Thursday, June 7, 2007

Passivity and the parable of the doctor

By Bob Sasseen

I have been concerned about student passivity, which was a much bigger problem than I expected, no doubt in part due to my own limitations. I wrote this parable to explain to the students and others how it hurt their learning and made me feel as a teacher. I told them it mostly wasn't their fault and they shouldn't feel too bad about it, but that if they could work on it, that would help their next teacher and their own learning a lot.

(In the parable, the tests the doctor runs are analogous to the kinds of objective feedback a teacher can get from observing students' speaking and writing, giving exams, etc. That can go far, but it's a lot easier to understand the students' problems if they ask questions when they don't understand, etc. Fortunately, in teaching there's nothing really analogous to the patient dying, but it was useful to dramatize the problem and illustrate how if they can describe their difficulties it will help the teacher help them learn much better.)

The Doctor

Once upon a time there was a doctor from a big city who went to a faraway village. He wanted to help the people there, to cure their illnesses and to improve their health. He set up a small hospital, and soon patients from the village started to arrive.

When the first patient entered his office, the doctor asked, "What are your symptoms?" But to his surprise, the patient said nothing. The doctor thought perhaps the patient didn't understand the question, so he asked "Where does it hurt?" Strangely, the patient still didn't answer. The doctor said, "Please tell me about your sickness." To his astonishment, the patient still refused to speak.

The doctor couldn't see anything wrong with the patient; she wasn't bleeding, limping, holding her head, or showing any other obvious signs of what the problem could be. So he performed some tests. He tested her reflexes, but they were normal. He took her temperature; it was a little bit high, but not a lot. He took a blood sample and analyzed it. There were a few abnormal features, but nothing that clearly indicated what the problem might be. The doctor was extremely frustrated. He felt that if only the patient would talk to him and describe what she was feeling, he could certainly figure out what the illness was and how to cure it. But with only the inconclusive test results to go on, all he could do was give the patient some antibiotic medicine and tell her to come back if the illness got worse.

A second patient came in. This patient didn't say anything either, but the doctor knew she must be ill or she wouldn't have come to see the doctor. Again, he performed some tests, but the results were inconclusive, so he had to make an educated guess about what the problem might be, gave her some medicine, and sent her home.

Almost every patient who came to see him behaved the same way. Sometimes the doctor could figure out the illness from the tests, and sometimes he guessed right, and the patient recovered. Sometimes, even if he couldn't figure out the problem, the patient got better on her own. But often the patient continued to have the same problem, and it often got worse. Some patients even died.

When a patient died, he performed an autopsy, examining the dead body to figure out why the patient died, and he usually found the cause. Then he knew that this patient must have experienced dizziness and headache, while that one must have experienced pain in her chest and ringing in her ears. If only those patients had been willing to tell me what they were feeling, what problems they were having, the doctor thought to himself, it would have been obvious what their illness was, and I could have cured it easily. What a terrible waste.

The doctor was very frustrated and unhappy. He had come to cure people and improve their health, but because of their mysterious refusal to speak, he was able to do little to help them. He tried everything he could think of, but it was no use. The villagers, too, were frustrated and unhappy. They had had such high hopes that the doctor could help them. But they continued to fall ill, and some of them died.

Feeling very sad, the doctor left the village and returned home to the city. Now and then he would think about his experiences in the village, but he never understood why the people there were unable to tell him about their problems.

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