January 9, 2010

How To Teach Everything

Do not try to satisfy your vanity by teaching a great many things.
Awaken people's curiosity. It is enough to open minds; do not overload them.
Put there just a spark. If there is some good flammable stuff, it will catch fire.
-Antole France, Nobel Laureate in Literature

My mom and I were talking the other day about the extreme skill of people who can synthesize lots of information and break it down into just what's important and just what you can remember. It came up because we had been talking about translation and culture in my Medical Student Leadership Group and I told them about an experience I had with translation over break:

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One of my mom's friends who is a Somali refugee had just had double bypass surgery in the hospital. Bypass surgery involves having at least one, but sometimes more of the major arteries that provide blood to the heart replaced, in this case with a vein from his arm, which is very atypical. Usually a vein from the leg is used because you have so many more of them) only to discover a few days after his discharge that he was almost seizing in pain. He returned to the hospital to learn that he had fluid building up in his pericardium (the sac of tissue that surrounds the heart and keeps it separate from the rest of the contents of your abdomen), which he had to have drained over the course of a few days in the hospital. He was then discharged again with a list of nine medications to take.

And here is the real problem: the discharge paper wrote the medicines as their brand names, whereas the pharmacy gave him the generics. I'm not sure if the pharmacy explained it to him but I know he didn't understand and they gave him no written material with any explanation of which drugs are which and which to take for which. When I got to his house, his son (who speaks and reads more english than his father) showed me the sheet that he had created from what he heard the doctors say the medications were for. We googled the medications to find out what they were - but we still weren't sure which were important for keeping him from having another heart attack and which were for discomfort (one of the medications he was prescribed was zolpidem, which is an anti-anxiety medication that is used to make you sleep).

So we called the cardiologist on call (a different one)and asked him which medications were absolutely vital and could he please tell us the generic names of them. He immediately said three medications were absolutely vital (in the true sense of the word), but the others were more flexible. There were even a few that he only needed to take if he was in lots of pain (oxycodone) or couldn't sleep (zolpidem) or had heart burn (omaprazole). When we explained to the doctor that he had an incomplete grasp of the english language, the doctor totally got it and just broke it down into the most basic (and like he said, most vital) components.

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When talking to my mom, we were recounting the best teachers, doctors, lawyers we knew and how all of them shared the quality of not giving people information to look more knowledgable but in a way where they knew it was being absorbed. I used to think that professors that simplified things were less expert, but in medical school my favorite professor yet spent an entire class talking with us about a bathtub metephor he had for homostasis, the ability of the body to re-balance itself after being thrown out of whack.

Plus, I like the part in the quote about a spark.

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"I could teach a monkey calculus - you just have to find a way of relating it to something someone cares about. For example, so you like the WWF, right?..."
-my favorite quote about education, from the movie Road Trip

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