I’ve always begun class with a question on the board to be answered by the individuals of the class. Sometimes the question is fact based and requires memory, other times the question requires thought. I like to make the kids think as appose to calculate the odds. When it comes to their choices many times they make bets (like gamblers at a horse race). Can I get away with this, will it be worth the effort, can I manage the negative outcome? I like to give kids the opportunity to consider why stuff happens. Kids live life now which scares their future oriented parents to death because parents know life is understood backward. This is a question pertaining to looking back and understanding why people did what they did. Human nature doesn’t change and the reasons why people do or don’t do something doesn’t change either.
1. Read the paragraphs about two life changing medical technologies that developed during the 1800’s. One was anesthesia and the other was antisepsis (sterilizing equipment and washing hands). One was quickly adopted the other was not. Use your imagination, place yourself in the 1800’s and think of a reason or reasons why anesthesia was quickly adopted and antisepsis was not.
“In a recent episode of the podcast Freakonomics, Dr. Atul Gawande contrasted the adoption rate in the 1800s of two new technologies: anesthesia and antisepsis. An anesthetic gas, which could be used in surgery, was discovered and first used in Boston, and “…within two months of publishing the result that a gas could render people insensible to pain, it was being used in every capital in Europe. There’s no internet. You had to send news by boat and horse. And within two months people were using it in the capitals of Europe, and by six years later there wasn’t a hospital in the country that was not delivering anesthesia care.”
Compared to anesthesia, the adoption of antisepsis was very slow, even though sterilizing equipment and washing hands could cut the rate of infection by up to eighty percent. Since infections were often fatal, an eighty percent reduction meant a huge savings of lives. And yet, according to Dr. Gawande, “a generation later, you still haven’t gotten to half of the profession doing it.””1
Teacher: a helpful hint —- Ask the students to THINK in terms of What’s in it for Me (the doctor?) Use a table and ask the students to work thru the concept of What’s in it for me (doctor)? What we want them to learn is our behavior is shaped by “What’s in it for me“? Worth it to me is a huge incentive. It’s what gives someone a purpose in life. Purpose is what motivates someone to put down the gaming device, get off the couch and DO SOMETHING fulfilling. In the case of antisepsis, decades went by where doctors wore filthy surgical clothing, in dirty operating rooms until doctors changed how they thought about their role as a surgeon. They began to think like laboratory scientists. Their operating rooms became as sterile as a bacterial laboratory, the doctors wore sterile gloves, gowns, hats, made to prevent germs. Doctors upgraded antiseptic standards because it became worth it to them. Change happens when the effort required becomes Worth it–in terms of Prestige, Money, Status, Respect, Appreciation, Success.
What are the Key Differences in change??
2. Let’s apply the concept of What’s in it for me? to our students. (WORTH IT FOR ME is an important calculation. It’s the difference between doing school and not doing school, doing drugs and not doing drugs yada, yada, yada)
Ask each student to write a paragraph stating What’s worth it to me? What would be the incentive to exchange the Iphone, the ipod, put the ipad down, stop texting, get off Facebook, Instagram, and have real relationships with real people in real time.
You know your students, feel free to write other questions.
Teacher Background Information: “The difference in the adoption rates of the two new technologies was caused by the fact that anesthesia helped the doctors as much as it helped the patients: “Surgeons don’t like having a screaming patient on the table. They had to do their operations in 60 to 120 seconds because you just didn’t have that much time when the orderly is holding people down. And having a patient asleep meant you could be meticulous — you were so much happier as a surgeon. And so this was a win-win for both.” By contrast, antiseptic protocols didn’t do anything for the doctors, and so they had no incentive to use them.”1 see below for more details
“Lister had read about the city of Carlisle’s success in using a small amount of carbolic acid to eliminate the odor of sewage, and reasoned that it was destroying germs. Maybe it could do the same in surgery.
During the next few years, he perfected ways to use carbolic acid for cleansing hands and wounds and destroying any germs that might enter the operating field. The result was strikingly lower rates of sepsis and death. You would have thought that, when he published his observations in a groundbreaking series of reports in The Lancet, in 1867, his antiseptic method would have spread as rapidly as anesthesia.
Far from it. The surgeon J. M. T. Finney recalled that, when he was a trainee at Massachusetts General Hospital two decades later, hand washing was still perfunctory. Surgeons soaked their instruments in carbolic acid, but they continued to operate in black frock coats stiffened with the blood and viscera of previous operations—the badge of a busy practice. Instead of using fresh gauze as sponges, they reused sea sponges without sterilizing them. It was a generation before Lister’s recommendations became routine and the next steps were taken toward the modern standard of asepsis—that is, entirely excluding germs from the surgical field, using heat-sterilized instruments and surgical teams clad in sterile gowns and gloves.” 3
“Giving Lister’s methods “a try” required painstaking attention to detail. Surgeons had to be scrupulous about soaking their hands, their instruments, and even their catgut sutures in antiseptic solution. Lister also set up a device that continuously sprayed a mist of antiseptic over the surgical field.
But anesthesia was no easier. Obtaining ether and constructing the inhaler could be difficult. You had to make sure that the device delivered an adequate dosage, and the mechanism required constant tinkering. Yet most surgeons stuck with it — or else they switched to chloroform, which was found to be an even more powerful anesthetic, but posed its own problems. (An imprecise dosage killed people.) Faced with the complexities, they didn’t give up; instead, they formed an entire new medical specialty — anesthesiology.”3
“So what were the key differences? First, one combatted a visible and immediate problem (pain); the other combatted an invisible problem (germs) whose effects wouldn’t be manifest until well after the operation. Second, although both made life better for patients, only one made life better for doctors. Anesthesia changed surgery from a brutal, time-pressured assault on a shrieking patient to a quiet, considered procedure. Listerism, by contrast, required the operator to work in a shower of carbolic acid. Even low dilutions burned the surgeons’ hands. You can imagine why Lister’s crusade might have been a tough sell.
This has been the pattern of many important but stalled ideas. They attack problems that are big but, to most people, invisible; and making them work can be tedious, if not outright painful.”
The reality of surgery before this idea is so gag-inducing that it seems amazing anybody lived through treatment. Operations were so dangerous to their patients that there were calls to stop performing them entirely, write Dennis Pitt and Jean-Michel Aubin for the Canadian Journal of Surgery.
“Bed linen and laboratory coats were not washed and surgical instruments were only cleaned before they were put away for storage,” they write. “The same probe was used for the wounds of all patients during rounds to look for pockets of undrained pus.” Pus and minor infection was just considered part of normal healing. A future president of the Royal College of Surgeons, J.E. Erichsen, went as far as to say “The abdomen, chest and brain will forever be closed to operations by a wise and humane surgeon.”
Death rates were extremely high, particularly after compound fractures — the kind where the bone pokes through skin. “Because this injury so often resulted in death from infection, most doctors would immediately amputate the injured arm or leg,” Harvard writes. And even that often didn’t work — particularly because reliable anesthetic wasn’t around yet, meaning many people died from pain and shock during and after operations.2
2. https://www.smithsonianmag.com/smart-news/idea-sterilizing-surgical-instruments-only- 150-years-old-180962498/