Edumucation and Other Things


While driving through the downtown of our small but not insignificant Midwestern city (there are corn fields five miles from the city center but we do have the state capital and a handful of miniature skyscrapers) I noticed a fat brown squirrel scampering down a tree and bounding across the street in the halting but graceful manner that can only be executed by a squirrel.   From between two buildings a large hawk dove at the squirrel and, opening its wings and rotating its talons forward at the last second, grabbed the squirrel by the head nearly decapitating it from the violence of the attack.   It flew back into the skyline with the limp body of the squirrel swinging from its claws.

My friends, the squirrel is us, you me and everybody bouncing along through life in our own halting, occasionally graceful manner.

The hawk is death.


Our good blog-friend Cosmic Connie over at Whirled Musings brings up an interesting point about the proliferation of easily obtainable on-line and mail-order degrees.  I think she is just scratching the surface of the problem.  While it is easy to identify fly-by-night diploma mills, most of what is considered legitimate higher education in this country is essentially the same thing; a lot more expensive with better ambiance and legions of fawning admirers but diploma mills just the same.

In fact, if there is a bigger scam than higher education or one supported by such a collection of self-interested grifters (who nevertheless bask in public adulation) I have yet to hear about it.  In terms of shadiness, only the CHIP program, an offshoot of Medicaid designed to funnel Other People’s Money into lucrative Pediatric Emergency Departments and Children’s Hospitals purpose-built to loot this rich bonanza even comes close.  Indeed, just as most of the money spent on the goat-rodeo of American Medicine is mostly wasted, most of the money spent on higher education is also mostly just thrown away producing little benefit to society except the employment of fearsome armies of educational bureaucrats who would otherwise be fit for nothing but agricultural labor.

That and serving as federally subsidized day care for 18-to-24-year-olds who would otherwise be inflating the unemployment statistics, safely warehousing them for another four years as sizable majorities of them pursue Mickey Mouse degrees.

Even prestigious universities are mostly now nothing but diploma mills and federal student aid farms where anybody who qualifies for student loans will be fed into the pipeline to emerge at the other end with as much money squeezed out of them as possible. If you think it is otherwise you are sadly deluded. A modern university is a self-perpetuating bureaucratic octopus, growing bloated as only an organization with unlimited access to public money can, and requiring only one thing: a steady supply of warm students shoveled into the front end to be kept in the mill as long as possible.

And the price of a degree keeps going up, outpacing inflation, not because the quality of the educational product has improved but because there is so much federal loan money available to pay for it.  The suckers keep lining up to borrow hundreds of thousands of dollars for easy, meaningless degrees that give them something to put on their resume when they apply for a job at Starbucks.  There used to be educational standards but now there is a university for everyone and a Mickey Mouse degree to be had at any level of educational ability and for any level of scholarly ambition.  May as well get a mail-order degree and save yourself the tuition.

The relevance to Goat Rodeodery?  Only that maybe the string of initials after everybody and his brother’s name may not mean as much as was once believed.  Certainly the number of initials, abbreviations, and credentials listed on a hospital identification badge is usually inversely proportional to real education.

You Missed It…

Every week or so I get a comment or an email from someone who was once passionate about the idea of Emergency Medicine but after reading my blog decided to eschew it in favor of some other specialty.

Unfortunately, I may have given the wrong impression about Emergency Medicine. It is true that much of American medicine is either a cruel grind or sublimely ridiculous.  Keeping this in mind however, Emergency Medicine is a blast.  It has everything: Sick patients who really need your help and are mighty appreciative of it. Absolute medical train wrecks who, tenaciously refusing to shuffle off their mortal coil, are dumped onto you with the expectation that you can and will squeeze just a little more functionally pointless life out of them.  Shootings.  Stabbings.  Every manner of human virtue and vice.  Minor complaints.  Serious complaints. Ridiculous complaints. Really, really ridiculous complaints.  You name it, we’ve got it and to reject the never-ending passion play and freak show of Emergency Medicine is to avow a certain disinterest in mankind, a desire to have nothing but sanitized interactions with your patients who have been scrubbed clean (often literally) and filtered through the Emergency Department.  People are generally on their best behavior in a clinic or the wards (or at least their better behavior) but in the Emergency Department we see them in the raw; man primordial, folly and nobility magnified.

But you have to love chaos.  I’ll give you that.  Not that the department is chaotic all of time but every now and then when the waiting room is packed and the ambulances keep rolling in with more critical patients, when the Friday night drunks are particularly demanding and the drug-seekers exceptionally whiny, when you are short-staffed and the charge nurse is making fists at you to move your many patients either in or out; when the impatient families are growing angrier by the minute and everybody is feeling harassed and overworked…when everything seems to be devolving into mayhem, confusion, and carnage you had best be able to prioritize and multitask like a friggin’ supercomputer or you probably actually won’t like Emergency Medicine.

The hurricane rages and blows.  Huge waves slam onto the deck as the rigging comes down around your head and the ship wallows in a following sea.  You are either the kind of lunatic who laughs at the gale and spits in the wind or this kind of thing intimidates you and you can only cling to the mast in terror.  I exaggerate of course but we have had off-service rotators in tears at various points of their brief exposure to Emergency Medicine.

Another Pet Peeve

“You goddman doctors killed my mother (who is sixty-two years old, on hemodialysis three times a week for kidney failure, has bad congestive heart failure, is blind and has double below-the-knee amputations from the ravages of diabetes, has had so many strokes in the last two years that the neurologists just stand in the door and sigh, is recovering from her fifth heart attack, has been in the intensive care unit six times in the last two years, and had a very  challenging case of pneumonia which was probably the result of aspirating the chicken soup her daugter fed her even though her strokes have made it difficult for her to swallow and all of her nutrition is poured into a tube going directly into her stomach).”

12 thoughts on “Edumucation and Other Things

  1. Yet another spot on post Sir Panda. As for the edumucation thing, another huge problem is that we now force everyone to get a masters or some random “doctoral” degree. Seems that once upon a time a BS/BA meant something, now it gets you next to nothing. And the cost is nuts! A girl in my class has 120K from undergrad and will have another 250K from medical school. Makes me glad I went to a cheap undergrad even if the med school will crush my financial soul for the next thirty years.

  2. Yet another great post, doc. I love your writing style and the fact that you hold nothing back. Keep it up!

  3. Absolutely love the description of EM panda. Thanks for just reconfirming that EM is where I want to go

  4. Your observations about the higher education system is right on! The politicians (Obama makes this point repeatedly) make it sound like if only everyone had a college degree then everyone would have great, high-paying jobs. The whole college/graduate system is mostly a scam for the benefit of all the professors, edubureaucrats, textbook publishers, equipment makers, etc. I do have nothing but respect for those in the engineering and engineering related fields however. I think there’s some real l’arning going on in those kinds of programs.
    I came out of an Ivy league school with a BS degree (bachelor of science, that is, or I guess the other reading would be apropos also) and the realization that I hadn’t learned anything new since high school. I guess I do have a diploma from an Ivy League school, which I guess is worth something when applying to more schooling and jobs and such.

  5. If in the land of the blind, a one-eyed man is king, is it not also true that in Nobama’s land of unicorns, rainbows, and universal college degrees, that the PhD’s shall lead us while those with a BA in Philosophy make the coffe and sweep the floors??

    Sorry, but if your college degree doesn’t actually TEACH you to DO something that you didn’t know how to do before–make sick people a bit better, build a bridge, increase the yield of a corn crop, find a cure for cancer, or build a nuclear power plant [example, BTW, not an all inclusive list]—

    –then what the hell are you spending your time and money on???? Go learn a skilled trade instead…has anyone seen what plumbers and electricians make? WHY? Because they can DO something most of us CAN’T!

  6. I’m writing from the road and am currently at a university library where the woman across from me is reading from an African American history book. Next to her are another woman reading an online intro to sociology textbook and a gentleman writing a paper for his English literature class. Christ, they’ll all end up as bureaucrats somewhere where they will likely deny insurance benefits to someone who did something meaningful with his life like unclog pipes, fix a motorcycle, or fight in a war.

  7. I disagree with some of your comments on higher education, as I feel that while yes, too many people go to college because they think they should, I do think that an incredible amount of great learning can still be had. A diploma mill has no intent of teaching anyone anything.

    Also, I’m not gonna lie. I used to be interested in EM, and while it was never your blog that dissuaded me (I’ve been reading it for at least 3 years), I definitely do like having the patients sorted out a bit, so that by the time they get to me, they have real medical problems. Or in my interest, they have real surgical problems.

  8. Yes, higher education is a complete scam. Why? Well, a B.S. degree in anything is useless if you don’t have the work experience for the job you are applying for. I got the whole “critical thinking” bull shit pushed down my through for four years in college. What a complete load of BS that was. Wow, learning parts of an animal in zoology sure is coming in handy. I sure do remember all of those plant names. I sure do remember all of those names for the proteins I learned in immunology and molecular biology. I sure do remember all of that information from the first semester in general biology. I sure do remember how to do some molar mass calculations almost a decade later. I sure do remember all of those 20+ reactions in organic chemistry.

    The real problem is that employers are forcing everyone to already have the skill before applying to the job. I NEVER see a job posting anymore for “on the job training.” When I graduated high school a decade ago, I would always see employers will to train a hard worker……….not anymore. Now employers are looking for certificats in this and that and this and that.

    Our work force has become so specialized that the way only way to get a new job is to do the same job that you do now because that is the only job you qualify for.

  9. Good to have you back…I stumbled over from Whitecoat.

    No other blog really appeals to that dark, intellectual and jaded little voice in the back of my head…

  10. “Workers 18 and over sporting bachelors degrees earn an average of $51,206 a year, while those with a high school diploma earn $27,915. But wait, there’s more. Workers with an advanced degree make an average of $74,602, and those without a high school diploma average $18,734”

  11. I am a Registered Nurse. In my thirteen years of being a nurse I have seen a guy in his nineties trying to recover from a TURP. I have seen people die. I have felt at times I have actually hastened death. I have dealt with patients who believe that I am their maid, chef, caretaker, and errand boy. I have dealt with families who are so deep in denial neither Stanley nor Livingston have a snowball’s chance in hell of leading them out of their refusal to see and to think of the best interest of their loved one. I have advocated for patients so often and so forcefully that it has led me to being fired. An overheard joke between a friend and myself got me fired. A change in ownership got me fired. I have a permanent pain in my back due to the kind of work I chose to do. I have to take morphine everyday just to function at a somewhat normal level of ability. I am treated like an addict, having once been required to go in to my doctor to watch a video on the new behavior contract that all opioid users must abide by, or the insurer will refuse to fill my prescription. I have to bring in my morphine pills every time I come in to see my doctor so that they can make sure I am not abusing this drug. I have given up one marriage, and my health to work hard for my patients, to see that they can at least get adequate care. I have been accused of trying to kill a patient because I entered her room in the middle of the night to check her Huber needle site. I was accused of abuse because I picked up a combative dementia patient and carried her to a stretcher because the EMT’s and the Police Officer in the facility refused to take the dementia patient to the hospital. The state investigated me and about two years of employment was lost as I fought the preliminary finding of abuse, and won. The state appealed, and I won again.
    I say all this to say this: I do not think that all of this effort amounted to anything. I am broke, unemployed, and am seriously considering leaving nursing. I am 48 and I have no prospects for any job in nursing, and I am not really qualified to do much else.
    I would say, if I were asked, that nursing is a minefield and not worth what it will require from you. If firemen can receive pensions for getting hurt on their jobs, and policemen can get pensions because they get hurt on their jobs, why can’t doctors and nurses be treated the same way? When I was in nursing school I wondered why most of the veteran nurses I spoke with were looking to leave nursing, some fifteen years ago, or more, I could only get at most a sad smile and the tired bromide “Nurse’s eat their young” Now I know that this is not literally true, but it is a profession that can grind your soul into dust. Just as with doctors, nurses are not blind to the sheer futility of some of the things we are asked to do, we see the waste, we see the doctors who want to run up the bill to the maximum, only to find, miracle of miracles, the patient is good to go home, not because that is the truth, it is just that the money has run out.
    Single payer, socialized medicine, Obamacare, whatever it is called today, none of it is going to help this system we have until we recognize what we all KNOW to be true, it is the system itself that is the problem. Nothing can be done to “fix” it. “It” is the cause of these problems.

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