I recently read two wonderful books on the medical profession, one by Jerome Groopman (How Doctors Think) and the other by Atul Gawande (Better). I’ve been thinking about how closely the tasks of teachers and doctors are aligned. Teachers have patients, although we generally call them students. Our “patients†also come to us with problems of one kind or another, usually a deficiency of knowledge or trouble with learning. Whether it’s in the classroom or in the office, we must try to diagnose learning difficulties that range from cognitive to emotional to physiological. The most striking similarity between the medical and the teaching professions is that both require caring practitioners. Groopman and Gawande make the importance of caring for patients breathtakingly clear.
In How Doctors Think, Groopman argues that physicians must treat the patient, not the disease. In medicine, specialists get more praise because of their extensive knowledge of specific ailments; yet specialists in many ways have an easier job because they have fewer options to consider. A general practitioner must try to narrow a set of symptoms into a possible diagnosis and then select which specialist a patient needs to see. As teachers, we also deal with many students who present nonspecific ailments but still need an accurate diagnosis if they are to be helped. Specialists in a discipline might know their content area incredibly well, but knowledge of a discipline helps little when dealing with the average patient. In a sense, the best teachers are general practitioners: those who diagnose student problems and direct them to the resources that help them remain in school and continue their academic lives.
Groopman discusses a study of physician wait time that illuminates the time restrictions that exist within the medical profession. A physician usually asks the patient to describe his or her symptoms, and after an average 18 seconds, interrupts the patient. Wow! But how often do teachers fall into the same trap? Understanding student issues and needs requires extended listening; yet our time is so precious—papers to grade, papers to write, meetings to attend—that we often rush to judgment about our students. We rely on stereotypes, concluding that students are lazy, unorganized, belligerent, or arrogant, without trying to truly understand what lies behind those behaviors. This rush to judgment causes us to care for students in ways that may not address important learning needs.
Gawande’s Better is worth the read for his exploration of the question “How do I really matter?†He makes these suggestions to doctors: “ask unscripted questions†(getting to know the patient), “don’t complain†(an all-too-common pastime in the medical profession), “count something†(scholarship), “write something†(share the results of your counting and think about ways to matter), and “change†(physicians too often get into ruts). Each of these five suggestions applies to the teaching profession in uncanny ways. The best teachers matter because they get to know their students, they remain optimistic despite the critical milieu of academe, they assess their own teaching as well as consider the ideas of other pedagogical scholars, they share their findings at conferences and in print, and they continue to develop as teachers. Teachers (like physicians) can always do better, and Gawande’s list points the way.
Gawande also writes about fighting for a patient’s life: “The seemingly easiest and most sensible rule for a doctor is: Always fight. Always look for what more you could do.†(161) Yet he argues that sometimes the physician must consider not doing more. Some of our students are not ready for the rigors of college or cannot continue, given unexpected circumstances. Accepting that not all students can be helped allows a busy faculty member to spend precious time on students who genuinely need our guidance and influence to keep fighting. Yet how can we tell when we have spent enough time with a student? Helping a student decide whether to stay in school requires inordinate insight and patience, and listening for much longer than 18 seconds.
Groopman and Gawande impress me as caring doctors (with writing skills that any academician would covet), and they point the way for caring teachers. In the medical profession, the struggle is epic—between life and death. But educational “life and deathâ€â€”the tipping point between a student finishing a college degree or becoming a dropout—is also compelling. Thinking about how we want our doctors to treat us might help us take better care of our students. A few more minutes devoted to a student is rarely time poorly spent. Only by truly knowing our students can we make those diagnoses that give them the best chance at healthy and rewarding academic lives.
Contact Ike Shibley at Ias1@psu.edu.
