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February 25, 2007

Wrong Answer Syndrome

There is a sociological… idea (I’m not entirely sure whether to dignify it with the term “theory”) called Male Answer Syndrome. A person afflicted with this syndrome (usually a male) finds it very difficult to say “I don’t know,” regardless of the question. Instead, they will take a guess, state a generality, or evasively answer an entirely different question that they prefer.

A slight variation of Male Answer Syndrome seems to exist in academia, which I’ll call Single Answer Syndrome. This malady includes Male Answer Syndrome’s inability to admit ignorance but also causes otherwise very intelligent people to stubbornly look for a single cause behind a complex effect. Why do we grow old? Is Hamlet crazy? What causes cancer? Does lowering taxes boost the economy? Once academic experts, be they professors, politicians, or doctors, decide on the single answer to these various questions, all other possibilities are not only incorrect but are also dangerously ignorant.

Medical students suffer from yet a third related infirmity, Wrong Answer Syndrome. The whole exercise of medical school (from a fairly cynical viewpoint) can be reduced to trying to get the right answer on a long series of questions. More correct answers means better grades, better residencies, and better careers. (Also, presumably, better medical care provided to patients.) The first two years of questions come entirely from formalized pen-and-paper (and computer-and-mouse) exams, in which the correct answer to each question is hidden along with three counterfeit confederates, i.e., multiple choice. In this format, students strive to get, at bare minimum, 70% of the questions correct, and really hope for 90% or better.

Here in my third year, the format changes so suddenly that I suffered from a kind of psychic whiplash from July until November. No longer did I have the luxury of staring at a question and giving it (on average) 70 seconds of thought. No longer was the right answer provided, waiting to be ferreted out from the wrong-headed. The new paradigm consists of my attending physician (who gives me my grade) turning to me without warning and asking me a question. Examples range from the fill-in-the-blank (“What structure do I have here in my forceps?” or “What antibiotic should I prescribe?”) to the short-answer/essay (“What do you know about quetiapine?”) I then have maybe five seconds to flip through my brain and pluck forth the right answer. Now, instead of choosing the answer from four or five possibilities, I have to fish it out from the entirety of my knowledge. Instead of looking down at a question, re-reading it, and underlining pertinent details, I’m looking at a patient’s rash, or an organ through a small bleeding hole, or my attending’s dead-eyed stare.

I spent a couple of days keeping a tally of my right and wrong answers to “pimping” (Defined by Craig Miller in his The Making of a Surgeon as “a term with a specific meaning in medical education, a meaning that has no demonstrable origin—and no clear counterpart in common usage. It is the asking of a student or resident, by an attending, of some question within the broad field of medical knowledge. The implication is of repeated needling, a probing for pockets of ignorance; in fact, pimping is a sort of evil twin or mutant outgrowth of the Socratic method.”), depending on what service I was working on, I knew 20-40% of the right answers. The tumble from getting 70-100% correct to 20-40% is stressful, frustrating and humiliating. There is small comfort in knowing I’m not alone, all my classmates have the same hunted look- we’re all suffering from Wrong Answer Syndrome.

And perhaps Wrong Answer Syndrome is the precursor to Single Answer Syndrome. The pain of being wrong as a student is such, and the consequence of making a mistake within the sphere of health care is so dire, that physicians are driven to clinging to a single rationale that they can more easily understand: “Heart disease is caused by cholesterol, therefore I should give my patients statins to lower their cholesterol,” as opposed to, “There are numerous theories as to the cause of cholesterol including but not limited to chronic inflammation, auto-immunity, viral attack, neoplastic connective tissue, and cholesterol. All may contribute to the disease, but we don’t have a good handle on all the possibilities, let alone therapies to combat them.” They aggressively assert the former, ignore the latter, and, the worst outcome of Single Answer Syndrome, have difficulty recognizing and admitting when they’re wrong.

The physicians I work with are mostly very good, but very few of them consult with another colleague, a reference work, or the internet when they’re not sure of an answer. And why should they? When they were trained, doing any of those things was called cheating.

February 16, 2007

Hunger Pains


Yesterday one of my co-workers glumly announced, “Geez, I wish that it would stop being so cold outside, so I would stop eating.” Then, she shoved a fun-size Snickers into her mouth – her twelfth of the day, she admitted – and washed it down with a swig of coffee.

I laughed, and then considered.

True enough, I too have been stuffing mountains of carbohydrates and proteins into my body since our cold snap began in mid-January. I can’t seem to get enough of those delicious Deli-Rye Triscuits, glorious baked potatoes, and any sized-or-shaped pasta. I’ve eschewed any kind of leafy green, not to mention any citrus fruit that isn’t in the form of a twist, perched neatly on the edge of a cocktail. And I’ll confess it here: a couple of nights ago while at work, I plunked two quarters into the break-room soda machine at eight o’ clock and poured an entire 12-ounce can of Coca-Cola Classic down my throat. Gasp!

Oh, and one more thing … I can’t stop baking.

When the thermometer plunges, it would seem that our Ice Age caveman-selves take over our appetites and satiety centers, screeching “OOO-ah-ah-ah. Chungawhignumba-bizzle-bazzle!” (Translation: “Omigod! It’s so cold! You’d better eat that entire polar bear liver while you can!”) My inner Neanderthal – a happy-go-lucky creature – has discovered fire and prefers her liver well-done. Our ancient brains warn us to pack on the pounds in times of cold stress for fear of those long, frigid nights without a single speck of food to sustain our lives. And we simply cannot help ourselves when instinct demands.

In the past three weeks, I have baked a pineapple upside-down cake, countless pans of brownies, six russet potatoes, two casserole dishes of ziti, stacks and stacks of cinnamon toast and English muffins, and three batches of peanut butter chocolate-chip cookies.

And, mind you, Joel and I only eat together now on weekends.

We heartily thank Mother Nature for the below zero temperatures that will keep summertime’s bugs at bay, but are looking forward to a slight warm-up to calm our ancestral appetites!

February 13, 2007

An Evening in Stripes

Perhaps it is the presence of striped clothing that inspires us, motivates us, and challenges us ... Or, perhaps it is simply that we are as we are, and the presence of stripes just accentuates our free and easy way of life.

#258: Stripes & Sippy Cup
#327: Stripes & Plaything
#482: Stripes & Profile

February 12, 2007

Song of Myself

This weekend's visitors Grandma, Grandpa and Taffy afforded us an opportunity to capture some of Adelaide's best attitudes. This one puts us in mind of Walt Whitman.


I too am not a bit tamed, I too am untranslatable,
I sound my barbaric YAWP over the roofs of the world.

February 11, 2007

Many Happy Returns

Many happy returns of the day, Mar!

This weekend we celebrated Mar's birthday with another visit to Clarkson, a halting four-part chorus of "Happy Birthday," and a yummy blueberry cheesecake. In addition to toasting the honoree and tucking in to a sumptuous lamb n' yam feast (prepared by Mar and Molly), we visited Mar's new digs, as she prepares to move across town in a month or so. We had aimed to sift through Mar's large storage shed of give-aways, but only managed to move a freezer from house to car before the afternoon pleasantly devolved into eating, chatting, knitting, reading, playing, and relaxing.

Ol' rockin' chair

February 5, 2007



The past few weeks have brought plenty of snow, ice, and chill to our corner of the world. Finally, it feels like winter!

Adelaide vs. Frosty