Tuesday, September 24, 2019

Part I

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When Medical School Gets Woke: Worldview Change Comes from the Classroom to the Culture

A shift in a worldview requires a fundamental intellectual change. When you’re looking at how that change takes place, Ground Zero would be the American academic environment, primarily the elite to most influential colleges and universities in the country. That kind of intellectual change tends to happen there first. Now, it doesn’t even happen there out of a vacuum. A good deal of what happens on an American college or university campus has a great deal to do with what’s going on in European campuses. That has tended to be the flow of information and the flow of direction in change.

Now, when you’re looking at many of those disciplines, Americans are paramount. But it is still the fact that currents in European intellectual fashion often pass like a contagion to the United States and then like the spread of a contagion. They go from the campus all the way through the culture, pervading, of course, the elites who care a great deal — a very great deal — about what the most prestigious academic institutions and their faculties think, and, of course, disseminated even more dangerously through the student bodies who become graduates and alumni and go out into the world sometimes not even understanding the ideological trends or toxins that they are carrying.

Over the course of the last several decades, there has been an enormous shift on those college and university campuses as you think of worldview, especially when it comes to an understanding of truth and reality. The old understanding of truth as an objective reality external to us has been largely replaced by a social constructivist relativist understanding, sometimes called a postmodern theory of truth that tells us that truth is just in the experience of observing or truth is entirely socially constructed. It’s a social movement that considers a position true when it is too that culture’s preference.

Or you can have the fact that in an even more sinister way, many leading theorists steeped in Marxism tell us that what’s really going on is there any claim to truth is just rightly understood, a claim to power and an effort to oppress. Even though that is an unworkable theory of truth, it is actually fantastical and irrational on its face, it is nonetheless dominant, especially in the liberal arts, the so-called soft disciplines on American campuses, the interpretation of literature, what used to be called English. Looking at departments like history and political science, not to mention the social sciences, most of those disciplines have now largely embraced a social constructivist, non-objective understanding of truth. But that has largely been contrasted in recent years by what you might call the other side of the campus.

Even as you can have a postmodern theory of truth taught in an English literature class, you really can’t have it taught in a chemistry class. The periodic table of elements doesn’t bend to a social constructivist idea or a liberationist idea of reality or of truth. So you’ve basically had this bicameral division on the university campus in which you can have very postmodern professors teaching in many disciplines, but generally not in the so-called hard sciences, much less than the applied disciplines like engineering or for that matter, medicine, dentistry. But is that simply now a matter of the past? Are we now looking at postmodernism virtually everywhere?

A signal warning on this comes in an article in The Wall Street Journal by Stanley Goldfarb, he’s the former Associate Dean of Curriculum at the University of Pennsylvania’s Perelman School of Medicine. Now remember, the University of Pennsylvania is one of the elite Ivy League institutions. You’re talking here about a former Associate Dean whose responsibility was the medical curriculum taught to doctors at the University of Pennsylvania School of Medicine.

Dr. Goldfarb writes an article, the headline of which is this: “Take two aspirin and call me by my pronouns.” That gives you a hint of where the articles going. Dr. Goldfarb writes, “The American College of Physicians says its mission is to promote the quality and effectiveness of healthcare, but it stepped out of its lane recently with sweeping statements on gun control. And that isn’t the only recent foray into politics by medical professionals.” He goes on to say, “During my term as Associate Dean of curriculum at the University of Pennsylvania’s Medical School, I was chastised by a faculty member for not including a program on climate change in the course of study.” He goes on to say, “As The Wall Street Journal reported last month, such programs are spreading across medical schools nationwide.

Dr. Goldfarb then asked the question, “Why have medical schools become a target for inculcating social policy when the stated purpose of medical education since Hippocrates has been to develop individuals who know how to cure patients?” He explains, he answers his own question. “A new wave of educational specialist is increasingly influencing medical education. They emphasize ‘social justice,’” put in quotation marks, “that relates to healthcare only tangentially. This approach,” he writes, “is the result of a progressive mindset that a porous hierarchy of any kind and the social elitism associated with the medical profession in particular.”

Very interesting. He identifies the two issues of concern on the part of those who want to transform medical education as coming from, by the way, a progressive mindset that in his words first abhors hierarchy of any kind, and secondly in particular abhors the social elitism associated with the medical profession in particular.

I’m going to interject here that when I am looking for a doctor, especially a specialist or a surgeon, when I’m looking for any kind of medical doctor, I’m going to look for one who is an elitist, who does have a good medical education, who did very well in medical school, who was very serious about receiving his or her medical education. I want to see all the right diplomas and certificates on the wall. I want to look for brand names. I want to recognize the university and its medical school, I want to recognize where the doctor did residency. I want brand names. Yes, unapologetically, when it comes to medical care for myself or my loved ones, and by extension I would think to anyone I want the best, and that does imply, it more than implies, it makes explicit, a hierarchy and there is a hierarchy in the medical profession including the fact that the doctors are actually the professionals.

It is their authority when it comes to the practice of medicine that simply does dominate. And I want a doctor whose influence, whose medical care, whose prescriptions, whose surgical approach, whose totality of medical professionalism is rooted in medicine as a science. I hope it’s rooted in a good heart towards humanity. I hope it’s rooted in a very good conception of truth and reality across the board. But right then with medical care on the line, what I’m most concerned about is a doctor who is at the very highest rank of the medical profession. But again, that’s hierarchy, and if you buy into the idea that all hierarchy is wrong, then you’re going to run face to face, head to head into the traditional understanding of medicine. There’s a reason why medical doctors have been particularly esteemed in society. We’ve counted on the fact that they have devoted themselves to medicine as a profession, as a practice, and yes, as a science, a way of knowing.

Writing about the changes taking place in medical schools, Dr. Goldfarb writes, “These educators focus on eliminating health disparities and ensuring that the next generation of physicians is well equipped to deal with cultural diversity, which are worthwhile goals,” he says. “But teaching these issues is coming at the expense of rigorous training in medical science. The prospect of this new politicized medical education should worry all Americans.” The bottom line in the critique offered by Dr. Goldfarb is that this new kind of medical education as it’s packaged is pushing out the kind of medical knowledge that we should expect of physicians. The tail is wagging the dog so to speak, and healthcare, perhaps even your healthcare, is going to suffer as a result.

Dr. Goldfarb writes from his own experience as the Associate Dean in charge of curriculum for one of America’s most influential medical schools. He writes, “The traditional American model of medical training, which has been emulated around the world, emphasizes a scientific approach to treatment and subject students to rigorous classroom instructions. Students didn’t encounter patients until they had some fundamental knowledge of disease process and knew how to interpret symptoms. They were expected to appreciate medical advances and be able to incorporate them in their eventual fields of practice. Medical education,” he writes, “was demanding and occasionally led to student failure, but it produced a technically proficient and responsible physician core for the United States.”

He says that that traditional American model first came under attack in the 1960s. We’ll stop here and consider the fact that that makes sense. In the 1960s you had this massive transformation of American higher education and you also had the American campuses show up as the most urgent centers for much cultural and social protests. Well, the story doesn’t end there. As Dr. Goldfarb tells us, the initial protests of the 1960s had now morphed into a major movement that is threatening to utterly transform not only the American tradition of medical school education, but the American practice of medicine. Dr. Goldfarb tells us that a decided core of largely Marxist-inspired critics began to demand changes not only in the total campus curriculum but in medical school curricular as well.

But then he goes on to tell us that this has now brought a title wave to the American medical school and its campus, “As concerns about social justice have taken over undergraduate education, graduate schools have raced to develop curricula that will steep future educators in the same ideology.” Very interestingly, he offers this observation, “Today, a master’s degree in education is often what it takes to qualify for key administrative roles on medical school faculties. The zeitgeists,” that is a German word for spirit of the age, “the zeitgeists of sociology and social work have become the driving force in medical education. The goal of today’s educators is to produce legions of primary care physicians who engage in what is termed population health.”

But in a way that should have our attention, Dr. Goldfarb continues by writing, “This fits perfectly with the current administrator-rich, policy-heavy, fall-over-function approach at every level of American education. Theories of learning,” he writes, “with virtually no experimental basis for their impact on society and professions now prevail. Students are taught in the tradition of educational theorists, Etienne Wenger, who emphasize communal learning rather than individual mastery of crucial information.”

But then Dr. Goldfarb circles back to remind us, we’re talking about the training of doctors and that has been premised upon the fact that what we need is a medical professional, a true physician whose practice of medicine is consistent with the very best knowledge with the very best training with, yes, an objective understanding of reality and furthermore, a commitment to the profession that is primarily about healing and preventing disease.

It’s that last part that is being used by many to try to enlarge modern medicine into just about everything addressing just about every ill in society. But Dr. Goldfarb points out that an individual, including an individual physician can only learn a certain number of things, can only cover a certain amount of curriculum and can only practice according to a certain kind of training. And his point is this, healthcare is not going to be improved by the changes that are now not only being demanded of medical schools but are actually happening.

But the story actually got more interesting after Dr. Goldfarb’s article had appeared in The Wall Street Journal. Just after that, the editorial board of The Wall Street Journal, released a statement that was headlined, “Corrupting Medical Education.” The subhead: “The reaction to Dr. Goldfarb’s op-ed proves his point.”

The editors wrote, “Stanley Goldfarb knew what he was talking about. Last week, the former Associate Dean of curriculum at the University of Pennsylvania Medical School wrote in these pages that climate change, gun control, and other progressive causes only tangentially related to treating illness were beginning to corrupt medical training. His piece,” said the editors, “spurred a social media eruption that immediately proved his point.” The editors continue, “Left-wing medical Twitter,” yes, there is such a thing, “piled on with virtue signaling that distorted Dr. Goldfarb’s argument. He didn’t write that doctors shouldn’t have opinions about political issues. He wrote that those issues shouldn’t interfere with the scientific and clinical training essential to producing doctors who can serve patients.”

But the editors went on to say the most disappointing response came from Penn Medical School, that’s the very medical school from which this former Associate Dean is now former. “Dean J. Larry Jameson and Senior Vice Dean Suzanne Rose sent a letter to students and faculty that is a case study in progressive correctness. The Dean and the vice Dean wrote in response to Dr. Goldfarb’s article, ‘Please know that the views expressed by Dr. Goldfarb in this column reflect his personal opinions and do not reflect the values of the Perelman School of Medicine. We deeply value inclusion and diversity as fundamental to effective healthcare delivery, creativity, discovery, and lifelong learning. We are committed to ensuring a rigorous and comprehensive medical education that includes examination of the many social and cultural issues that influence health, from violence within communities to changes in the environment around us.’”

The most obvious implication of that statement from the Dean and the Vice Dean would be that the students at the University of Pennsylvania’s School of Medicine were traumatized by the fact that a former Dean in charge of curriculum had raised such issues. That tells us something about the young people who are the students in America’s elite colleges and universities, even medical schools, not only the faculty and administrators.

But Dr. Goldfarb is pointing to something that most parents and American citizens don’t know, and that is at the elite level of the leadership of so many of these universities and professional schools and driven down through the administration in particular, there is an increased attention to A, the student has consumer above all else and then B, cultural change as the central mandate of the university.

What these administrators desire and demand would be faculty who basically work for students as if they’re mere customers, and then faculty who also want to work for social change throughout the entire society. Sometimes when you have a media development like this, it’s interesting and profitable to wait a couple of days and see what kind of letters to the editor appear. My favorite in response to this article appeared from Ronald Sinclair in Las Vegas who wrote, “Decades ago while a political science major at the University of North Carolina, I took great comfort in the belief that the smart kids taking the hard science courses and preparation for becoming our doctors, dentists, and scientific researchers were free from, and had no time for the self-righteous drivel delivered in too many of my liberal arts classes. I guess not so much these days. Dr. Goldfarb’s piece was chilling.” Indeed it was.

Part II

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Coming to a Curriculum Near You: Less Science, More Social Justice

But next, we note that it’s not just America’s colleges and universities. As I said in the beginning, there is a pass down, a filter down process throughout the rest of the culture and of course that means high schools and even middle schools and elementary schools as well. As a matter of fact these days, many of the same ideas and intellectual agendas show up in pre-school. But now I want to turn to an article by John Murawski entitled, “Woke History Is Making Big Inroads in America’s High Schools.”

He writes, “Like growing numbers of public high school students across the country, many California kids are receiving classroom instruction on how race, class, gender, sexuality, and citizenship status are tools of oppression, power, and privilege. They are taught about colonialism, state violence, racism, intergenerational trauma, heteropatriarchy, and the common thread that links them. Students are then graded on how well they apply these concepts in writing assignments, performances and community organizing projects.”

Now we have seen the proposed ethnic studies curriculum in California, but this article tells us that much of the same kind of curriculum is already being taught in many California high schools. Murawski writes, “At Santa Monica High School for example, students organize and carry out a systematized campaign for social justice that can take the form of a protest, a leaflet, a workshop, play or research project. They demonstrate,” we are told, “their mastery of the subject matter by teaching about social justice to middle school students.”

Now talk about a filter down. Here you’re not just looking at a generalized pattern, here you’re looking at the university is producing the teachers, the teachers teaching the high school students, and the high school students being assigned a project to influence middle school students.

The author also takes us to the Environmental Charter High School in Lawndale, California, where students, “Are assigned to write a breakup letter with a form of oppression,” that is the student writing about the student’s break up in a breakup letter, but not breaking up with a human in a relationship, but rather with a form of oppression. What might those be? “Such as toxic masculinity, heteronormativity, the Eurocentric curriculum or the Dakota Access Pipeline.” Students are asked to, “Persuade their audience of the dehumanizing and damaging effects of their chosen topic.” Now you’ll notice here this isn’t about teaching high school students how to think, it’s about training them of a certain determined way of thinking and then force feeding this not only to the students but to all of those within the students influence.

And speaking of the agenda here, recall that conversation we had on The Briefing about the proposed California ethnic studies curriculum. As a follow-up to that in this article, Melina Abdullah, a professor of Pan African Studies at California State University, Los Angeles, she’s a board member of the National Association for Ethnic Studies, said clearly, “We don’t want students to have the option not to take ethnic studies. It is as important as taking a lab science.” Well, of course you have to ask the question as important to whom, but more importantly, doesn’t this take us back to Dr. Goldfarb’s article in The Wall Street Journal where you have the same concerns about medical education? Here you have the argument that taking ethnic studies on the part of 14 to 18-year-olds is as important as taking a lab science.

Well, let’s not just ask the question important to whom? But let’s ask the question important for what? One of the frustrating realities about education is that it has to be focused and it always is limited. When you’re looking at a curriculum, a battlefield for sure in almost every educational environment, you’re looking at the fact that to add this means you have to subtract that. And when you’re looking at this kind of argument, what gets subtracted are the traditional disciplines that have at least in previous eras of human understanding led to human knowledge and success, even foundational to that success.

But here you have the replacement of many of those disciplines and curriculum subjects with the new agenda that is being driven and is being driven by a larger agenda for social change. Let’s change the issue here from the training of medical doctors to let’s just say for example the training of engineers, the kind of people who design, oh, I don’t know, a major suspension bridge. The fact is it might actually be far more important to society that those who are going to be designing massive suspension bridges over which we will drive, that they have another lab science class or they have another class in the hard sciences or at least what are considered to be the hard sciences.

We have already seen over the last several decades that many lawyers are complaining that the education in law schools has been primarily towards again, an agenda for social change and apart from the traditional training of lawyers, but it’s one thing for that to happen when it comes to the law, it’s another thing for that to happen when it comes to engineering. If I’m going to cross that bridge, I want the engineer to have a classical engineering education and again, if I’m going to drive over that bridge, I’m going to hope that that engineer graduated near the top of the class.

But the article by John Murawski makes clear it’s not just to California problem, He takes us to Wake County in North Carolina where he tells us, “10th graders were asked at the beginning of the school year to answer a diversity inventory worksheet, asking them to identify the gender, race, ethnicity, age, sexuality, ability, religion and socioeconomic status for themselves as well as about their friends, neighbors, teachers, and others.” That teacher’s initiative was at least temporarily blocked after parents complained, but the fact is that many parents never even know or know far long after the fact that their offspring have been trained and taught in just this way.

Part III

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Journalism in the 21st Century: The Gender Editor of the New York Times Makes the Paper’s Worldview Clear

But finally, I want to draw attention to last Saturday’s print edition of The New York Times, a full page of the paper with just a few words, a statement from the gender editor —yes, the paper has one — the gender editor of The New York Times, Jessica Bennett. Here are the only words printed on that full page, “We want gender coverage to exist across sections, platforms, and subject matter. It is a lens through which we cover the world. It’s all part of our larger mission to pursue the truth, shine a light on overlook stories, and hold power to account.” That’s not a particularly new admission from The New York Times, but what is really interesting and worthy of our note is the fact that the paper has presented this particular statement as advertising copy for itself.

It’s advertising to its readers that it is to be trusted, it is to be read, it’s to be bought because of its gender coverage and the fact that it has a gender editor. And it goes on to tell us what we really need to know because here’s where the paper actually tips its hand. You would think that you would have a major American newspaper saying our agenda and purpose is journalistic professionalism that is based in a claim and a practice of objective journalism, journalistic objectivity. I’ve discussed the challenges of that concept even recently on The Briefing.

But notice to the contrary, The New York Times is telling us here that that’s not really its purpose at all. Instead, it is driving gender coverage as it says, as a lens through which we will cover the world. That’s really, really interesting. It’s a stunning admission, but it’s an admission the paper is very proud of. Part of the paper’s “larger mission to pursue the truth.” We’ll, check on that. “Shine a light on overlook stories.” Well again, good for you. But the final words, “And hold power to account.”

What exactly does that mean? That’s the language of turning the entire order upside down in order to meet the demands of the new gender revolutionaries. And you can count on the fact it is that revolutionary vision that is the understanding of gender behind the gender coverage and the gender editor of The New York Times.