Sunday, February 15, 2009

Lions and Tigers and Bears, oh my!

If it's not donkeys at the airport...


or Cows in the road...


Then it's killer bees in the trees outside my apartment.


Never seen anything like it before. One moment they weren't there, the next moment they were. An the most aggressive little suckers you've ever seen. 3 of them chased a butterfly as it flew by. Poor flutterbye :(

Makes exams in 2 weeks look like a piece of cake. Hopefully bee resistant cake though.

Saturday, February 14, 2009

Thursday, February 12, 2009

Pulmonary Edema

"Pulmonary edema is not a hydrostatic phenomenon!"...that's what he said to justify the exam question. With one sentence, what little hope of respect for this man's knowledge vanished. He said it so dogmatically, so emphatically, with such expertise. Clearly, he doesn't have a clue what he's talking about.


Cardiac pulmonary edema is caused by elevated pulmonary capillary hydrostatic pressure leading to transudation of fluid into the pulmonary interstitium and alveoli. Increased left atrial pressure increases pulmonary venous pressure and pressure in the lung microvasculature, resulting in pulmonary edema.

At some level, if you know you don't know that you don't know, you'll never know.


image Our current director said yesterday that he believed that "lecturing is one of the most ineffective methods of learning and teaching." And he said it in a manner that was truly engaging.  I think that is current dogma, and the way it's being done here, I would agree. The problem is that is CAN be a very effective method of learning if done properly. And unfortunately that takes, time, preparation, understanding of visual technologies, engagement and talent. I see very little of that here.

A good lecture is focused on the lecturer. The lights are up and the slide show merely augments what the speaker is saying. The primary visual aid should be the lecturer him- or her-self – the effective lecturer is a "player" and presenting the "role" of the content. It is a social interaction between the audience and the speaker to engage both in a give and take process so that encoding can take place in the learner's brain.

This unfortunately requires a very deliberate process of preparation on the part of the professor, and a real commitment to the process. It requires they know the subject matter well enough, and are not afraid of engagement with the student. It requires attention to visual aids that enhance and augment what is being said. It requires paying attention to the syllabus, the required text and the state of the art in learning technologies.

When teachers treat teaching in a professional manner (and that doesn't have to translate into dry, humorless or cold hearted) magical things can happen...and do. But when they treat it as a retirement gig in the Caribe, its laborious for them, and for the students...and very little learning takes place. Those who know, teach...

Why is it that as you move up the ladder from preschool to graduate school that teaching skills and professional approach to teaching seem to decrease exponentially?


Monday, February 9, 2009

Doctorates for Allied Health


Is the clinical doctorate appropriate to the profession as an entry-level degree, as a postgraduate degree, or not at all? That question has been floating around for a long, long time in the allied health professions.  For many professions like physical therapy, nursing, audiology, and pharmacy, the answer is "doctorate, YES", but variable as to where that level should be attained (i.e. entry level vs. graduate degree after entry-level has been practiced.  There have been all sorts of claims, but clearly being called "doctor" has proven valuable to educational institutions who gladly accept huge tuition to get there.

But clearly there will be confusion on the part of the public. A patient off the street not accustomed to this discussion will see the "doctor" as a physician unless very specifically isolated from the generic experience. For those professionals that practice mostly in separate venues this is rarely an issue (pharmacy, audiology, physical therapy), but place a "doctor" where customarily a MD or DO physician is found, and there is likely to be confusion and an increased expectation on the provider.

The driving force is clearly education institutions, faculty and administration. Providers like physician assistants and nurse practitioners don't need that added education to be accomplished providers. Other than to increase individual education expenditure and possible debt, and to increase the already confused world of medical care, will the patient be served in this process? Will healthcare for the expected 50 million uninsured be improved? Will access issues be resolved with higher degrees of education demanding more money in salaries and benefits? Likely not. But the train has pulled out of the station, and if history proves right, nothing will change that.

Patients be warned...ask about the credentials of your provider and protect thyself. The doctor you see many not actually be the doctor you expect. Medical training is 8-12 years long after college and includes post graduate medical training in residency for a reason. It's not just a's a different educational experience.

Sunday, February 8, 2009

Happy, Happy

To my Mom and Dad, HAPPY 55 years...totally amazing, totally awesome! It shows a level of love, commitment, sacrifice, support....that I can only aspire to have in my life. I don't think I'll ever miss anything more in life than knowing someone cares unconditionally. You've defined it.

To my sis in law, HAPPY Birthday...Hope is was a wonderful day for you! Thanks for your support and love these past years.

Sorry I missed the bash. When the limo pulled up I thought he had the wrong house and sent him on. Ooops!


Tuesday, February 3, 2009

Who the...?

Endospore Ok, who IS this guy? He has been coming to our class now for several of the last sessions. He's not a student and he sticks out like an endospore on a malachite green positive stain.

I'm pretty sure he is  new faculty, likely taking over the class in which he sits. But we've not been formally introduced. I know I'm a bit of a off the cuff sorta guy, but my Mama and Pop taught me well...when someone is new to the room, you introduce him or her to the folks you are with. I know the instructor knows who he is 'cause I've seen them talking. So, why not introduce him to the group? It's rude, it's downright obnoxious. Worse, he came over to our small group discussion and looked over my shoulder at my computer (the last inner sanctum I actually control) and picked up the book I was reading (A BRS review book on the subject). Ugh!! God knows what kind of gram negatives, salmonella or clostridia are riding bareback on his hands. I'm going to disinfect, sterilize, and autoclave (121 deg centigrade) the book when I get home today.

Halls of Ivy This place is unbelievable. Schools in general are unbelievable. We've been bitching about the communication for months. Treat students with honesty, and respect and the results are amazing. Treat students continually in a manner that has them defensive, and imposed upon, and you get...this! It's so simple..don't you get that? " Good morning everyone. You'll notice a new face in class today who is going to be walking around and listening to class. Everyone, I'd like you to meet Dr. So and So; And by the way, his hands are not infected with various and sundry microorganisms so allow him to fondle your books at will."

I am continually amazed at how academia works, or doesn't.  The halls of ivy, kudzu, or (in my case) palm fronds, is filled with people playing elaborate parts and no clue at what human interaction is when dealing with students.  I think there is a cultural thing to about students as lowly waifs, worth no more than a string of blue beads.  Why is it that the most simple tasks become so complicated in academia? What?Like my prof uncle told me when I began teaching..."I hope you know what you are doing, because they haven't a clue about what they are doing." He was so, so right.

Monday, February 2, 2009

Big Shots

"Big shots are only little shots who keep shooting." - Christopher Morley