I was talking with my mom recently, and she said something very interesting about the world of medicine that got me thinking about the world of education. She’s got a bunch of health problems, so she was telling me all about what it’s like going from doctor to doctor. She described it as “a medical conveyor belt.” She said, “You get on at one point, and then it just moves on its own without a whole lot of input from you, the patient.”
I thought this was interesting – partly because she’s my mother and I love her – but partly because it sounded an awful lot like how we at Hawken describe traditional schooling, as the “industrial model of education.” So I asked her to tell me more about what she meant by “a medical conveyor belt,” and she told me this story.
When she was pregnant with my older sister, she felt really confident going into the hospital to give birth. She was a nurse, so she understood hospitals and the world of medicine, and so when she went into labor she and my dad drove to the hospital feeling pretty good. They checked in and went to a waiting room where she and my dad sat for about two hours.
Eventually a doctor came in and, without introducing himself, tapped my mom on the knee. Her leg jumped up much more than it normally did, and it startled her. The doctor turned to the nurse in the room and said, “What is this woman’s blood pressure?” And the nurse said, “I don’t know, we didn’t take it.” The doctor rolled his eyes, took my mom’s blood pressure, and found that she was in danger of preeclampsia. At this point, my parents started to wonder if the people running this place knew what they were doing.
Preeclampsia is a condition where high blood pressure can lead to seizures, and it can be really bad when you’re in labor. The doctors and nurses around her jumped into action at this point. They got an IV going and they were checking her vitals and injecting her with needles. They did most of this without talking to her about what each step was, so my mom was starting to get nervous.
She asked them, “What’s in that needle?” and the nurse would say something vague like, “It’s for the pain.” My mom said, “I don’t want that,” and the doctor told her, “Yeah you do,” and gave it to her anyway.
At this point, my mom was starting to get pretty upset. She wasn’t sure how bad things were getting, because the doctor wasn’t really talking to her, and she wasn’t confident that they had it all under control.
Once the painkillers started to kick in, she began bobbing in and out of consciousness. She had been having contractions for the last several hours, but now that she was all doped up she didn’t feel them building up and building up like she had before. So she would be lying there with her eyes half open, and then all of a sudden get jolted awake by the pain of being in mid-contraction.
When she was ready to give birth, they were wheeling her to the delivery room and she cried out with another unexpected contraction. The doctor huffed and said, “We could do without the sound effects.”
She gave birth to a baby girl, was sewn up with over one hundred stitches, and was sent home the next day.
Two years later, when she had me, she went back to the hospital, and this time when she was rolling into her room in the hospital, she started to cry. The nurse asked her, “Why are you crying?” and she said, “Because I don’t know what you’re going to do to me.”
This is the medical conveyor belt. You step into the hospital, and from that moment on, you don’t make a whole lot of decisions. Doctors are supposed to ask your consent when treating you, but it’s not like you’re on the decision-making team. If you’re on the medical conveyor belt, you’re expected to lie there and let them work. They’re the professionals; you’re just the patient. What do you know anyway?
A Different Approach
Four years later, my mom got pregnant with my little sister, and this time she decided that she wanted to do things differently. She went with a facility called the Childbirth Center where she worked with a midwife and was able to plan out exactly how she wanted to handle her delivery. There was a plan, of course, to rush her to the hospital if she had any complications, but they explained all of the different circumstances where that might occur and how likely they might be.
I remember the Childbirth Center fondly. I got a little Star Wars toy to play with, and I remember sitting in the halls where the lights were pleasantly dim. My mom said that when she went into labor, they told her to do whatever she wanted to do. If she felt like going for a walk, she went for a walk. If she wanted to go to the lounge and watch TV, she went and watched TV. If she had a contraction, my dad was there to hold her.
They had painkillers if she wanted them, but my mom declined. At one point they suggested she might want a shower, which sometimes helps the process along. When she felt like it was time, she told them she was ready. She lied down in her bed, the midwife came in to guide the whole process, and half an hour later my sister was born. (I don’t remember this, but apparently when my dad came into the hall, he asked if I wanted to see the baby, and I replied, “Nah.”)
In the end, she didn’t have any painkillers and she ended up getting one stitch. More importantly, she felt good about the entire experience. There weren’t any moments of helplessness or powerlessness. She wasn’t a problem that the doctors needed to solve – she was a woman giving birth to a child, and they treated her as such.
Teaching for Dignity and Autonomy
This story got me thinking a lot about the similarities between medicine and education. There are a lot of students in the “industrial model of education” who feel like they’re on a conveyor belt. They move from room to room, teacher to teacher, and they’re told what is best for them to learn. They don’t really get much of a choice over whether or not they read a book, take a class, write an essay, or have a discussion.
It’s hopefully a less painful experience than childbirth, but the idea that they’re not actually making any of the decisions about their own education can be just as frustrating and demoralizing. A lot of students just lie down on the belt and give up.
What the Childbirth Center did, that I think we can emulate, is give a lot of that autonomy back to the person at the center of the experience. My mom wanted the same things the doctors did: to give birth to a healthy child.
And students want the same things as their teachers: to be thoughtful, open-minded, well-educated young people.
It’s not impossible to let a woman in labor decide whether she would like to take a walk or a shower, and to wait for her to tell you when it’s time to deliver. And it’s not impossible to ask students what they need next, what we should teach them, in what order, and at what pace.
Of course, just like with a midwife, there are safety nets for when things don’t go according to plan. A student might decide that they don’t want to work on this paper right now, but they have to learn to write papers. They might not find math engaging right now, but they need to learn math.
At the Mastery School, we have a system of foundational credits to make sure that students get everything they need, and that is clearly communicated. Part of us keeping the students safe, the way that a midwife needs to keep a patient safe, is letting them know when they are in need of something they’re not getting.
But it’s essential that students have a say in this process. I don’t want any students to feel like they’re being sent from class to class, being poked and prodded with textbooks and essay assignments, without knowing what’s happening or what’s coming next.
There are so many students who spend day after day, year after year, just letting teachers tell them what to do next. The dignity of decision-making is denied them. Maybe when they get to be a bit older they can choose some of their classes from a list of electives, but a lot of students have already learned that the best way to deal with the conveyor belt of traditional schooling is to put in a minimal effort and wait till it’s all over.
There’s a better way to do things. It doesn’t have to be an industrial, one-size-fits-all model where we treat students like passive vessels. We can include the student in the planning; we can listen to their needs.
When we do that, it shows them how to value their opportunities. They start to buy into their own education when they get to co-create their experience. And if we do it well, we can keep them safe and at the same time give them the dignity of choosing their own path.