No sooner had I finished typing the title to this piece when a colleague dropped by my office to inform me that said professor who was in town was a certain place on campus if I wanted to try to find him and talk to him. “Umm, ok, does he want to see me right now?” I asked. “I don’t know” was the reply. So I was like, hmm, ok, well if he wants to see me, great. But I’m not gonna get all packed up and lug all my stuff over there just to say hi and be in the way of whatever he’s doing – thats weird. I have nowhere to lock my stuff, so I would have to pack up my laptop and everything I'm working on to run across campus. I did end up meeting later in the day with said prof and it was great. He's an outstanding physician-researcher, and much was accomplished. We spoke of projects, current work, future work, and different problems going on right now. But for some reason I have gotten the general feeling from others lately that we should be running around kissing ass and doing what we’re told. But I don’t get it.
Perhaps medicine isn’t for me cause I don’t give much of a shit what people think. In fact, I would HATE to have students under me who were kissing my ass, looking to me for the answers and not thinking for themselves. I want students under me who think of themselves as scientists, and logically go about making decisions. I need students around/under me who are creative and logical. Don’t get me wrong here – if there is a professional project we are working on and someone has advice as to what needs to be done/what can be done better because they’ve done it before, etc, I’m all ears. But this idea that I’m going to run around looking for you to shake your hand or beg for you to tell me what to do next…gimme a break here.
Of course this particular situation means nothing; it’s the hierarchical attitude in medicine that worries me. The attitude that careers are what matter, that the science and medicine are second to recognition, prestige, and glory. (And of course, that’s all a distant second to doing what you are told.) What’s important is that at some point in your career someone calls you a “medicine rock star” and you are recognized with a ceremony (waste of time) where you stand up to accept an award and acknowledge how smart you are. Perhaps this is me railing against capitalism, a futile pursuit. But maybe not. At Auburn I worked with someone who loved the science and was curious about the questions, and curious about the answers. I worked with a real scientist. We thought of how interesting it would be to discover, to solve a problem, to push science ahead one small step at a time. If career recognition was discussed, it wasn't with much interest. With Cornell I have met many of those special types of people as faculty members and colleagues. Yet something about the medical system itself seems to encourage this hierarchical, non-dissenting atmosphere.
In the college classroom, I always told my students to argue with me. If you think a question on your exam was poorly worded or I was wrong, please argue. You can’t offend me. You can’t hurt my feelings. Is there anything more impersonal than good science? What good is a test question if I can’t adequately defend it as a teacher? What good is it if I can’t critically examine the task at hand, and admit if I were wrong?
In Sinclair Lewis’s “Arrowsmith”, many times the theme is played out that nothing is quite as pure as the love of science, of discovery, of pursuit of truth. I think there is nothing worse than a student who doesn’t dissent, who won’t dig in his/her heels on a well-thought out point. Then, if they are wrong, they remember why they are wrong. If they are right, they understand what it means to be a scientist, to logically follow a pattern of thought, to gather previous evidence, to gather your own data to test what appears to be happening, and then to draw conclusions about natural phenomena. Don’t look around at people with more age or more degrees; rather THINK for yourself, learn the process. And THEN ask those with more fancy ivy-league degrees and important titles. THEN ask them, once you’ve made some conclusions. Then, and only then, when you defend your answers when right, understand thoroughly where you’ve erred, and have a whole list of ideas to test next; then you shall call yourself a scientist. A degree is nice – it recognizes that someone else thought you were a scientist. But you may or may not be. Many a great scientist had no formal title; many people with formal titles, and fancy ones at that, never will learn to be scientists.
In "Arrowsmith", Martin (a physician-scientist), recalls:
"He preached to himself, as Max Gottlieb had once preached to him, the loyalty of dissent, the faith of being very doubtful, the gospel of not bawling gospels, the wisdom of admitting the probable ignorance of one's self and of everybody else, and the energetic acceleration of a Movement for going very slow." Chapter 21, II, p. 219.
Later, Max Gottlieb (a science mentor to Martin) espouses:
"'I make many mistakes. But there is one thing I keep always pure: the religion of a scientist. The normal man, he does not care much what he does except that he should eat and sleep and make love. But the scientist is intensely religious — he is so religious that he will not accept quarter-truths, because they are an insult to his faith. He hates the preachers, who talk their fables, but he is not too kindly to the anthropologists and historians who can only make guesses, yet they have the nerve to call themselves scientists! Oh, yes, he is a man that all nice good-natured people should naturally hate! He speaks no meaner of the ridiculous faith-healers and chiropractors than he does of the doctors that want to snatch our science before it is tested and rush around hoping they heal people, and spoiling all the clues with their footsteps; and worse than the imbeciles who have not even heard of science, he hates pseudo-scientists; and worse than those comic dream-scientists he hates the men that are allowed in a clean kingdom like biology but know only one text-book and how to lecture to nincompoops. He is the only real revolutionary, the authentic scientist, because he alone knows how little he knows.'" (Gottlieb) Chapter 26, I, pp. 267-268.
A good scientist knows that things should be questioned; he/she is entrenched in the skeptic's thought process that demands evidence for statements that otherwise seem innocuous. A good scientist knows the value of dissent.
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