Monday, October 22, 2012

Doctors, Meteors, Assessment Tests, and When to Wear a Lab Coat

(and a brief note about why your next doctor probably won't be an AVC graduate)

The world is full of sad news --- car bombs, presidential candidates bashing on each other with clubs like two disgruntled cave men, the latest view of prices as you drive past the gas station.

Here's a number that seems especially discouraging: 91%.

We've heard a lot about Romney's 47% and Occupy Wall Street's 1%, but the number 91% refers to something very direct and personal to me at AVC.

That is the number of students who take the AVC assessment test (a fair and validated instrument, with appropriate cut scores, or so various accreditation bodies verify) and who (big sigh) cannot go directly into college-level math.

Nine out of ten folks who start at AVC need remedial math. Most are graduates of high school, and yet most can't do college-level math. In fact, some cannot really do any math. (Is it just me or has anybody else had this experience? Let's say my Coke at McDonald's comes to $1.92. I don't want back more pennies, what I want back is a dime, so I give the clerk two bills and two one-cent coins, which is to say, $2.02. This sometimes causes great confusion . . . "but you have given me too much," etc. I want to say, "Hmm, just give me back the amount the cash register is telling you to give me. It will all work out in the end: trust me.") And so okay, reality is reality and so we offer Math 70 and various stepping stone courses to work up to higher levels.

There is no shame in this: my father had severe learning disabilities, and if I took the assessment test today myself, I only put my own odds of a good score at 50-50. (I do though know what "50-50" means. But maybe that's just because of the 50-50 Raffle I enter each Christmas at the AVC Foundation fundraisers.)

It seems to me from a social aspect this score remains grim for several reasons. One is money: remediation --- this is NOT the politically correct term, by the way, but John Hall told me it was okay to use it --- is expensive. Not that we pay teachers much money (compared to most things, we don't); but we do have to pay them something, and we have to keep on the lights and heat the buildings and buy dry erase markers and all the rest of it. Even the assessment test costs taxpayers money: about five bucks a throw, if memory serves. Education ain't cheap.

And what about lost opportunities? All these non-math-doing folks are presumably also not bringing their own insights and stories and solutions to technical fields. They are not helping to design planes or build bridges or send rovers to Mars. There's an expression, "brain drain," about US firms having to plunder the upper middle class of other countries, in order to get the doctors and engineers they need to run a business. If we won't teach math well, India will, or South Korea, or somebody on Mars. This is not to say that lots of AVC students don't start low and work their way ever higher. They do, and we have very good retention and very good matriculation rates in our entire math sequence. But math-challenged people certainly are less likely to become microbiologists or tax accountants or surgeons: that's just plain truth. Society loses out.

And of this 91%, some or most folks are probably not making good choices as financial consumers, in the credit card rates they agree to or their auto loans or even votes for what they will or won't support on a bond election. Mathematical ignorance costs everybody.

It makes me wonder even who my next doctor will be.

After all, I am getting up in years, so sooner or later I will begin to need doctors on a fairly frequent basis. (Me and about a zillion other baby boomers.) Robots just don't seem like the answer yet. ("Excuse me, but do you have a robot doctor made by Apple? I really don't trust seeing a Windows operating system robot for this visit.") In the ad above from an issue of Life magazine in 1962, a young man, studying to be a doctor, has fallen asleep while burning the midnight oil. I bet his math scores were just fine.

His wife, prim and modest in her buttoned-to-the-neck nightie, hovers above him, worried. The poor dear is working himself to death, she seems to be thinking. (Let's hope this is not the Halloween version, and that she is not thinking, Ah, finally he's asleep! Now I can pour hot coffee down his collar to get even for what a jerk he has been all day!)

One question this ad makes me wonder is what is HER math assessment test score? In 1962, women made coffee and sometimes babies, but were not supposed to be thinking about medical school. Yet let's just be rational: apparently the man here is some kind of narcoleptic slacker who can't stay awake long enough to finish his chem midterm. She in the meanwhile has her hair done and seems alert and ready to go. Let's send HER to school in his place ---- she's the one I want taking care of me during an all-night 12 hour operation.

In fact, in 1962, women apparently solved a lot of problems. Here's another loser doctor, one page later.

He looks less like he has a headache and more like he's been hit on the head with a club during a presidential debate. Luckily for him, God's gift to medicine is steady at hand: there's a woman, right nearby. Of course she's the size of a Barbie doll but she brings with her a plate of magic pills. Frankly, I don't want to go to see any doctor who can't manage to get his own aspirin without assistance, but she looks so happy and confident (in contrast to how he looks so grim and befuddled), that the ad leaves me with hope for the medical establishment yet.

Of course, if I don't like how he looks, that makes me wonder, what should a doctor look like?

Here is an illustration from a medical school textbook in 1899. The doctor handles a difficult birth, and the green post-it is your AVC blogger covering up a rather graphic and distorted vagina. (This is, knock wood, still a family-friendly blog.) Here is the illustration:

He has no gloves (I am old enough to remember when my dentist did not wear gloves, nor his assistant, and nobody in his office wore a plexiglass welding mask, either), our 1899 doctor probably has not used any kind of sterilizing antiseptic, and they are probably doing this delivery on plain household linen. He looks ready for business though, with a determined air and his sleeves pushed back. What's most interesting is the haircut and mustache. He probably rode a velocipede too, and sang in a barber shop quartet. Ah, those were the days.

How would you feel to wake up on an operating table facing this inquisition?

Well, of course, as soon as you got the wool out of your head, you might wonder why nobody has a mask on or gloves. Since Dr. House himself is there, this must be a serious case indeed. It's probably hard to tell in this blog version, but blue eyes predominate (welcome to one of the movie star cliches that Hollywood just won't let go), and on the men three out of the four have a beard or sexy stubble. From a photographic standpoint, I admire the blues and white --- great art direction here on this DVD case for the show House, M.D. --- and I wonder too about the choice to give the women such very striking lipstick. I guess we don't mind if doctors now are women (and to update the first ad, then it would be the worried husband bringing Starbucks to his exhausted wife), but if our doctors are going to be women, then we want them to be 10s, in the lab and out of it.

As these things go, Greg House is pretty hot himself. Is this what we now what our doctors to look like? No tie, no lab coat, gorgeous, maybe able to play the blues (he can, anyway), sexually active? True, his sex partners are often paid companions, but if he doesn't have any guilt about it, then maybe I should not mind so much either. America likes informality, after all. I can't decide if he looks like the new generation doctor or if he's just some bored indy film director about to give yet another press conference at Sundance.

Like the BBC television series of Sherlock Holmes, Dr. House is supposedly some kind of off the charts genius, somebody with an emotional life more damaged than the nerves and muscles in his bad leg and with an on-going addiction issue, but somebody who (we assume) doesn't need a calculator to balance his checkbook. The "real" House, actor Hugh Laurie, grew up in Oxford but went to Eaton and Cambridge, where he was an Olympic-quality rower, and, according to Wikipedia, became somebody who "plays the piano, guitar, drums, harmonica, and saxophone." Well now, top that, Tom Hanks.

When we're not voting with our Nielsen boxes, maybe we don't care what our doctors look like. The actor who played house was making something on the order of a third of a million dollars per episode. Go, blue eyes. He doesn't need to know math, so long as his portfolio broker does. For the rest of us, we will trust the AMA to do the certifying, and trust, too, AVC's fabulous RN program to have done its job. Somebody out there must be able to do some math, and maybe even figure out a pharmaceutical prescription or two, along with how to read an x-ray machine and what to do if a meteor lands on one's head. That doesn't happen too often, true, but you can never be too confident. After all, lightning hardly ever strikes twice, but as Gary Larson points out, there are always those statistical anomalies....

AVC's blog is curated by Charles Hood, Language Arts, and does not represent the official position of the Board of Trustees on meteorites, math scores, or the attractiveness of major movie stars. His email is


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  2. I am a current AVC student, who is apparently part of the 9%. I hadn't realized that the statistics were that extreme; it makes me wonder if [and when] the high schools are going to start delivering students that are capable of college-level math, or if the gap between high school standards and college standards is going to grow into an ever wider chasm. Or, even more frighteningly, if college standards are going to be lowered in the same manner that high school standards have been lowered.

  3. I graduated from high school in Peru, in the 80's. I remember when I took my admission exam for the University (in Peru); I was well prepared with the Math learned in high school. When took the AVC assessment test, my old math skills came back and I was eligible for MATH 150. To be honest (in my experience) it was a relative easy exam.
    As a foreigner, I see the differences between the education system in my country, and the American system. I think that there is an emphasis in independence, but there is not a real guidance to students. What I mean is that, it seems to be no guidance or mandatory courses to graduate from high school. When I was in high school, it was mandatory to take algebra, geometry, trigonometry, physics, chemistry, anatomy and biology. We also learned Peruvian history, world history, philosophy, logic, religion (about different religions). The teachers were strict and parents were involved and interact with the teachers. If we didn't pass a class we went to summer school (an embarrassment to us, it meant no vacation) sadly to say, here I had witness many kids who don't have the basic skills to take the AVC placement test. I have experienced the same situation at a fast food restaurant, when a kid stares at you if you give him additional money to make even change. It is sad because we are giving up on the future generation, the messages we get from the media seem to be: hey, who needs education, become a dancer, a rapper, an actor. “BREAD AND CIRCUS”…
    We are losing the education race to China, India, Russia, and Europe, and if we lose that race we will lose our economic power. I believe that we must invest in education. We as a nation cannot afford cuts in the education system in lieu of avoiding cuts in Defense, because we will not be able to build the next generation tank or warplane or aircraft carrier if we don’t have good engineers and scientists on our side. That is why this moment in history is so important, because we have had stared and the precipice in 2008, and now we have to decide: are we going to grow America’s “brain trust” or we must prepare to enter the third world, it is that important. Our country’s future demands sacrifice from ALL.

  4. My apologies for the typo, please delete my previous submission. Thank you.
    One more thing to add, I understand your point about being "family-friendly", but a medical image? I think we are reading a College blog, and we are mature adults, and any image posted in this academic level blog should not be consider or deemed inappropriate. If someone is going to pursue a career in the medical field, you are going to see body parts of many shapes and sizes that is the nature of job. The human body is nothing to be ashamed of, the only taboos and "no-no’s" are the ones we create on our own.

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