On Teach­ing

by Stan­ley Falkow

A grad­u­ate stu­dent came to my of­fice re­cently to say that she was in­creas­ingly both­ered by anx­i­ety and the 'ter­ror' of hav­ing to speak at lab­o­ra­tory meet­ings. She had also learned a month ago that she was ex­pected to lec­ture to a class or­ga­nized by her men­tor. The thought of hav­ing to lec­ture to 20 or so com­plete strangers had now led to sleep­less nights and she was phys­i­cally ill as well as men­tally dis­tressed. She had been told that all of this could be 'fixed' by a small dose of a beta-blocker or an anti-anx­i­ety drug like Ati­van. She had tried this but it did not help her enough and she was now seek­ing my coun­sel be­cause she had been told that I had writ­ten that I suf­fered from sim­i­lar symp­toms when I was a young sci­en­tist. Did I have a se­cret I could share? She con­fided in me that she was con­sid­er­ing giv­ing up her life long dream to be­come a 'col­lege pro­fes­sor'. I gave her sev­eral pieces of ad­vice and told her how I was first able to get some re­lief af­ter my first at­tempt to lec­ture to med­ical stu­dents in 1966. It oc­curs to me that this stu­dent may not be alone and I have heard from a num­ber of peo­ple that read­ing my 'con­fes­sion' that I had suf­fered from panic at­tacks early in my ca­reer had been help­ful to them. So per­haps the read­ers of my fa­vorite blog might find it help­ful as well.

Fig. 1. Trou­ble jump­ing in? Source

I had lived with anx­i­ety and ac­tual panic at­tacks, as well as the con­stant fear of hav­ing them for over 10 years be­fore I was asked to de­liver a se­ries of lec­tures across town from my job at Wal­ter Reed to the sopho­more med­ical class at George­town Uni­ver­sity. I had not yet es­tab­lished a truce with the demons liv­ing in my thoughts. Yet, when­ever I was faced with a de­ci­sion to do some­thing I feared, like ac­cept an in­vi­ta­tion to speak at a meet­ing or, as in this case, teach in front of an au­di­ence of 150 stu­dents, sit­u­a­tions that were ter­ri­fy­ing on the one hand but res­onated with my am­bi­tion or sci­en­tific ca­reer, my first re­sponse was to say "Yes, I'll do it.!" In­deed, I Wanted to do it!! How­ever, once alone with no de­fense against my self-gen­er­ated fears, I would be­gin to plot how to avoid what I had agreed to do. This had be­come my MO for deal­ing with sci­en­tific meet­ings. I would ac­cept and then the day be­fore, I'd call and can­cel be­cause I was 'sick' or gave some fab­ri­cated other ex­cuse. But in this case, by ac­cept­ing the in­vi­ta­tion to teach at a lo­cal uni­ver­sity, I un­der­stood that if I agreed, there would be no escape—nor did I want to es­cape. There was part of me that des­per­ately wanted to 'be on stage' and to take on the role of a teacher.

Those first lec­tures at George­town took place in the fall of 1966. I was ab­solutely ter­ri­fied as I stood be­fore the class. True I had given a few re­search sem­i­nars be­fore, but these were di­rected to small groups of peo­ple who by and large knew the ba­sic sub­ject mat­ter. Not that I wasn't fright­ened when I gave re­search sem­i­nars. But, here in the class­room set­ting the ter­ror I ex­pe­ri­enced was more global and more 'dan­ger­ous' since I felt more ex­posed. As I be­gan to lec­ture, I was sweat­ing pro­fusely, and my heart was pound­ing in my ears. I felt so light-headed that I thought I would, at any sec­ond, pass out. I was look­ing for some­thing to hold on to steady my­self. There was a podium but it was awk­wardly placed to one side of the stage. So I stood on a stage in front of ris­ing rows of seats oc­cu­pied by a group of peo­ple not that much older than me who were by now look­ing quizzi­cally at me and then one an­other. The fac­ulty of the De­part­ment of Mi­cro­bi­ol­ogy, led by Arthur Saz, were in the front row all wait­ing to see what I could or couldn't do. Med­ical stu­dents of that era were in class for hours at a time re­ceiv­ing de­tailed lec­tures il­lus­trated by glass lantern slides one af­ter an­other on sub­ject mat­ter that ranged from the dull to in­ter­est­ing to the ex­cit­ing and even ex­ul­tant. Which was I to be?

I be­gan the lec­ture in a hes­i­tat­ing, ner­vous, much too low voice. "Speak up" one of the stu­dents yelled, "We can't hear you from up here".

I spoke louder but in a chok­ing tremu­lous voice. "I want to dis­cuss with you over the next sev­eral hours the bi­ol­ogy, the epi­demi­ol­ogy and the na­ture of in­fec­tion caused by bac­te­ria that can in­fect the hu­man in­testi­nal tract".

I was cer­tain that in any sec­ond I was go­ing to faint from fright. I looked around for some­thing to steady my­self. There in the cor­ner of the stage was an old wooden stool, the kind of fur­ni­ture that one still sees in a bar or in school lab­o­ra­tory class­rooms. I walked over to this wooden seat that was to be my haven of sta­bil­ity. I picked it up and car­ried it de­lib­er­ately to the cen­ter of the stage and put it forcibly down. I then sat on it and faced the au­di­ence. I had not said a word since my fal­ter­ing open­ing sen­tence. The au­di­ence was fol­low­ing my ac­tions in­tently.

I con­tin­ued, "When deal­ing with po­ten­tial gas­troin­testi­nal in­fec­tion, one of the first things that a physi­cian wants to know about is the patient's stool!"

I swear to you that I had not in­tended the use of the word stool as a pa­tient spec­i­men to co­in­cide with my suc­cess­ful search for some­thing to sit upon that hap­pened to be, well, a stool. The au­di­ence thought this was an in­tended play on words. They be­gan to laugh. I looked at them. I was puz­zled. I was even more hor­ri­fied! What had I done?

"What's wrong?" I asked with a puz­zled look on my face. They laughed louder at my feigned in­no­cence. Faced with this laugh­ter di­rected at me, I did what any man would do un­der the cir­cum­stances; I checked my fly to see if it was un­zipped! Al­though I tried to do this dis­cretely, all men will agree, it never is dis­crete enough. It did not es­cape the no­tice of the au­di­ence. Some peo­ple were now laugh­ing re­ally loudly. For­tu­nately, I sud­denly re­al­ized what had hap­pened and I smiled at them sheep­ishly with ob­vi­ous re­lief. They laughed louder.

These un­in­tended play on words that led to laugh­ter re­laxed the au­di­ence and me. I had never felt quite so at ease be­fore in a lec­ture. So I be­gan to de­lib­er­ately look for hu­mor to in­tro­duce into my lec­tures. When I told them about Shigella and dysen­tery I told them about my en­counter with the mon­key who had pelted me with fe­ces. I ex­ag­ger­ated, I mimed. I played my own straight man and, rel­a­tively speak­ing, I re­laxed. The lec­tures were a suc­cess. I had found by ac­ci­dent a means to re­lax while speak­ing in a group. I learned that the key to us­ing hu­mor in my lec­tures, at least for me, was to make my­self the butt of the hu­mor, never oth­ers. Since my sub­ject mat­ter was scat­o­log­i­cal, it was not dif­fi­cult to get them to laugh. Shit is of­ten funny.

I told the stu­dent who had sought my coun­sel that I did not sug­gest she be­come a stand-up comic. Rather I sug­gested she try to find some­thing in her lec­ture ma­te­r­ial that she felt most com­fort­able talk­ing with oth­ers about and to make it her ini­tial fo­cus. "Don't", I said, "try to daz­zle them with data and your in-depth knowl­edge of the minu­tia of the sub­ject." "Rather", I ad­vised, "Talk to them as if you were ex­plain­ing the ma­te­r­ial to your Mother or, even bet­ter, your Grand­mother. It is what I try to do whether I teach, or give a sci­en­tific talk. I think it will re­lax you too."

Fi­nally, I told her that I was not cured by this ex­pe­ri­ence but it did pro­vide me with a tool that got me through a tough time. I found, as well, that some­thing that I had kept as a deep and dark se­cret about what I per­ceived was a fa­tal weak­ness in my char­ac­ter was not viewed that way by most peo­ple. I told her about the demons in my thoughts. Rather, they al­ways would re­as­sure me and try to help. Lit­tle by lit­tle I got bet­ter. And, be­sides, she had taken the first step by ad­mit­ting to oth­ers what fright­ened her.

By the way, the demons in my mind still re-visit now and again but I just tell them a bad joke and they give up and go away.

Stan­ley Falkow is the Robert W. and Vi­vian K. Cahill Pro­fes­sor Emer­i­tus of Mi­cro­bi­ol­ogy and Im­munol­ogy and Med­i­cine in the De­part­ment of Mi­cro­bi­ol­ogy and Im­munol­ogy at Stan­ford Uni­ver­sity.