Listening to my former students who ended up with MD degrees, there are negotiations in the medical profession, especially in large settings, which sound remarkably the same as any blue-collar labor negotiations. How many days off? Which hours for work? And so on. These are even issues that are negotiated up front during the hiring process.

Not too surprisingly, this situation means that (on average) the attending physicians who work in the evenings do not necessarily have the same profile as those who work during the day.

The demands from the greater fraction of sleeping people, in the evenings, are also less (just board a long-haul transoceanic flight that leaves in the afternoon or early evening – the cabin turns into a flying dormitory within moments after the refuse from that first, quickly-served meal is collected).

There are places in a hospital where circadian rhythm rest cycles do not matter: the Emergency Room, for one, and the Intensive Care Unit, for another.

Improving care in the ICU by coaxing senior physicians to take the evening shift is a challenge in doctoring.

The ICU is an interesting place, in addition, because the bulk of the information comes from electronic monitors, and these data are used to make strategic choices for treatment, often with an overriding sense of urgency.

I recently learned of an interesting solution to this situation (and the fact that this solution exists tells you that it is, in fact, considered a problem).

That solution? Find a comparable hospital in a time zone that is 12 hours away, in a reasonably interesting and attractive part of the world, and let the attending physician serve 8-12 months at this location, where the day shift locally equals the night shift back home.

Does being on-call and hooked up by distance, for a more experienced and senior physician, compensate for the day/night difference when that same person will never be serving the night shift back home?

Currently, data are being collected about this, but there is at least one large academic hospital that I just learned about (no, not the one where I am) that has been trying this out for a while. The other location is in a large city along the coast of Western Australia.

At first the idea struck me as just weird, but changed my mind within a few hours.

Mark Evanier works in the television and movie business. He tells this joke when he gives The Speech to some would-be creative artist.

A man arrives in a strange city. He wanders around and eventually finds his way to a local tavern where folks crowd around a roulette wheel to gamble. He pulls some cash from his pocket and joins in.

After a while, a waitress wanders up to him and whispers, “The wheel’s crooked.”

“Thanks,” he says. But he doesn’t quit.

A few minutes later, the waitress notices him still losing money at the table. She sidles back up to him and again whispers, “Didn’t you hear me? The wheel’s crooked!”

“I know,” he says as he lays down another bet and promptly loses again.

The waitress is baffled. “Then why are you still playing?” she asks.

The man replies, “It’s the only wheel in town.”

Evanier has a four-point moral to The Speech.
(1) The system is not fair.
(2) It’s never going to be fair.
(3) You have two choices: Play under the system, as it is, or get out.
(4) If it should happen to pay off, it pays off big.

from:
Coppola, B. P. “Learning to Play a Rigged Game” The National Teaching and Learning Forum, 2000, 9(2), 6-9.

What fraction of the people in the US who have voiced mistrust of science and its predictions are, today, running to spend two minutes in the shadow of the moon?

To them, I say: trust in your faith and look to the sky.

Mirror Birthday should be a thing.

Reflect your  lifetime backwards to get perspective on what those years mean.

This year is a fun one for a chemist. I’m 60, so go to my birth year (1957) and look backwards by 60 years to see what was going on in 1897.

1897: the year electrons were discovered, and Dow Chemical was founded

1957: electrons and Dow Chemical were as old as I am right now

And also, the pencil sharpener was patented, as well as the movie projector; the first internal combustion submarine sailed, Bram Stoker’s “Dracula” was published; and Oscar Wilde was released from the Gaol Prison.

I was at dinner with some of my graduating seniors a few weeks ago, and they were recounting an elementary Astronomy course that they had taken this year (as seniors, to fulfill science elective credit) in which their stories about the course were (1) only thinking about it on the day before the exams and (2) that the exams (and thereby the course objectives) were lists of memorized information. Even at that, in the few days that had passed, the number of the Jovian moons that they could recall was already going down.

I asked the question: can it possibly be worth tuition and time to memorize lists of stuff that one could call up on a Wikipedia page on one’s phone in about as much time as it takes to read this sentence?

Recent reports about proposed changes to the Harvard and Duke University general education programs have been brutally honest about something I think we rediscover generation after generation, namely, that many “general education” courses are worthless. When I was in school, we certainly had versions of science courses that are still know by names such as “Rocks for Jocks” and “Physics for Poets.”

Faculty committees at both Harvard and Duke are convinced that the core values of the Liberal Arts education need to be resuscitated.

I have no argument with that position at all. But in the reports, you also read this:

How do we combine this structure with a robust pass-fail policy to further promote academic experimentation? What student mentoring structure will need to be in place to promote a deliberative engagement with the curriculum and ensure students embrace and meet expectations? How will this be financed? What other academic support structures may be necessary?

These statements drive me nuts because they are not much more than the latest version of what makes “Rocks for Jocks” such a bad idea, namely, that students are not actually being given the opportunity to make a mistake – a bad choice – and then learn how to deal with it and/or make the best of it.

What is particularly surprising is that nearly everyone embraces the conceptual value of “learning from failure,” yet we have systematically reduced the ability for students to make mistakes – or when we do, we anticipate it and then minimize the potential consequences.

“How do we ensure that students embrace and meet expectations?” is really asking “How to we ensure that students do not make a mistake?” My reply: let them.

“A robust pass-fail policy to promote academic experimentation” is really saying “A system of consequence where risk is actually mitigated.” My idea: it is not actually risky business when you swaddle a student in bubble wrap and fill the world with warnings and safety nets.

Professors are embracing “gamification” because they will tell you it promotes risk-taking, when I believe it does exactly the opposite because the actual risk has been removed.

And almost everyone has mindlessly embraced a world full with “custom tailored or adaptive” recommendation about what you should do or buy or watch based on the analytics. Why is it seen as positive to remove the opportunity to discover something?

Full disclosure: I took one course in college as pass-fail. As a chemistry major also interested in art, I took my first drawing class pass-fail. I was not taking a risk; I was mitigating it. I engaged the course, and I would have gotten an “A” (as it turns out), but I was playing it safe. My professor was quite disappointed when I said I was taking the course pass-fail, and I did not understand why for a long time. But his message was not lost on me, and I took three other drawing classes for a grade and never exercised the pass-fail option again.

Did I approach these latter courses more seriously? I honestly cannot say. Frankly, I was too good of a student in the first place. I would like to think that the choices I made – turning to academic advisors as the last resort, because I wanted to figure things out on my own, and often going for the instructors that others warned against – were statements of my willingness to take actual risks, make decisions, and work out challenges that crept up along the way.

I never quite thought about it before, but it really ought to be called the “pass” option. How many students who take “pass-fail” ever actually fail?

It is sometimes true (and reasonable) that you get the idea that you have made a horrid mistake within the first moments of making a decision, and the best decision can be to bail out. Learning how to detect a real disaster as opposed to over-reacting to a challenge is also a useful skill to have. I was a dual chemistry and physics major for about one week, which lasted as long as it took to take one hour of the first third-term physics course. I ran like the wind because I was able to evaluate the situation and make a decision.

Somewhere along the way, getting less than an “A” grade, regardless of what you learn (or not) has become a risk, thanks to the imagined consequences, often including the complete melt-down of one’s professional future prospects.

The real risk, perhaps, is that we are not providing the kinds of experiences with decision-making, failure, and recovery that are necessary for the educated person to have, while they are in school, where the real consequences are not learning how to cope with real life.

And in real life, in which many things are (in fact) “pass-fail,” the “fail” carries actual consequence.