Wearing Vibram fivefingers is a lesson in guidance systems. For those who've not seen them, fivefingers create the feel of barefoot running. When I use them, every pebble is an acupressure point. My left heel can't bang on the ground like it used to. This is running carefully observed, and it's recharged my faith in the idea that the body self corrects. You just need to listen to pain. Yes, pain. Pain is part of the runner's guidance system.
Now, something's happened to the guidance system at Goldman-Sachs. There was pain in investments designed to fail. The guidance system is kicking in now, because people outside Goldman-Sachs are paying attention. I've been thinking about investing in a stock and a bond fund and I asked the brokers, "Is there any exposure to Goldman-Sachs in either of these funds?" They told me I wasn't the first person to ask. Lots of potential investors want to steer clear of Goldman-Sachs. That's what I mean by a guidance system. There's a moral compass, and it always points north.
Something's happened to the guidance system at Johns Hopkins University's surgical training program. Recently I wrote about animals used in surgery training and in labs. I found out that only three medical schools in the country, Johns Hopkins, University of Tennessee College of Medicine at Chattanooga, and USUHS, allowed students to operate on animals. I wrote each school and asked why. The Tennessee folks declined to comment. The Uniformed Services University of the Health Sciences (USUHS) said "animals are only used where no acceptable computer, simulation or other educational alternative exists," which ducks the question, because alternatives do exist, and they are more than "acceptable." An article in volume 147, issue 2 of Journal of Surgical Research has called simulation the new paradigm in surgical education.
Then there's Johns Hopkins, where the director of surgery, Dr. Julie Freischlag, wants students to operate on pigs. The students get two surgical lab sessions and use pigs to try out various surgeries.
Dr. Freischlag has been quoted in Nature news saying that the sessions help students decide if they want to go into surgery. The lab also trains those who won't become surgeons but still need to know how to start intravenous lines and work with sutures.
"The first time our graduates stitch you up in the emergency room as interns, they will have already done that on live tissue before. They will be safer and better. I think most of us would hope they have actually done that on someone or something else before us."
Dr. Julie Freischlag, quoted in Nature news
Every year, about 50 pigs give their lives at Johns Hopkins. A lot more pigs give their lives to become bacon. Still, we're talking medical school here, not Denny's. There's a standard to uphold, and the majority of US medical schools find that students learn more by working on simulators. A student surgeon will have supervised operating room experience as well. So the image of a first-time surgeon saying "Wow, I've never operated on a real person before - hand me that sharp knife thing" is just false.
Gerald Moses, who heads the simulation lab at the University of Maryland School of Medicine, put it like this: "Sparing animals discomfort elevates the whole paradigm of learning."
Do we really train compassionate doctors by bringing suffering to animals? If it causes pain, shouldn't we be listening? I'm going to think about that on my next run, feeling every pebble underfoot, and self correcting.
Photo credit: MonkeySimon via Creative Commons License.