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Teaching = Consciousness?
June 17, 2009 - 11:55am


My acquaintance Crazy Larry, an actor, has been supplementing his income by serving as a fake patient for doctors-to-be. You’d know the name of the testing-prep company that runs the program—evidently one of three or four steps toward U.S. licensing—for (mostly) foreign students. They probe Larry several hours each day before they’re allowed to practice on human beings.

Larry’s meant to portray various symptoms and give a little feedback about their bedside manners, and the whole thing is watched by supervisor-graders through unseen cameras. He’s got stories, many too horrible to be told, but my favorite is how one young doctor, not quite fluent in English, listened to Larry’s chest then said, “Turn around so I can do you from behind.”

And I hope you’re as frightened as I am that Larry says that nine times out of ten, if he’s wearing a giant skin-cancer prosthetic, the students never notice or ask about it. What’s the old saying? Fifty percent of all doctors graduated in the bottom half of their medical school classes….

Larry’s not meant to comment on the supervising doctors’ manners or methods of critique and instruction, but he can’t help but notice that some are not terrific teachers. They don’t say things clearly, such as, “You did X very well, and I liked what you did with Mr. Larry’s Y, but next time please don’t be so intent on rote actions. You took the pulse of the goiter hanging off his neck, but never marked it in his chart.” Instead the teacher-doctor often says something convoluted, such as, “In the instance of which there are not any particulars you should never not go to the etc.”

Larry made the stunning observation to me that to be a good teacher one must be conscious—a loaded word for him that equates to having sense, sensibility, and verbal facility. I’d like that as a definition, of course, being a teacher, but I wonder if he’s right? He did, after all, have heatstroke last night and has hypothermia this morning.


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