Monday, February 16, 2015

When In The Course

As high school teachers go, he was an anomaly.  A rare mix of humor and excitement, he was able to extract from his students the last ounce of concentration left at the end of a busy school day.  He taught my United States history class.  Long after I had collected acceptances from colleges my senior year, I sat engaged and learning a subject I frankly had little interest in.

He was constant energy.  He zoomed about the room, the tempo of his voice nearly as erratic as it's volume.  The attention demanded by his motion was only second to the content of his lecture. He made history both intoxicating and palpable.  A memorizer of theorems, a solver of equations, I struggled to imbibe the spray of knowledge shooting in my direction.

I never studied so hard, and yet looked forward to each and every lesson plan.

One afternoon he walked into the classroom and wordlessly turned on the overhead projector.  I read quickly through the large text on the screen:

When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature's God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.--That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, --That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.--Such has been the patient sufferance of these Colonies; and such is now the necessity which constrains them to alter their former Systems of Government. The history of the present King of Great Britain is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world.

It was the first two paragraphs of the declaration of independence.  Our assignment was to memorize the words.  Then we would have five minutes to write the paragraphs by rote memory.  The groans and sputters from the students lasted nearly the whole class.

Each night I sat with paper and pencil.  The first few days were spent memorizing.  My surprise, however, was that speed was also an issue.  Not only did I have to know the material, I had to be able to spew it back on command.  Occasionally my hands would cramp, and I would have to stop for a few minutes and rest.

By the day of the quiz, I must have written those paragraphs hundreds of times.  I and my classmates  finished with just seconds left.  Our teacher dutifully walked up and down the aisles collecting the loose-leaf papers covered with mostly illegible sprawl.  And then he paraded up to the front of the classroom, and with great pomp and circumstance he threw them into the trash.

The collective gasp was interrupted by a particularly brave girl in the front row.  She wanted to know why it was so important to memorize the words when we could look them up.

The teacher smiled wryly and a sparkle flashed across his face:

One day there may no longer be paper, or computers.

We all sat dumbfounded wondering if our beloved teacher had finally fallen of his rocker.

But strangely enough, years later, I still have those words deeply ingrained in my memory.

When in the course of human events... 

Maybe he was trying to teach us that the tyranny of despotism was not something read on paper but carried in one's bosom.  Our forefathers didn't need to memorize words because the fight for freedom and equality was emblazoned on their backs from personal experience.  Generations later, prospering from the battles our ancestors won, my teacher wanted his students to hold these ideas (and words) as dear as those who originally wrote them.

This is our foundation.

I find so many parallels with what is happening in medical education today.  We love to dispense with the old ways in favor of all that is new and shiny.  We are starting to talk of discarding large chunks of medical education as irrelevant.  We have mostly abandoned physical exam skills due to the flexibility and ease of diagnostic testing.

And I see my old teachers standing in font of me as if they were addressing a high school US history class:

What if there were no CT scans?

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