Letter From The Berkshires
October, 2011
© 2011 Joel

Note: I was happy to receive your responses to “What’s Wrawng With You (September, 2011), an essay long overdue. My comments in this edition on Over-Diagnosed: Making People Sick In The Pursuit Of Health may be my most important contribution ever to the welfare of my readers. I urge you not to miss it.

Get Dressed!

Those who haven’t grasped that two fables, The Blind Man and the Elephant and The Emperor’s New Clothes, underlie much of what I think and write need to have their eyes examined and get dressed quickly. To these please add the 1940s kid’s book Monkey Do.

Quotes of the Issue

Whether the universe is composed of an infinite number of blind atoms or one all-seeing nature, two things are clear. First, I am a part of the universe governed by nature, and second I am related in some way to the other parts like myself. Because I am related to the other parts like myself, I will not seek my own advantage at their expense, but I will study to know what is in our common good and bend every effort to advance that good and dissuade others from acting against it. If I am successful in this, my life is bound to flow smoothly, as one would expect for the dutiful citizen who is always looking out for others.”–Marcus Aurellius. (I know of an extraordinarily wealthy family whose children spend their vacations at the school they’ve established in Rwanda. They may not know the quote above; they live it.)

Remember when teachers, public employees, Planned Parenthood, NPR and PBS crashed the stock market, wiped out half of our 401Ks, took trillions in taxpayer funded bailouts, spilled oil in the Gulf of Mexico, gave themselves billions in bonuses, and paid no taxes? Yeah, me neither...”– MoveON

“Americans can be sold on anything.”–A Polish friend

Troy Davis

Unitarian minister Galen Guengerich stressed, in his sermon on September 25, 2011, that “Troy Davis is dead because he was not wealthy and white, like Dominique Strauss-Kahn. I’m not saying that Davis was innocent or that DKS was guilty,” the minister continues. “But enough evidence suggests that DSK might have committed a crime and that Troy Davis might not have that the disparity in outcome looks to me like a travesty of justice.”

We quickly dismiss the testimony of a hotel maid, yet as quickly reject the recanting of seven of the Troy Davis witnesses, on whose testimony he was put to death. Davis was not found guilty beyond a shadow of a doubt, this from one who is not yet unalterably opposed to capital punishment.

In a related case, execution was probably too kind for russell brewer, the man responsible for dragging African American James Byrd Jr. to death in 1998. Byrd’s family pleaded to commute brewer’s sentence to life in prison on grounds of mercy. I’m not as kind. I favored exile on a desert island, where the murderer could stew in his unrepentant hatred and ponder all he’d lost. The father of the Norwegian that murdered all those youngsters in July would rather his son have committed suicide, another good idea. Unlike Troy Davis, however, these men were clearly guilty.

Obama Update

Americans voted for Barack Obama because he was smart and idealistic, spoke with passion, wrote beautifully, wasn’t George W. Bush and was a black American- not necessarily in that order. Supporters who bought his lofty rhetoric are now sorely disappointed. Some campaign promises are no longer mentioned, much less fulfilled. Where’s the hope and where’s the change? In a tribute to Steve Jobs titled “Where have you gone, Joe DiMaggio?” Thomas Friedman wrote “the paucity of Obama's audacity is striking." My biggest beef with the president is that, of all things, he’s a disappointing speaker. Slogans and performance values worked in 2008, but Obama is running for more than cheerleader, and his current numbers don’t look good.

Raising taxes on “millionaires” is a stupid, nonproductive slogan, considering the intent is to raise taxes on Americans earning a million dollars a year or more. A millionaire is one who has a net worth of at least a million dollars, as in some who read this letter. “Every American his fair share” suits me better.

Really Rich

October 9th I had the pleasure of attending a talk by former New York Times drama critic and current writer for New York Magazine Frank Rich, sponsored by the Berkshire Theater Group. (Rich is also producing a Home Box Office sit com about the first woman vice-president, with no political ax to grind.)

When asked why Americans aren’t more up in arms about gridlock and the economy, Occupy Wall Street notwithstanding, Rich answered Americans are too depressed to fight. Yes, almost everyone feels a sense of powerlessness and overburdened. I believe, however, that Americans are too busy soothing themselves with TV shows, celebrity culture and minor creature comforts to even think of how to fight. In plain English, we’ve been bought.

On other points I heartily agree with Rich. It’s going to take a disaster the magnitude of the market collapse of 2008 or another 9/11 to bring us all together. More important, as Rich echoes Thomas Friedman, we need a political equivalent of the late Steve Jobs, by which he means a leader of extraordinary vision. When asked if any political figure he knows of fits that bill Frank Rich was flummoxed. He couldn’t name a single Republican or Democrat, nor can I.

British economist Martin Wolf told Fareed Zakaria on GPS, October 9th, that he can’t believe that anyone in our government wants further economic decline. I disagree entirely. Tea Party inspired Republicans are committed to taking out Obama and the Democrats in 2012 in part because of ideology, in part because they champion those who see to it they never lose. One wonders what kind of America the rich and powerful are willing to tolerate or wish for. Has “private vice is public virtue” become private vice is private vice?

Impatients

Over-Diagnosed: Making People Sick In The Pursuit Of Health by H. Gilbert Welch, M.D. et al Beacon Press, 2011.

Ever wonder why doctors call us patients? The original meaning of patient is “one who is injured or suffers in another way.” Please keep that in mind as you read this and the next time you’re at the doc’s.

The UC Berkeley Wellness Letter reports that half of all Americans take prescription medications. More than one in three seniors take at least five medications, most commonly to lower cholesterol and blood pressure; nearly half of twenty to fifty year olds take more medication than ever, too (mostly for depression). One in five children under age twelve regularly take at least one prescription drug, as do thirty percent of teenagers. “That’s a lot of medication,” the report concludes, “and many people are undoubtedly taking drugs they don’t really need. The more drugs people take, the more they’re likely to experience side effects.”

Amen, would say the author and physician H. Gilbert Welch, who claims that over-diagnosis occurs “when individuals are diagnosed with conditions that will never cause symptoms or death,” and that “excessive diagnosis can literally make you feel sick.” His volume Over-Diagnosed: Making People Sick In the Pursuit of Health is courageous and long, long overdue. If you read one book in the next ten years, please readers, pick this one,

Dr. Welch takes disease as seriously as any competent physician. His targets are mindless screening tests and procedures, such as those which have lately been in the news, not genuine efforts to cure disease. “An over-diagnosed patient can only be harmed,” he maintains, “and the simple truth is that almost all treatments have the potential to do some harm.”

That we are becoming a nation of hypochondriacs is undeniable. When public personalities like Steve Jobs die we’re treated to endless coverage about the specifics of what brought them down. Read Welch and you’ll discover the source of this obsession. Chapter Two is subtitled, “How Numbers Get Changed to Give You Diabetes, High Cholesterol and Osteoporosis.” How’s that for provocative? Welch reports that “cutoffs are set by expert panels of physicians.... (concerned with) value judgments and even financial interests.” Remember when a cholesterol reading of under 240 was normal? “All of a sudden the threshold for abnormal cholesterol fell.... to greater than 200 and created forty-two million cases of high cholesterol on the spot.” And in the case of individuals with “prehypertension,” eighteen million cases is the number.

Unsurprisingly, the experts who came to these conclusions “were paid consultants to companies making cholesterol drugs.” Additionally, “the head of the diabetes cutoff panel was a paid consultant to eight of the leading drug manufacturers...(and) nine of the eleven authors of recent high blood pressure guidelines had some sort of financial ties...to companies that make high blood pressure drugs.” Anyone who has anxiously awaited medical test results or is taking prescription medication for a newly discovered “condition” has reason for concern. I can hardly wait to hear the screams from the medical industry and associated stooges against what Welch has written.

New technologies can lead to unnecessary and unwanted findings. “Even a simple x-ray can see too much,” writes Welch. “Even if you feel fine, these scans can find a lot wrong with you. But these abnormalities rarely go on to cause problems later.” Prostate cancer screening gets a licking, too. Welch contends that “the fastest way to get prostate cancer is to be screened for it.” Only 3% of men are at risk of dying from that disease.

Welch is unafraid of controversy. Regarding cancer, he contends that “some cancers don’t progress at all. Some cancers will never make a difference to patients. Nonprogressive cancer never causes problems because it is not growing at all.” Welch doesn’t deny that certain cancers kill and must be treated. He questions whether doctors “should be looking for these cancers when you are well.”

What will dermatologists make of Welch’s allegation that “non-melanoma skin cancers almost never metastasize and almost never cause death: some doctors even wonder why they should be called cancer at all.” As for colon cancer screening, “Almost one in three adults have polyps. This is far more than will ever develop colon cancer. Colon cancer screening does lead to a tremendous amount of people having polyps removed.”

Undoubtedly you’ve heard of “spots” on livers, lungs and kidneys. “Such nodules could plausibly be cancer. But they almost never are.” One could argue that if patients kept all these facts in mind they’d be far less anxious about a cancer diagnosis. “The truth is that it is very hard to ignore something once it has been found- even if ignoring it is the right thing to do... It’s a lot easier not to do the test in the first place.”

I love what Welch writes about pregnant women. “Pregnancy is not a disease, but increasingly doctors are treating it like one.” I’ll let you read more about that on your own. As for genetic testing, “a diagnosis that suggests you are at risk for particular diseases has serious consequences. It gets everyone...worrying about the bad thins that are just waiting to happen.” I know how doctors use the power of patient worry to their advantage. Re-read the story of my HIV tests in Growing Up Gay.

How refreshing to hear a doctor make some common sense! “A person whose life was apparently saved by screening might not have needed treatment in the first place, and a person who apparently died because he or she failed to get screened might have had an aggressive, untreatable cancer that couldn’t have been detected early or wouldn’t have responded to treatment if it had been.” We need to screen the studies themselves for data about “how much the absolute risk of death was changed by early detection...what people were put through to achieve this benefit, how they got tested, how many got false alarms, how many were over-diagnosed and how many were harmed by unneeded treatment.”

Some doctors profit handsomely from over-diagnosing, while others fear law suits for good reason. Many physicians genuinely believe that screening for early detection benefits their patients. Welch takes aim at “an entire medical-industrial complex that includes Pharma but also manufacturers of medical devices and diagnostic technologies, freestanding diagnostic centers, surgical centers, hospitals and even academic medical centers.”

It takes a strong, determined patient to stand up to such an army. The “medical industrial complex “ has human behavior on its side. Welch writes of the “intolerance of uncertainty,” which, along with anxiety, is actually abetted by excessive diagnostic testing. Patients run the risk of lapsing into “catastrophic thinking.” None of this makes the evening news or is reported on by Dr. Sanjay Gupta, “but people do get hurt (by diagnosis) all the time. Some of the harms are minimal, but some are quite severe.”

I know people who have suffered needlessly and mightily for no good reason on this account. “Being given the label of a diagnosis can make a person feel more vulnerable. It makes him think something is wrong, something he needs to worry about. This induced vulnerability undermines the sense of well being and resilience that in many cases defines health itself.” Repeating that sentence verbatim ought to be a medical school requirement.

Serious abnormalities, Welch reiterates, and so do I, must be treated, “but the best strategies for the mild ones may be to leave well enough alone, in fact it may be better not to look for them in the first place.” This is revolutionary stuff. Try selling it to most physicians, much less the worried well.

“The public has been primed for this response, having been bombarded with messages about the value of getting tested from doctors, public health officials, the media, and maybe even their own mothers. People have not been encouraged to approach these messages critically, nor have they have been taught how to judge whether the messages reflect solid science or are really just propaganda.... And it doesn’t just affect the individuals tested, but those who hear their stories as well, including friends, family members and acquaintances.”

Welch gives us much to ponder. “The presence or absence of symptoms is a critical distinction in assessing the importance of an abnormality, because symptoms are one of the best predictors of serious problems.” He becomes concerned “when diagnoses are made in the absence of symptoms because “abnormalities or diseases diagnosed that early are not reliably destined ever to cause symptoms.”

How we proceed as patients, or as friends and kin of patients, is up to each of us. “Some may prefer to pursue health (while maintaining) minimal medical contact while they are well...(while) others may want to pursue disease and avoid death at all costs.”

Welch concludes, “Some would argue that early diagnosis has nothing to do with prevention, since the whole purpose is to find disease, not prevent it.” Also, “Many of us harbor abnormalities that are not destined to produce consequences. So ironically, the fastest way to become sick is to become engaged in this type of preventive care.” Patients should be required to repeat those thoughts verbatim.

Your newsletter writer will do everything he can to promote the ideas in Over-Diagnosed.

G. Calvin Welch practices at a V.A. hospital in Vermont. He frequently speaks about medical screening on network television. He was assisted by Dr. Lisa Schwartz and Dr. Steven Woloshin of the Dartmouth Institute for Health Policy and Clinical Practice.

School Daze V: Who Will Teach Our Kids?

“A lack of commitment to education in families and communities makes the entire field of education seem unattractive, demoralizing dedicated teachers and turning off talented students from teaching.”– Michael Spense, Nobel laureate, in Foreign Affairs, July/August 2011

“The quality of the teacher corps is more crucial to school reform than anything else.”– The New York Times

Note: Of my fifty or so readers, a numerical majority currently teach or have taught school. Among you are a retired principal, a former supervisor of student teachers and two retired college teachers, one of whom still tutors. The rest of you’ve all gone to school.

I’m beginning to think that religion has a place in public education after all. On Sundays Christians ought to kneel, Fridays Muslims bow to Mecca, and Saturdays Jews sit reflectively as they give their thanks to God for those who teach. This series takes the position that teachers are being scapegoated, and that even in the best of times they’ve been under-appreciated and woefully underpaid. In no way does this deny the existence of lousy teachers who ought to lose their jobs, but that’s not all that is going on here.

A Canard Line Cruise We Can’t Afford

A common argument, made recently in a letter to The New York Times, holds that if teachers want lawyer’s pay (which they don’t), let them work lawyer’s hours twelve months of the year. Teachers can only work as many months as schools are open. If we wish to extend the school year we’ll have to ask children, parents- and taxpayers- first. As teachers are paid for ten months work, would not their salaries have to be proportionately increased if schools stayed open in the summer?

The idea that teachers get paid for their summer vacations is simply laughable. Their average national pay of $48,000 for ten months work is paid in twelve installments. A long ago superintendent of the affluent Great Neck, N.Y. schools addressed a class in school administration at N.Y.U. How dare teachers smile as they passed him on the street in summer; they too should be at work. The only way to get rid of him was to kill him, the superintendent added, an intriguing proposition.

Typically, a teacher’s official workday runs from 8:30 a.m. to 3:00 p.m.. Once home, her family and personal needs wait while she corrects papers, plans lessons and rounds up materials. Parent conferences are frequently held before school opens, at lunch time or evenings on the phone. Just maintaining a classroom’s look can take several hours after work. Not infrequently, teachers work from dawn to dusk. They can’t leave the sales floor or close the office doors for even a moment, and they barely have time to use the bathroom. Unlike most actors, teachers must be on stage almost all the time.

Some imagine that college students, career changers and the unemployed are falling all over themselves to teach our children. The unspoken reality is that even among the pool of Americans who may be enticed to enter teaching, I doubt enough possess the skills or personal traits to succeed without unprecedented training and support, In addition to loving kids and learning, an uncommon shrewdness in understanding, motivating, guiding and controlling young people is required. And a teacher’s sensitivity must live within a skin as thick as steel.

Prospective teachers need the stomach to take on a job most people in their right minds wouldn’t even consider. How many potential classroom wizards are willing to work for laughably inadequate pay and often dangerous, disrespectful conditions? (Go inside most inner city schools and look around.) To imagine otherwise is a ticket to frustration. An outstanding first grade teacher I worked with in Manhattan told of the nights she cried herself to sleep, not about the children but about the job. Still think teachers are in this for the time off and the pay?

We’re told that countries with the highest student achievement have the brightest teachers, implying cause and effect between the two. Singaporean, Finnish and South Koran teachers are drawn from the top of their college classes, and those country’s schools are undeniably excellent. The importance of education in those societies, parental expectations, the kinds of baggage children bring or don’t bring, the homogeneity of their cultures, and student seriousness and self control are factors seldom mentioned.

American education benefited, albeit perversely, when the brightest women became schoolmarms because they were excluded from more prestigious businesses and professions, Was their success due to the contents of their craniums more than the variables in the preceding paragraph? And how can we induce them to change jobs and teach a class?

What if America’s teachers suddenly came from the top of the intellectual crop and their unions somehow vanished, yet student achievement barely budged? Would not critics pull a Jackie Gleason “humma, humma, humma?” Perhaps Miss Grump was less scholarly than Ms. 2011 but knew kids better. My mother, a graduate of a two-year program at the Harriet Melissa Mills Training School in New York City, was praised by former students and parents long after she retired. Mother was a model teacher for over thirty years and a teacher born as well as trained. I graduated near the top of my class, yet some former classmates who were mediocre students became far better teachers.

A colleague in our CP unit in Manhattan misspelled so many words that the unit coordinator ran to erase her blackboard when the principal walked by. This woman who worked wonders with disabled children wouldn’t have her job today. And remember my prep school teachers from the beginning of this series? I’d prefer an effective teacher from lower in his graduating class to these intellectually gifted gentlemen any day. The correlation between teacher excellence and their grades in school remains controversial.

If Americans truly value education and are concerned about the quality of teachers, an examination of how classroom practitioners are recruited, trained, evaluated, retained and treated surely follows.

Recruitment

Is the prospect of being prematurely fired from a “failing” school sufficient to motivate a college graduate or career changer to enter teaching? We need replacements for those whom we so enthusiastically fire and those who retire or resign. Should we again desire and prioritize smaller classes, more teachers will be needed still. I, too, would like schools stocked with top notch, well paid, adequately protected teachers. From where are the superior beings coming, our imaginations?

Over twenty years ago, teacher union lion Albert Shanker acknowledged it was “getting more difficult to find teachers of acceptable or high quality, (especially now that) all sorts of other professions have opened up to women.” Whether to first make better teachers, then raise their pay, or go the other way around is a conundrum, although I believe that higher compensation for teachers currently employed is a matter of simple equity, Wisconsin’s Governor Walker please excuse me.

“U.S. Plans to Replace Principals Hits Snag: Who Will Step In?” read a New York Times headline February 8, 2011. Replacing principals of failing schools is the “centerpiece” of the Obama administration’s $4 billion program, yet “there are simply not enough qualified principals-in-waiting to take over,” the article reports. ”The supply of principals capable of doing the work is tiny.” One specialist acknowledges that “these people don’t grow on trees.” Nor, in my opinion, do first rate teachers.

Radical reformers act like they want to abolish the career of teaching altogether. Recruit fresh, motivated talent from the top of college classes for three to five year tours of duty and then replace them. Issues like tenure, seniority and peaking early would then be moot, and we would never have to offer more than entry level compensation .

Some say the benefit of experience levels off somewhere between a teacher’s third and fifth years, although The New York Times reports it takes five to ten years to get up to speed, after which a teacher’s performance levels off. Teach for America’s commitment is a two year minimum, although more of their members are staying on, Their alums can then go on to greener pastures and tell their children about the time they fought the good fight, and, if they’re honest, how difficult teaching really is.

What, then, qualifies a teacher besides an urge to save the world? I would include enjoying the company of children. Knowing how to motivate a variety of growing personalities to learn. High expectations of oneself without perfectionism. Freedom from ethnic group or racial hang-ups. An extraordinary imagination and inventiveness. The ability to deal with pressure from many sides. A stick-to-it ethos that rivals velcro and a spouse who earns much more than yourself. Are people born with these qualities, or can they be made? We had better hope it’s not exclusively the former.

Education Secretary Duncan is engaged in a “national teacher campaign,” whatever that means. His dream is to emulate countries that “don’t allow anyone to teach who doesn’t come from the top third of their graduating class.” Think of the splendid teachers we would eliminate in that bold stroke, like my spelling challenged colleague and my mother. Harvard’s Tony Wagner advocates a “West Point for teachers.... a new National Education Academy modeled after our military academies.” Hup, two.

A novel approach to recruiting teachers is Teach For America (TFA), est. 1990. The New York Times opines that “young college graduates now go into blighted schools to teach in much the same way that an earlier generation went south to march.” Currently, 14,000 academically distinguished college graduates commit to teach for at least two years in economically disadvantaged communities throughout the country. Corps members, as they are called, take relevant courses and attend a five week summer boot camp before they go before the kids. Members receive the same salaries and benefits as their teacher certified peers

TFA’s results are a bit conflicting. Corps members are evaluated principally on their students’ standardized test scores. Studies indicate that TFA member’s students score higher on achievement tests, particularly in science and math, than those of traditional classroom teachers. Some critics claim the test score differentials are statistically insignificant. Increasingly, according to TFA, members stick with teaching after their two year commitment or prepare for school leadership positions.

Despite their can-do spirit, many members have been known to fail conspicuously. Columnist Matthew Miller explains that although even traditionalists understand that “the certification process keeps good people out, what burns them up is (the notion that) any smart person can just walk in and teach.” Again, are teacher made or born? And, are the best teachers necessarily the academically smartest and vice-versa?

While few dispute that improved compensation and working conditions would draw a corps of better teachers, less attention has been paid to the lack of prestige attached to the job. One teacher told a reporter, “Tell someone you’re a teacher...at a cocktail party....and he’s suddenly needed across the room.” South Koreans call their teacher’s “nation builders. Lisa Lauritzen’s magnificent “A Teacher’s Poem,” published in the New York Times in the 1990’s, got it right.

I am a New York City public high school teacher
Do not look surprised.
Do not feel sorry for me
Do not pity me.
Do not offer me your condolences....
Do not ask me when I plan to get a real job,
Apply to law school,
Or what my first career choice was.

An alternative to traditional recruitment methods that was prevalent In my mother’s early days of teaching was called the “casting couch.” Mom knew several women- for all her faults herself excluded- who slept their way into the classrooms of the 1930s. I’m surprised some smart ass innovator hasn’t tried reviving that one.

Teacher Certification and Professional Preparation

What do you have to do to become a teacher? Except for Teach For America and similar outfits, states require teachers to be certified, and most states don’t make getting certified that difficult. Pass the required course of study and student teaching and you’re in.

Before our brave new world of school reform, prospective teachers and principals had to pass tests designed by a Board of Examiners to be employed in New York City. (That system has been long abolished, and the old Board of Education headquarters in Brooklyn is now condominiums.) Applicants were also tested for proficiency in written English and clarity of speech. The latter may have accounted for why my Tuesday principal refused to talk to me. Never will I forget his announcement over the P.A. system one glorious May morning in 1967- “Boice and girlce: spring has sprunk,”- but I digress.

We felt special for having gone through a step beyond being certified by Albany. I found the long multiple choice test in my field somewhat superficial, though. A Masters degree in speech from an accredited university program would have sufficed for basic knowledge. Requiring candidates to diagnose a sampling of speech defects using real children, then explaining how we would treat them, was much more useful.

Controversy swirls around the topic of teacher preparation. Traditionally, graduation from a school of education was the norm. Teachers-in-training majored in their subject or specialty (early childhood education, special ed. etc.). Developmental psychology was required, as were courses in curriculum and teaching methods which were regarded as malarky. Supervised student teaching provided practical experience, although less than the medical school-like internships for teachers in use today.

Schools of education are in disrepute now more than ever. Today’s mantra is “Teaching has no body of knowledge like in medicine or law.” What the devil do they want, good dermatologists? (I wish more docs and lawyers had the personal skills to match their erudition!)) Whether or not teaching is a scholarly pursuit, reaching children is undoubtedly an art. “The excellent teacher is a great artist,” said Albert Shanker. “Greatness implies a certain creativity.”

Teachers colleges may have let us down, but few doubt the necessity of teachers knowing their field and being able to work effectively with children. Supervised hands on experience is a part of every program. Reporter Matthew Miller learned from teachers that “the best training comes when classroom veterans mentor new teachers on the job, especially in urban schools, where the turnover is so high.”

California’s Education Plan recommends that teacher training begin in undergraduate school and that local school districts offer apprenticeships for education majors. Others believe that teacher training needs to be deferred until graduate school, following four years of specialization and the liberal arts.

Five years ago the New York Times asked, “Who Needs Schools of Education?” Teacher training needed to become more focused on- of all things- how to teach. “One of the biggest dangers we face is preparing teachers who know nothing about practice,” former Teachers College, Columbia president Arthur Levine maintains. Education schools at Stanford, the University of Virginia, and little known Emporia State in Kansas, Levine praises, do not subordinate teacher preparation to teaching theory, enhancing their image within academia, or engaging in research.

The New Republic’s Matthew Miller refers to the “profession-versus-craft debate.” Harvard School of Education’s Joseph Featherstone adds, “John Dewey was right in saying....that we were a theory ridden and administrative culture. We don’t value the realm of practice.” Tellingly, a Teaching Company course on tape, The Art of Teaching: Best Practices from a Master Educator,” begins with “How to handle the first day” and not Evolving Blackboard Theory.

Emporia State in Kansas, est. 1863, boasts a teacher education program which is “one of the more rigorous majors” on the campus. The entrance standards are notably high. “Professors...demonstrate in painstaking detail how to teach specific lessons.” Kansas kids rank well above average in national tests. So when we agitate to abolish schools of education, do we mean all of them?

New York State’s new Relay Graduate School of Education devotes almost all of its curriculum, if one could call it that, to “hands on teacher preparation.” Relay students attend no lectures because they do not have a campus. Their training takes place in the schools to which they are assigned. They meet regularly, however, to analyze videos of teachers in the classroom and to discuss what “works” and doesn’t.

An associate dean at Teachers College, Columbia believes this narrow form of training “dumbs down teaching.” I was thinking of that very word when I read of Relay. Are teachers so dumb they need such detailed roadmaps? Where is room for spontaneity? A knowledge of development psychology and educational philosophy are indispensable, it sees to me, for those who work with kids. By what standards are teachers to evaluate educational strategies and proposed reforms? Teachers in training need plenty of practice, supervision- and background.

Forty-seven states now offer nontraditional paths to teacher certification, among them Teach for America and New York City Teaching Fellows, which supports teaching as a second career. A Times education reporter charges that “recruits with no experience are given a quick and dirty version of education school- a few weeks of classroom management, learning theory, literacy (the teaching of reading and writing), diversity training- then placed in the classroom, with coaching by mentors.... The advantage is that they teach and study for the degree at the same time.”

What to do with teachers after they’ve been hired will be the subject of the next installment. Teacher support, evaluation, tenure, termination and -gasp!- unions will be among my topics. And I’ll take on teachers who cannot, and therefore should not, teach, and those who stand in the way of their being fired.

Joel: Letters