Humour

Keeping the patients coming: Not so elementary, Watson.

by reestheskin on 10/08/2017

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Well, I thought the Swiss connection with Sherlock Holmes were the Reichenbach falls (I had to visit, a few years back). But no, I read that:

Except in Switzerland, where the stories were banned from railway bookstalls for fear they’d inspire criminality, Sherlock Holmes was big business from the moment of his inception.

But of more interest to the medic:

In 1882, as a newly qualified doctor with a practice in Southsea, Arthur Conan Doyle found himself chronically short of sick people. He therefore used the empty office hours to write his tales about the “consulting detective” who was based on Joseph Bell, the Edinburgh surgeon who knew at a glance what was wrong with the patients parading before him

There is a widespread delusion in the UK that you can accurately plan how many doctors you need. This is a mistake, both for society and for the doctors themselves. As we move forward, I think we will see more medics emulating one of the great ones.

And, as for the book, reviewed in the FT (‘The life and death of Sherlock Holmes’), it highlights that Holmes’ nemesis was not Moriarty, but lawyers.

Sunsetters on the horizon

by reestheskin on 08/08/2017

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WHAT do you call someone who is over 65 but not yet elderly? This stage of life, between work and decrepitude, lacks a name. “Geriactives” errs too much on the side of senescence. “Sunsetters” and “nightcappers” risk being patronising. Perhaps “Nyppies” (Not Yet Past It) or “Owls” (Older, Working Less, Still earning) ring truer.

I am OK with soon (as in the David Bowie song) being patronised. I like ‘sunsetters’ best. Sipping G+T watching the sun go down, in Africa.

Economist.

Note added in proof: Here are some more:

Hopskis: Healthy Old People Spending Kids’ Inheritance

Woopies and Jollies: Well Off Older People, and Jolly Old Ladies with Lots of Loot

No scab doctors here

by reestheskin on 03/08/2017

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“Just fun or a prejudice? – physician stereotypes in common jokes and their attribution to medical specialties by undergraduate medical students”

Paper here. Seriously.

Inverse care law and cats

by reestheskin on 21/07/2017

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My mother in law has two ‘Italian’ cats. One has worms, the other apparently not. Medication time. The diseased cat refuses the medication, whatever enticements are on offer. The undiseased (or cat at ease) scoffs not only his own medication, but that of his partner.

There are plenty of cats in South Wales, and I doubt that coal dust kills off the worms. Julian (Tudor-Hart), where did the idea come from? [ Yes, before you write in, not quite the inverse care as JTH meant it, but metaphors are the viruses of novelty, so who knows.]

Not so much split personality, but man-in-the-middle

by reestheskin on 17/07/2017

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Via Bruce Schneier:

The trouble began last year when he noticed strange things happening: files went missing from his computer; his Facebook picture was changed; and texts from his daughter didn’t reach him or arrived changed. “Nobody believed me,” says Gary. “My wife and my brother thought I had lost my mind. They scheduled an appointment with a psychiatrist for me.”

But he built up a body of evidence and called in a professional cybersecurity firm. It found that his email addresses had been compromised, his phone records hacked and altered, and an entire virtual internet interface created. “All my communications were going through a man-in-the-middle unauthorised server,” he explains.

Nosology

by reestheskin on 06/07/2017

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How to select medical students…………..

On the topic of quotations, though, a longer recent discussion about Hanlon’s Razor on the Farnam Street blog includes this rather nice one from the German general Kurt von Hammerstein-Equord:

I divide my officers into four groups. There are clever, diligent, stupid, and lazy officers. Usually two characteristics are combined. Some are clever and diligent – their place is the General Staff. The next lot are stupid and lazy – they make up 90 percent of every army and are suited to routine duties. Anyone who is both clever and lazy is qualified for the highest leadership duties, because he possesses the intellectual clarity and the composure necessary for difficult decisions. One must beware of anyone who is stupid and diligent – he must not be entrusted with any responsibility because he will always cause only mischief.

The Razor Returns | Status-Q

I wish I had said that

by reestheskin on 04/07/2017

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A large part of Kahn’s legend rests on his fame as a pedagogue, and although his parallel teaching career was driven by financial necessity, he became renowned for his ability to inspire students with a more elevated vision of professional practice than the technically advanced but psychically stunted approach characteristic of postwar American architectural education. (emphasis mine)

From a (book) review in the NYRB about the late architect Louis Kahn (Salk institute etc). “Psychically stunted.” Sounds like some other sort of professional education I am more familiar with.

Inverse dermatology

by reestheskin on 29/06/2017

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I guess you could call this inverse dermatology.

 

Benign paternalism in teaching. And nappies.

by reestheskin on 19/06/2017

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Thanks to Betsy DeVos & Co., “school choice” has become a hot-button issue in the US. But across the pond in Germany, choice looks a lot less like private school vouchers and a lot more like…democracy. At Dolli-Einstein-Haus elementary school, kindergarteners exercise their voting rights weekly through “kids’ councils,” collectively choosing everything from class activities to what’s served at snack. The one limit on their civil liberties? Teachers reserve the right to decide when a kid needs a diaper change—to which we say, fair enough.

EdSurge.

Pathological medical students

by reestheskin on 07/06/2017

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Some nice memes in this letter from an MD student in Australia. Please discuss. Pharma might be interested

Considering this, if we thought about the pervasive attitudes that inform our definition of a “good” medical student as a disease, it’s hard to believe that we would not try to treat it.

Academic Medicine.

DOI: 10.1097/ACM.0000000000001700

The day they banned Powerpoint

by reestheskin on 06/06/2017

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Edward Tufte’s ‘The Cognitive Style of Powerpoint’ is funny. The problem is that it is not just funny, but deadly serious. Literally. His argument and case studies concern how humans died because people failed to understand how to communicate. And the title says it all. Powerpoint (at least its templates) degrades communication.

Communication is a big thing in medical education, and it is not unusual to have to sit through tedious talks on the subject. They usually start with Powerpoint slides, so at least you know that they are not going to say anything worthwhile and you can get your phone out and play.

Below is a memo, from Jeff Bezos, of Amazon.

Perhaps the single most important thing we could do to improve university education to is to remove all copies of Powerpoint. Words matter. Sentences even more.

Edward Tufte Kills a Kitten

 Via Visually. See more  here

Medical education and the TARDIS delusion.

by reestheskin on 30/05/2017

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I saw this giant problem in my education, and I actually designed a course called, “Physician Heal Thyself, Evidence-based lifestyle.” I brought in all these doctors who are experts in sleep medicine, sleep, fitness nutrition, food as medicine, functional medicine, integrative medicine, osteopathy and acupuncture. I got them all in a room and said I want you to teach students what we’re missing. We need to make this medical school education and have to implement this into the board certification programs as well as board exams. If it’s not required, it’s not going to be taught.

No, I am not taking this too seriously. Awhile back, I compiled a list of all the things we needed to  inflict on / ask medical  students to know : I had to buy a larger hard drive. And as for this ‘new medicine’ George Bernard Shaw described it a long time ago.

Quartz

The raw eggs bit, I could not manage

by reestheskin on 25/04/2017

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Emma Morano’s singular achievement in life may have been perseverance. She lived for 117 years, crediting her longevity to raw eggs and her lack of a husband. She died on April 15.

NYT

Surgeons should not look like surgeons

by reestheskin on 28/03/2017

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For a flavour:

Now if I had to pick, I would overcome my suckerproneness and take the butcher any minute.

Incerto here. Deadly serious.

The pleasures of arithmetic and arachnophilia

by reestheskin on 27/03/2017

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Their conclusion was that there are 25m tonnes of spiders around the world and that, collectively, these arachnids consume between 400m and 800m tonnes of animal prey every year. This puts spiders in the same predatory league as humans as a species, and whales as a group. Each of these consumes, on an annual basis, in the region of 400m tonnes of other animals.

Martin Nyffeler of the University of Basel and Klaus Birkhofer of Lund University, quoted in the Economist.

“An estimated 400–800 million tons of prey are annually killed by the global spider community” Link

Student life: Not the muse, but the masseuse

by reestheskin on 20/03/2017

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This weekend, my wife and oldest daughter visited her first-choice college, the University of Tennessee. There was one curious moment in an otherwise wonderful weekend. The tour guide noted that the university was there to help students get through the trauma of exams. It brought in masseuses to massage away the stress. It rolls out a sheet of paper, passes out crayons, and lets the students express their rage against algebra. Oh, and it vowed to bring in puppies, so students could cuddle something cute to take the edge off their anxiety.

Quote on Memex from Tyler Cowen’s new book, ‘The Complacent Class’.

‘Some diversity training-programs, for example, are like blistering — they are somewhat painful to endure and have no beneficial effects.’

Timothy Wilson in Redirect, the book that nobody from HR seems to have read.

 

There is only one way to ensure that assessment is light-touch. Universities should rebrand themselves as banks.

Comment (Mintaka) on an article on the TEF from one of the HE commissars (Nick Hillman).

A defence of the beanbag geneticist, it is then.

by reestheskin on 02/03/2017

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In 1924, a 30-year old journalist on the Daily Express came to Cambridge aiming to interview Haldane. She was Charlotte Burghes, née Franken, and she had a young son, Ronnie. Haldane and Charlotte became lovers, but before they could marry she had to seek a divorce, a procedure that carried substantial social stigma at that time. A university committee resolved to strip Haldane of his readership, which was only restored by successful legal action.

From a review of a new biography of JBS Haldane. The article referred to in the title of this post is here.  I know of no other branch of biology that can build so much, on so few assumptions.

“books of the type written by the current hotshot Op-Ed writer at the New York Times may get some hype at publication time, manufactured or spontaneous, but their five year survival is generally inferior to that of pancreatic cancer.”

Nassim Taleb Numbers matter: the Lindy effect at work.

More medic collective nouns.

by reestheskin on 14/01/2017

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After my earlier post, Alun a dentist and advisor to dentists reminded my of a few more and some now ones”

  • a brace of orthodontists
  • a sleep of anaesthetists
  • a shrink of psychiatrists
  • a clot of…..
  • a cut of…..

This stops here….

Except that the Economist (14/1/2017) offers some additional ones (beyond a “distutility of…”)
– a quandary of economists
– a befuddlement of economists
– and my favourite: a surplus of economists

Which all leaves me a a little discombobulated.

The collective noun for a bunch of economists.

by reestheskin on 10/01/2017

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I remember this as a medical student game. A ‘scab of dermatologists’; a ganglia of neurologists; a ‘bone of orthopods’; a ‘pulp of dentists’. Sam Shuster’s contribution (from memory…) was: a ‘dementia of statisticians’.

In the Economist, Donald Norbert comes up with one for Economists: a ‘disutility of economists’. (Economist, 7/1/2017)

I see the end brightly now

by reestheskin on 09/01/2017

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Laurie Taylor in fine form

“Our university is to appoint a “nostalgia liberation officer” to protect the small number of academics who are unable to come to terms with the exciting new nature of higher education.

Concerns that even these steps may not prove sufficient have raised the prospect of the university creating “a safe space” where nostalgia dons would be free to talk endlessly about the time when universities were “a community of thinkers engaging in intellectual pursuits not for any external purpose but as an end in itself”.”

Xmas day and it is all about food

by reestheskin on 25/12/2016

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Geoff Norman opened my eyes to the (useful) parallels between cooking and medicine (‘Medical expertise and mashed potatoes’). This little quote from the Economist, is at a mature tangent:

Compare this to the fate of Lymeswold, which was created in the 1980s and touted as the first new English cheese in 200 years. It was initially highly successful, but when demand outstripped supply, the manufacturers cut corners and released stocks before they had matured, resulting in its demise less than a decade after its birth.

Sounds a little like some aspects of doctor training in the NHS.

Optimising the production of Masterpieces and genius work

by reestheskin on 15/11/2016

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There is a witty spoof on the ‘contact hours = quality education’ debate (sic) in the THE. AKA why are ministers so stupid.

Ministers are concerned that despite large differences in the quality of novels, they all seem to cost the same. From now on, under the National Assessment of Fiction Framework (NAFF), the quality of novels will be scientifically measured according to the number of pages they contain, and prices will be set accordingly. Ministers are said to be delighted to have finally proved that Riders, Jilly Cooper’s 900-page epic, is three times better than Jane Austen’s insubstantial Pride and Prejudice.

It reminded me (yet again) to track down something I had read many times on Brian Randell’s web page here. Computing was lucky because the inventors got to do so much before the academy tried to close it down.

Masterpiece Engineering, T. H. Simpson, IBM Corporation, (Via Brian Randell’s web page here.)

“Here on this spot in the year 1500 an International Conference was held”.

It seems that a group of people had gotten together to discuss the problems posed by the numbers of art masterpieces being fabricated throughout the world; at that time it was a very flourishing industry. They thought it would be appropriate to find out if this process could be “scientificized” so they held the “International Working Conference on Masterpiece Engineering” to discuss the problem. As I continued walking round the garden, now looking a little closer at the ground, I came across the bones of a group, still in session, attempting to write down the criteria for the design of the “Mona Lisa”. The sight reminded me strangely of our group working on the criteria for the design of an operating system.

Apparently the Conference decided that it should establish an Institute to work in more detail on production problems in the masterpiece field. So they went out into the streets of Rome and solicited a few chariot drivers, gladiators and others and put them through a five week (half-day) masterpiece creation course; then they were all put into a large room and asked to begin creating. They soon realized that they weren’t getting much efficiency out of the Institute, so they set about equipping the masterpiece workers with some more efficient tools to help them create masterpieces. They invented power-driven chisels, automatic paint tube squeezers and so on but all this merely produced a loud outcry from the educators: “All these techniques will give the painters sloppy characteristics”, they said.

Production was still not reaching satisfactory levels so they extended the range of masterpiece support techniques with some further steps. One idea was to take a single canvas and pass it rapidly from painter to painter. While one was applying the brush the others had time to think. The next natural step to take was, of course, to double the number of painters but before taking it they adopted a most interesting device. They decided to carry out some proper measurement of productivity. Two weeks at the Institute were spent in counting the number of brush strokes per day produced by one group of painters, and this criterion was then promptly applied in assessing the value to the enterprise of the rest. If a painter failed to turn in his twenty brush strokes per day he was clearly under-productive.

Regrettably none of these advances in knowledge seemed to have any real impact on masterpiece production and so, at length, the group decided that the basic difficulty was clearly a management problem. One of the brighter students (by the name of L. da Vinci) was instantly promoted to manager of the project, putting him in charge of procuring paints, canvases and brushes for the rest of the organisation.

Some people try to optimise the shit out of everything. Or, as we might say in South Wales, ‘tearing the arse out of it’.

EdTech the Devil’s way.

by reestheskin on 29/10/2016

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Great post by Bryan Alexander, titled ‘ A Devil’s Dictionary of Educational Technology’. If you work in it, you will recognise it. I will start off with my favourites

Powerpoint, n. 1. A popular and low cost narcotic, mysteriously decriminalized.

YouTube, n. The ideal educational technology: everyone likes and uses it, it’s reliable and free, and neither you nor anyone you know has to support it.

Here are a few more:

Active learning , n. 1.The opposite of obedience lessons.

Asynchronous, adj. The delightful state of being able to engage with someone online without their seeing you, while allowing you to make a sandwich.

Best practice, n. “An educational approach that someone heard worked well somewhere. See also ‘transformative,’ ‘game changer,’ and ‘disruptive.’” (by Jim Julius)

LMS, n. 1) A document management system, whereby a faculty member can transfer a single document to his or her students. Curiously overpowered for this purpose, nevertheless universally deployed.

2) A good way to avoid legal notices about copyright.

3) The graveyard of pedagogical intentions. A sump for IT budgets.

Nice procrastination piece, or reality check, depending on whether you teach or you deliver teaching.

‘You Americans have the best high school education in the world. What a pity you have to go to college to get it.’ In Alan Kay

Edtech redux

by reestheskin on 25/10/2016

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Blackboards, school buses, Nissen huts, and the pencil (via John Naughton, with original link here). Sadly, you have to invest time and effort in learning how to use it  — so little to recommend to the multitaskers

pencil

We don’t need no teachers

by reestheskin on 24/10/2016

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‘People pay a lot for a great education now, but you can become expert level on most things by looking at your phone.’

Sam Altman quoted in the New Yorker

It is just nice to see it in black and white. So simple. BTW, the quote came via the wiser (not ‘smarter’) Nick Carr, who commented: ‘By “a really good life,” Altman means a virtual reality headset and an opioid prescription’.

Failing again. Improved possibilities.

by reestheskin on 04/10/2016

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I have always thought two Irish writers great guides to life: Samuel Becket, and Brian O’Nolan (aka Brian Ó Nualláin, Flann O’Brien, Myles na gCopaleen ). Becket’s line, in a postcard of the lithograph by Tom Phillips of him, hangs on my wall: “No matter. Try again. Fail again. Fail better.” But now I have come across something more fitting for my state, and with optimism:

“I work on, with failing mind, in other words, improved possibilities.”

Review of The Letters of Samuel Beckett, Volume IV, in the FT.