemed everyone was anxious to leave."

"I need it, but I'm not in a position to afford it because of what's going on up stairs in financial aid with our money. There is also the issue of the dropbox and the pdfs getting passed around. I have First Aid on pdf and there are tons of files like that going around. We all have things we struggle with. Can you say that you have been perfectly clean your whole trip to Lebanon?"

"I don't really see how my imperfections excuse yours, but I can tell you that I have legitimately earned my place to be here and I have never cheated. If you see me doing something wrong, I would hope you would let me know."

"So, I just wanna make sure we're friends."

"We're cool, bro. Are you going to delete the files?"

"Are you going to report my name?"

"I already told you that I wouldn't this time."

"Well, I respect you for sticking to what you believe."

The conversation ended, but I still felt like I failed. I wish I hadn't come off so hard during the first encounter and that I hadn't promised not to name names. I think what I did was right, but it could have been done better. I wish that it hadn't been necessary. I wish Marianne Jennings were my shoulder angel.