"May I ask you a ques­tion?"

by Elio

My first lec­ture (in 1958, long ago) was to med­ical stu­dents and the sub­ject was DNA. I felt priv­i­leged to be given the task to talk about this sub­ject, which was born in its mod­ern in­car­na­tion not many years ear­lier. The ex­is­tence of DNA had been known since 1869, thanks to a young Swiss physi­cian, Friedrich Mi­escher. How­ever, for years its role was rel­e­gated to some ob­scure and not very in­ter­est­ing func­tions of the cell. That it is the hered­i­tary ma­te­r­ial had to wait un­til 1944, when Av­ery, McLeod, and Mc­Carty demon­strated that it in­deed car­ries the hered­i­tary in­for­ma­tion. And 9 years later, in 1953, Wat­son and Crick told the world that the DNA mol­e­cule is a du­plex wrapped as the now fa­mous dou­ble he­lix. Soon, this dis­cov­ery made it pos­si­ble to en­vi­sion how DNA is repli­cated, that is, how it makes a new copy every time its cell di­vides, and how the ge­netic in­for­ma­tion it car­ries is ac­tu­ally 'read' by the cell's ma­chin­ery.

Fig­ure 1. Elio circa 1956.

Heady days, those, and lec­tur­ing about the 'Queen of the mol­e­cules' de­served spe­cial re­spect if not ac­tual ven­er­a­tion. So, I pre­pared my­self ac­cord­ingly and spent un­told hours mak­ing sure that I would make it rise to the oc­ca­sion. An aside, to ex­plain the con­text of what this is about.

In the early and mid 50s, the US gov­ern­ment had de­cided to sup­port ba­sic bi­o­log­i­cal and med­ical re­search at a pre­vi­ously un­heard-of level. Grant money be­came avail­able prac­ti­cally for the ask­ing, at least to rea­son­ably qual­i­fied re­searchers. Med­ical schools took ad­van­tage of this bo­nanza. Even the hith­er­tos less promi­nent ones rapidly trans­muted them­selves into re­search in­sti­tu­tions. To staff them, they turned mainly to Ph.D.s, most with lit­tle ex­pe­ri­ence in med­ical ed­u­ca­tion. I sup­pose that in au­gust schools with ex­pe­ri­ence in ed­u­ca­tional mat­ters, the tran­si­tion may have taken place in an or­derly fash­ion. Not so in my own ex­pe­ri­ence. The med­ical school I first joined as young as­sis­tant pro­fes­sor was re­cently founded and al­though its young fac­ulty was made up of quite dis­tin­guished sci­en­tists, we were left pretty much alone in de­vis­ing a cur­ricu­lum. Not sur­pris­ingly, we turned to what we knew and de­cided that a hefty amount of sci­ence couldn't pos­si­bly hurt bud­ding physi­cians and may even do some good. This, in mod­er­a­tion and with rea­son­able aware­ness of how this fits in med­ical ed­u­ca­tion, is a wor­thy goal. But the aim should be for the stu­dents to be mind­ful of the sci­en­tific method, not just be sub­jected to an avalanche of sci­en­tific facts. 'Drink­ing from a fire­hose' it has been called. To il­lus­trate the ab­sur­dity of our ap­proach I need only men­tion that we gave lec­tures on bio­chem­i­cal top­ics that had been cov­ered in the Bio­chem­istry course the pre­vi­ous year, bliss­fully ig­nor­ing what the cur­ricu­lum looked like.

In my lim­ited ex­pe­ri­ence, things got bet­ter in the 60s, a time of so­cial re­newal (re­mem­ber, Flower Power, the Bea­t­les, etc.) that called for ac­count­abil­ity by all, the fac­ulty of med­ical schools in­cluded. By that time, I had changed schools, al­though the old at­ti­tude was about the same in both. But now the stu­dents held rather loud protest meet­ings, ask­ing why they were taught what they are taught. Partly be­cause their protests made sense, and per­haps be­cause it was in keep­ing with the tenor of the times, we lis­tened, more or less re­luc­tantly. A bunch of new cur­ric­ula emerged all over the map. By and large, they not only an­swered the stu­dents' im­me­di­ate con­cerns, but were based on rec­og­niz­able gen­eral prin­ci­ples. Life in med­ical schools be­gan to make more sense for stu­dents and fac­ulty alike.

To come back to my DNA lec­ture, I don't re­mem­ber the de­tails, but that be­ing the mid 50s, I prob­a­bly gave it to 'em with both bar­rels. Surely, such an au­gust topic de­served spe­cial at­ten­tion. Af­ter the lec­ture I took the el­e­va­tor, when a stu­dent leaped in be­fore the door closed and, some­what breath­lessly said: "Doc, can I ask you a ques­tion?" Aha! I said in­wardly, I stim­u­lated one stu­dent at least. "Go ahead," I ut­tered. He said: "Doc, what's good for dan­druff?"

 

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