Saturday, May 2, 2015

Benjamin Franklin Would be Appalled

Benjamin Franklin would likely think that Americans today are idiots.  

If we could bring him back from the dead, Franklin might shake his head in dismay and incredulity that many of use misconstrue the words of the Constitution—or, worse, take it as inviolable Gospel.  

Franklin, we know from his own words, would not have wanted his descendants to be so ham-strung and literal minded. Indeed, the primary architect of the United States of America warned against taking the Constitution as the final word when he wrote that the Constitution would need to be revisited and revised (perhaps every 19 years or so).

It seems that many Americans still think that Franklin, like all the Founding Fathers, was prescient, even omniscient. Yes, Franklin was an amazing man, perhaps the ultimate American, with countless, profound achievements to his name. He was the finest American example of a man who pulled himself up by his own boot straps—but God-like? No. Humans are imperfect, and so are the ideas they come up with.

Taking Franklin’s quotations as perfect and perpetually true (even though they have a strong track record of being apt, and Franklin’s aphorisms have long resonated with humanity) is one thing.

Interpreting the Constitution—one of the major founding documents Franklin helped to draft—in a literal way is another. How could we possibly assume that the Constitution must be and will always be a perfect blueprint for every conceivable issue and obstacle America might face?

How can we possibly take the text of the Constitution to mean only one thing, in perpetuity, without paying any attention to the context in which it was written?

Textual interpretations of the Constitution are absurd and simplistic. (I’m talking to you, Antonin Scalia.)

Beyond the Constitution, why do we blindly assume that everything that was true in Franklin’s time must still be true now? Can Franklin’s advice to humanity still be seen as Always True? Yes, there are connections, and constants, but our nation is a very different place from the land Franklin knew.

What worked for Franklin and people in Franklin's time will not, in most cases, work now.

To ignore this fact is asinine, particularly when it comes to the idea of the American Dream.

Monday, April 27, 2015

The MS Epidemic? The MS Rip-off by Big Pharma?

MS walks are everywhere…celebrities with MS are always in the news…new treatments for MS are constantly being announced, and fundraising for MS is always going on.

Why is MS so prevalent? Why are the medications for MS so expensive? These are questions I am bound and determined to answer.

I recently learned definitively that I have MS. Having this thing is something I didn't really believe or didn't have to think about for a very long time. Not until a few months ago, anyway.

I had 16 years between my first, strange "attack" (losing my sight, albeit in one eye) and the obvious return of this insidious disease.

It was long enough to let me believe that I had somehow gotten off easy, that it had all been a silly mistake, hyperbole on the part of doctors, or that maybe I had a rare, benign form of MS that was never going to be an issue.

But it turns out that 16 years is the amount of time people usually have between first attacks and the progression of MS. The disease might as well be on a timer.

I did not have another attack, per se, to let me know MS was back, or still hanging around; I just felt super crappy, tired, confused. I felt this way for months.

Seemingly out of nowhere, speaking became a problem--and for me, as a teacher, it was an especially big deal. I couldn't find my words. The speech problem scared me to death. It was intermittent and only happened for a few seconds, here and there, but I noticed it.

I was also having trouble holding a pen and using my hand. Dropping things became a new, annoying issue in my life. There were also weird spots of numbness on my leg as if a ghostly hand were squeezing me.

Making Christmas cookies this year was nearly beyond me. It was just too much multi-tasking--about as hard as I imagine it would be to follow a recipe in a foreign language. As an intuitive cook who does not need a cookbook, does not need to measure things, and can normally throw down about seven different dishes at once, the Christmas cookie debacle was the warning bell that clanged the loudest for me.

So, it was a constellation of symptoms that likely were not visible to others and that sounded stupid and complain-y when I tried to explain them separately. But after several months,  I finally had to admit that these symptoms, taken as a whole, were not normal at all. (I had been worried first that I had Alzheimer's, then perhaps that I had ALS. It didn't occur to me for quite a while that it was MS again.)

After MRIs and such, and feeling frustrated that the only neurologist I had a referral to was a neurologist I did not like, I requested a second opinion and found a wonderful, avuncular neuro (as we call them). This physician scrapped the litany of pointless, invasive tests the first neuro had prescribed. "Why bother?" he said. "We know it's MS because we have your original MRI films and we can compare the new ones to the old ones. So let's stop wasting time and get started treating you."

(Side note: spinal taps are not necessary for an MS diagnosis. I knew this 16 years ago because I did my research after doctors kept begging to stick needles in my spine. The thought horrified me, and I learned that spinal fluid tells doctors nothing about MS and does not aid in diagnosis; it's just another test they were used to doing in the old days but do not need to do (and good, kind neurologists will never push a lumbar puncture anymore). You can say no: I did. Just say no.)

My newfound neurologist could hardly believe I had lived so long and so well with no DMDs (disease modifying drugs). I had turned those down 16 years ago as they were all daily shots that came with near-constant flu-like symptoms…no, thanks!…and they cost $50k a year.

But now, it seemed, a medication was in order. I could inject myself daily (no thanks, again!) or try one of the brand-spanking-new pills.

And herein begins our adventure.

All MS drugs are at least $50k a year. Crazy, right? Well, they're more like $63,000 as the prices all went up inexplicably (except if you live outside the USA, and then the drugs are a fraction of that price). Why the exorbitant price tags?  No one knows. Even the old-school drugs recently doubled in price--and that doesn't make sense, does it?

I patted my fluttering heart and took a big breath. "It's a good thing the drugs are so expensive," said my neurologist, trying to calm me.

He said this, I think, because it turns out that the MS drugs are so expensive that literally nobody can afford them so they end up being free, or nearly free. How this makes financial sense for Big Pharma, I have no idea, but whatever. It's because we're all really guinea pigs, I think.

The cost, however, makes one wonder where all the MS fundraising dollars are going. Why do pharmaceutical companies need to charge so much money for these medications? It takes forever for a new drug to come out…and even then, no one knows for sure if the drugs actually work.

The $63,000 drug I chose costs me $40 a month. Everyone else I've talked to is getting it for free. (I must not have bargained correctly.)
Tecfidera swag: this is what nearly $6,000/month buys you.
Notice the elegant but way too small pill holder.

I had to wait more than two months for insurance to approve it. The first oral medication I chose was NOT approved…because my insurance company doesn't have a deal or relationship with the manufacturer of Gilenya.

It turns out that the drug that I waited so long for, Tecfidera, the other oral MS medication, makes me sick. Side effects include flushing (embarrassingly deep red and totally random flushing). Also, GI issues that range from annoying to ohmyGod.

Pay attention here, dear readers: the most important side effect of Tecfidera that I experienced is motor skill deterioration--particularly, mobility issues.

Tecfidera was making my legs feel stiff and heavy, and it was causing problems with my balance. After falling--hard--several times, for no reason whatsoever, and noticing that it was getting harder and harder to walk, I finally made the connection to the medicine.

Upon researching this issue, I learned that many other MS patients on Tecfidera will corroborate my story about walking, balance, and leg problems. Check Facebook; check  Twitter. There are legions of MSers with new leg issues that started when they took Tecfidera. 

Add losing half my hair to this mix of good times, and I made a decision to stop taking the pills.

The next day, Tec free, I had no more leg/foot/balance problems.

I am not taking Tecfidera any longer. Two months of progressive worsening of my symptoms, and I am  done. This is my opinion, but there is something not right about Tec--something that makes me suspicious. I just learned that the chemical in Tecfidera, dimethyl fumurate, was originally used to clean leather. It's a cleaning solvent. Wouldn't it be cheaper--and just about as sickness-inducing--to drink some Old English furniture polish?

The paranoid part of me wonders if the MS medications, including Tec, make people feel worse in order to sell more drugs? Other drugs? Think about it: if a DMD causes you to nod off several times a day, then you need a stimulant. If your legs aren't working right, you need something for spasticity, such as Baclofen…and maybe you will also need a drug that's just for walking (many MS patients take one of those…I think it starts with an A). The stimulant doesn't let you sleep, so then you need some Ambien…you get the picture.

If I were better at math, I could figure out precisely what the statistical benefit may be to taking a DMD (and there may very well be no benefit; no one knows!).

By taking no drugs, I have an average relapse possibility of 27%. With the drug, 16%. The drug companies like to say that all their drugs help MS patients experience 49% fewer relapses and few or no new brain lesions. If you only have a 27% chance of experiencing relapse, then halving that 27% is not actually that big of a deal.

The reality is that the chances of experiencing relapse are either 0% or 100%--with or without medication. Still, people are terrified not to take the DMDs.

And yet--so many people I've met online in the MS groups are also suffering side effects and attributing these symptoms to "progression." I know the feeling: you think, "Thank God I started taking this drug…the MS was getting crazy bad all of a sudden!" You don't stop to think, "Hey wait a minute: I felt better before I started popping all these pills."

Going from a vitamin a day to two Tecifidera (plus Pepcid, Zyrtec, aspirin for side effects), and a fistful of Vitamin D, probiotics, fish oil, etc., and then starting to add Provigil and something for spasticity of the legs…it was getting ridiculous.

I believe the medication I took for MS made me worse. Without it, I am feeling better already. This leads me to wonder if the DMDs are safe; I know they don't feel "healthy."

Rather than making me feel as if I were getting better, I felt as though I were sliding down a slippery, rocky mountain, picking up speed as I came crashing down.

I said, "Enough." People are asking me already, "So what med will you try next?"

I don't know if I will try another med right now (I am taking Protandim; this is a natural combo of various oxidant supplements that mimics or exceeds the efficacy of BG-12, aka Tecfidera).
The symptoms that were bothering me were the fog and the fatigue. If I can keep those at bay, I will be happy. Staying ambulatory and active is what I care about; for me, Tecfidera felt dangerous when it came to walking, running, using my legs.

The only real option I have now is keeping healthy and caring for myself. Eating raw foods. Drinking vegetable juice. Taking vitamins and Protandim. And maybe I can get my brother to run a race with me.

A week ago, I was thinking I would need to start using a cane. Today, I am buying running shoes.

Great MS support groups exist online--one thing that's going on are selfies people take of themselves flushing beet red because of Tecfidera. And tonight, I saw this posted  (it's funny to me because it's so true: MS is like a frenemy. Sometimes it is nice to you, and then just when you think you're doing well, it kicks you in the shins…or makes your hand stop working because you're tired):

Thursday, April 2, 2015

"Salinger," the documentary. Many unasked and unanswered questions.

Salinger (2013) Poster

Tuesday, March 17, 2015

Wide Reading + Frequent Writing= Literacy for Life

Worth a watch--Nancie Atwell wins $1 million for her teaching, and gives it right back to her school.

I try to do the same thing as Atwell does: let my students choose their reading (when school allows me to), and I also encourage frequent writing in the genres that appeal most to my students.

If we get it right, our kids can achieve amazing things, great quantities of work (reading, writing) even without official "assignments."

We should all be reading at least 50 books a year; we should all have impressive writing portfolios by year's end. Not because we have to, but rather, because we want to.

Some day, I hope to have my own school, as Ms. Atwell does. In the meantime, congratulations, and thank you, Ms. Atwell, for your good work!

Friday, February 20, 2015

Are Teachers Bosses, or Should Teachers Be Leaders?

The longer I teach, the more I realize and the easier it is to recognize how good teaching is not authoritative, but rather, collaborative. 

And I don't only mean that teachers should collaborate with each other (although I do believe that). I mean that teachers and students should collaborate. 

We, as teachers, should model how we can all help each other to develop ideas.

Furthermore, even though a teacher does need to control a classroom, I personally believe we "control" through mutual respect--and not through fear. 

I will never be compared to a dictator, and that's a good thing!

Just as the business meeting graphic above illustrates, I think teachers should be mostly operate from the right-hand side, the "Leader" side.

My classroom is a circular one; I conduct discussion groups, workshops, Socratic (though more informal than that) seminars.

It's the best way to learn, I think. It's how I learned in college. It's how, ideally, we should run life: a meeting of the minds, full of positive modeling, brainstorming, bouncing ideas off one another.

(I actually dislike work meetings, however. That's probably how students tend to feel most of the time--as if they are attending seven hours of boring meetings every day, 180 days a year).

The circular, informal, come-learn-at-my-kitchen-counter approach works for me because I am lucky to teach small classes. My students generally want to be there. I also adore working with teenagers because they are so funny, so honest, so refreshing--and yes, all of that helps me teach the way that I want to.

Still, I think we can all develop our teaching skills afresh at any time. 

It is never to late to change the way we do things. 

There is always hope; there is always a way back to re-discovering teaching and learning as the utopia it was meant to be.

Friday, January 16, 2015

The End-Game: It's Not What We Think It Is

Ennui and dissatisfaction have long been part of the human experience--perhaps more so now than ever. 

More people are depressed. More people don't know "why [they're] here."

The existential angst only becomes worse when people have been groomed their whole lives to "get into a good college" or  to "get a good job" and then, they can't do either (given the unbelievable competition for college spots and the insanely high tuition rates, or the dearth of jobs available after graduation--even the lack of decent-paying jobs). 

Or, they manage to accomplish one or the other, but still, nothing feels satisfying, because they never bothered to figure out who they are, what they want to do, and how they can best contribute to human progress.

So why are we so depressed? Probably because we expect to be happy. We're constantly told that the point of life is happiness…but is it really? Is that why we're alive? 

It would be nice to think so, but happiness is a vague term, and those who seem like they should be happy (the well-off, the safe people with comfortable lives) are often the least happy of all.

[Social media, of course, makes it worse, as everyone puts on the happiest face they can, most of the time, and we start to wonder why we aren't as seemingly happy.]

The bottom line is that we are competing rather than co-operating, and that drives us for a while, often into college or half-way through it, until we collapse in a heap, feeling empty and wondering about the point of all the effort, all the competition.

Many of us push our kids to succeed, but never explain what "success" really means. It's like being told to "sit here and wait for the present," but you never get a present; you're just waiting (for what, you don't know).

As a teacher, I see so many kids who are driven to be the best, driven to study for a certain career (one that means nothing, personally, to them, but one that looks good, like the traditional doctor or lawyer jobs). 

What I'd like to see are people enjoying school and learning for the sake of learning. We should read books not to know what color tie Jim was wearing in chapter three, but rather, to know what the novel taught us about life, about human experience.

I don't believe much in either grades or homework, which probably makes me an idealist (and I went to Sarah Lawrence).  Punishment, to me, is usually misguided and stupid, and counter-productive.

Does that make me a rebel, or someone who understands there is a better way?

I was compelled to write this after reading a very interesting essay about these larger goals, the point of all the pressure we put on our kids.

We need to ask ourselves if we as parents, or we as teachers and school administrators, are teaching the right lessons and asking the right questions.

If we truly want to help our kids, we need to help them to feel engaged, capable, and worthwhile. It's not all about the labels we wear; it's about how we feel in our skin.

The best goals to have, it seems to me, are the ones we can't actually teach but can only urge people to experience for themselves: confidence in our ability to manage life; helping others; developing meaningful relationships; doing good, inspiring work that doesn't feel like work, but is instead a joy. Learning constantly. Reading. Engaging with the world.

Tuesday, December 23, 2014

Bad Writing Advice Debunked

As a teacher of writing, I spend much of my time trying to undo the tightly-knotted, deeply ingrained, and wholly incorrect writing advice my students have gotten in years past.

Now, I am not accusing other teachers (particularly teachers of younger students) of being bad at teaching writing; I'm really not.

What I am saying is that there are some old rules that were never correct in the first place and should be buried now. These rules don't help kids write, and they certainly don't help me help kids write...because I have to waste so much breath debunking the myths.

First up?  You CAN start a sentence with "And" or "But" or "So" or "Yet." Start a sentence however you want! Anyone who tells you can't do that is wrong. And you can tell your teacher I said so.

There are no grammatical rules anywhere that prohibit this practice.

Similarly, a sentence fragment may be wholly intentional--and effective. I frequently tell my students to vary their syntax (write long, complex sentences followed by fragments) because it grabs attention. Professional writers are allowed to use sentence fragments, and so are you!

Next? Begin that essay with a question (as long as you answer it in the next line; not to answer the question is begging the question, and that's annoying).

I constantly tell my students that posing a question and then answering it is a easy way to begin a timed essay. Inevitably, I hear that some teachers said students were never allowed to do that.

"You are allowed; many great writers start essays with questions," I counter. So just do it if it works.

What about passive voice? That's typically a huge no-no (and even spellcheck/grammar check looks for it):

'We now know that telling writers to avoid the passive is bad advice. Linguistic research has shown that the passive construction has a number of indispensable functions because of the way it engages a reader’s attention and memory. A skilled writer should know what those functions are and push back against copy editors who, under the influence of grammatically na├»ve style guides, blue-pencil every passive construction they spot into an active one.'--Steven Pinker, Harvard psycholinguist from his book, (on right).

I will add that I have even seen entire schools banning use of linking verbs in an effort to eradicate any vestige of passivity. This is completely misguided--so much so that I can hardly deal.

"Is" and "was" are sometimes essential verbs; banning them does not create spectacularly clear and strong writing. No, it only makes for some crazy-awkward sentences that I then have to fix. Don't ban linking verbs. 

Don't ban anything. Writing is about communication; it is about sharing ideas. Teachers should help students enjoy writing, and writing should feel natural.

Too many rules make writing a nightmare.