I went to the doctor for a physical the other day. To be clear, I like my doctor and think that we finally understand each other reasonably well. But as part of the preliminaries, a nurse came into the room and started asking questions.
Nurse: Are you feeling depressed?
Me: No, but if I were, I wouldn't tell YOU.
Nurse: Have you lost anything important to you in the past year?
Me: Well, I mislaid my cell phone for a few minutes, but I found it again.
Nurse: Have you....
Me (interrupting): Look, just take my vitals and let me see the doctor. I came here for a physical, not a mental.
No, that's not what I said. I was meek and compliant, if somewhat confused by her sudden concern for my mental health. I make a point of not antagonizing someone who will later be jabbing a needle into my arm. But it's what I wish I could have said.
I like to think of the doctor-patient relationship as one in which I pay the doctor—with or without an insurance company proxy—to do for me what I cannot do for myself, because of his knowledge (medical school and experience), and his ability to access certain services which I cannot (medical tests, prescription drugs). More and more, however, I find the medical establishment taking on a paternal, authoritarian role, as well as poking and prodding into areas not part of the unspoken contract. For example:
- Psychological questions such as the above. A simple, "Do you have any other concerns?" should cover anything he thinks a physical exam might miss.
- Insisting that adolescent children be examined without a parent present. The only reason they want to do that is to ask the children questions they may not feel comfortable answering, and given the doctor's position of authority and respect, to my mind this borders on abuse. Schools do the same; I'll get to that later.
- Asking a young child if anyone smokes in his house, as happened to my nephew. If the child has any breathing issues, this is a right and proper question to ask, but of the parent. Not of the child.
Doctors, nurses, and other medical personnel: I appreciate your knowledge, your experience, your respectful and friendly manner, and your willingness to work with me for the improvement of my family's health. I hope you appreciate my cooperation, respect, and knowledgeable concern about health matters. But I need a partner in health, not a nosy nanny.
That incident with the medical profession reminded me of my greater concern: education. I won't go into all my experiences with the educational system—as student, parent, aunt, friend, and volunteer—but I long ago came to the conclusion that the school system, especially but not exclusively the public schools, is an even greater nosy nanny than the medical establishment.
Teachers, principals, school psychologists, and others from the educational system: I appreciate your skills, your experience, and your often genuine concern for my children. I hope you appreciate my respect, volunteerism, and knowledgeable concern for my children's education. But my family needs a partner in education, not a nanny.
- Teach my child important academic subjects. (This includes the arts, in case you think I mean only the 3R's.)
- Do not ask about his private life or the lives of his family members.
- Do not give him psychological or medical exams.
- Do not try to teach him ethics or moral behavior. Teach the rules of proper classroom behavior, by all means, but leave questions like, "When do you think it's okay to lie?" to the family—and to philosophy classes. Demonstrate ethical behavior by your own example, please—but not as part of the curriculum.
- Leave my child's feelings, emotions, and beliefs alone. They are his, and pressure on the part of an authority figure to reveal them is abusive.
- Don't feed my child. I will feed him breakfast and dinner, and send a bag lunch to school with him. It's none of your business whether the bag contains sprouted wheat bread with organic carrots and hummus, or McDonald's drive-thru fare, or a fluffernutter sandwich and Doritos.
- Don't be a babysitter. If my child is not actively learning, send him home. Contrary to what you apparently expect, I do not rejoice when the big yellow bus swallows him up in the morning, nor is my first thought when school vacation approaches, "What am I going to do with him under foot all day?"
If you've made it this far without giving up on me as hopelessly out of sync with modern society, let me assure you that I realize there are many families who welcome the school services I despise, and I can see why the public schools are considered a reasonable venue for providing them. But if we're going to do that, they really need to be provided on an opt-in, not an opt-out basis, just as you should be able to choose to receive special offers (known to many of us as junk mail) when you sign up for something, but the default situation avoids them.
By all means, offer before-school breakfast to students who need it, but don't make my child sit on the bus while waiting for the classroom doors to open. Stop using incentives and pressure to try to attain 100% participation in your school lunch program. Let an optometrist come in to the school and offer free eye exams, but get parental permission first. (I mean real, specific, informed permission, not a general release signed at the beginning of the year and without which the child can't attend school!) Make it very clear to the children that they do not have to answer questions that make them feel uncomfortable (math problems excepted); better yet, don't ask such questions in the first place. Provide counselling for individuals or groups if the parents assent, but stop the practice of sending whole classrooms to such sessions, especially without parental knowledge and informed consent.
I make it sound as if we had a terrible school experience, and that was not the case. Most teachers and administrators were helpful and respectful, even if they did consider us weird. But it took much more knowledge, time, and attention than most parents are able to give, to craft a school experience remotely serving our family's needs. Even so, a lot slipped through our hands, either because we didn't know what was going on, or because we had to choose our battles.
All too often, "partnership in education/medicine" means that we are supposed to endorse and enforce whatever the teachers/doctors decree. That is no partnership, and it is unacceptable. As long as the medical and educational establishments expect such to be the case, they should not be surprised to find people—and mostly bright, thoughtful folks they should want to be part of the mainstream—turning more and more to alternatives.
Since money changes hands in the transaction, it's tempting to consider doctors and teachers as our servants, and I'm sure their specialized training tempts them to view themselves as our masters. In the long run, however, a good, working partnership can achieve much more.