Knowing What Good Is

Long before "Moneyball," John Madden, who coached the National Football League Oakland Raiders caught my attention with a sort of rant as he was filling in some down time during a game. "You know," he said, "People think football players have to be big, intimidating guys, but really you can't win games with that. You need the quick, little guys who run so close to the ground the defensive lineman have trouble finding them; you need the big guys, sure, to protect the passer and to rush the passer, but you also need the gazelles, the wide receivers who if they weren't playing football might try out for ballet and you need a quarterback who can see the whole field and who can throw accurately sixty yards or fifteen. You can't just have one type. You need 'em all."

Gabrielle Munter 

Then came Michael Lewis's "Moneyball," where talent scouts talked about players and rated their likelihood of success not just by what they had done on their high school teams, but by how they looked, whether, as Billy Beane put it, "They look good in jeans."  In the movie adaptation, one scout doubts the prospects of a player because his girlfriend is homely. "Not even a five, I'd say. I mean guy with a girl like that has no confidence."

There is no purer form of meritocracy than professional sports because you can actually keep score, on the teams and on the players. 

Of course, what Moneyball demonstrated was that the people who were suppose to "know baseball" did not know what scores to look at and they fell back into superstition, superficiality and gossip.

Two phone conversations highlighted the cluelessness of the men who select who gets into medical school stuck with me: I had phoned a dean at Vanderbilt, where my son, who was a premedical student, was struggling with calculus and I remarked that I had never used calculus beyond the final exam in calculus and the only reason I could see it was included in the requirements set down by the American Association of Medical Colleges is that the guys on that committee got good grades in calculus and they were trying to select people who were like them. 

"Oh, no," the dean told me. "Math is the language of science. You have to be good at math."

"Excuse me," I asked, "But where did you go to medical school?"  He had not gone to medical school. He was a sociologist.

The other conversation was with a dean who guided undergraduate students at Wesleyan University.  I had phoned because the son of a good friend had been told to take a year off after graduation before applying to medical school and my friend did not understand than and neither did I.  He was not unusual in getting that advice: the college advised kids to take a year off after college, to work somewhere, in a lab or even in the Park Service, before applying to medical school and the dean told me this was a good idea because it helped them mature and to be sure medicine was really what they wanted. Wesleyan wanted only the very top students applying right out of college. 

"And," I observed, "This explains why your catalogue can say that 98% of your premeds graduate with an acceptance in medical school. So you don't have to take the heat for those unsuccessful applicants."

At Wesleyan, at least, the calculus course provided the answers to the test questions before the exam, my friend's son told me, so calculus was not a gauntlet  tool used to eliminate hopeful premeds. 

Many, if not most medical students suffer from the imposter syndrome, when they arrive in medical school. They know they are not doctors and they cannot quite imagine what they need to do to transform into doctors. In the old days, they got this sense of inadequacy reinforced in anatomy labs, in courses in microbiology, where an insane number of bacteria and viruses were served up to memorize.  Some, if they were lucky in the first two "preclinical years," discovered something they actually liked and were interested in which gave them hope they might become a good neurologist or surgeon, even if they were not much good at memorizing the side effects of random drugs. 

But the point is, those who were guarding the gates, and those who were selecting for talent were simply not very good at their jobs, from college to early medical school. 

I had two conversations with deans which drove home this point. In college, I met with the dean who oversaw premedical students because I did not want to take a higher level calculus course. He told me I'd need to have that math to do the reading in my upper level courses. (He was a economist.) I replied that I had already taken those upper level courses and had not noticed any difficulty doing the reading and had done well in those courses. At that point, he swiveled around in his desk chair, pulled out a drawer from his metal file cabinet (before computers), plucked out a chart and start thumbing through it. He was also the director of undergraduate admissions and he had my application file. 

"My God!" he gasped. "How did you ever even get in here?"

"I'm not the one to answer that," I replied. "But I've made it to the end of my junior year."

In fact, I refrained from saying, not wanting to antagonize this man who I needed for higher math dispensation, "And I've been on Dean's List every semester." 

The next dean conversation was less fraught. It was in fact, friendly. The dean was driving me back to New York City from his Adirondack home, where he had invited five medical students in their final years. The school did not give us grades, although it did track grades for us in the various courses so it could guide us where to apply for internships. "You were in the middle of the class, maybe just below the median your first two years," the dean told me, "But in your clinical years, you got honors in everything but Pediatrics. Hell, Fred Plum gave you honors, and I can tell you I can count on one hand the number of students who got honors in neurology over the past ten years. So, what got into you?"

I knew very well what had got into me, and it wasn't that I worked any harder in the clinical years.  It was the difference between multiple choice questions devised by microbiologists who asked if fungi had chitin in their cell walls and hematologists who asked you on rounds to tell them why a particular patient had anemia, what the different possibilities were and how to figure out which pertained to this patient.

The wonder to me, then and now, is how we get so many really talented people flourishing in medicine. It seems to me we get good people despite rather than because of the talent scouts.

The thing about medicine is it is a very broad arena. Like the football team, you need all sorts of different talents: the heart surgeon likely will make a terrible psychiatrist and vice versa. 

The other thing is that while you can read law, or you can read history, you cannot just read medicine. You have to do medicine, and for that you need an organization of teachers who know medicine.

The next generation is going to be interesting. Colleges have noticed that the talent is flowing toward money. The "top students" (if we can believe the colleges even know who these are) want to go into finance, Goldman Sacks, not medicine, or even law.

These 18 to 22 year old kids are sophisticate enough to see that doctors in America now, have drifted into the social strata of British doctors: Mostly upper middle class, making $90,000 to $200,000 a year, depending on specialty, which is about what a McDonald's franchise owner or an enterprising plumber can make.

And as this reality has sunk in, medical school classes have shifted toward majority females, who are likely to not be the sole providers for their families, who want to limit their hours at work and maximize time off. 

Some doctors in some specialties make much high salaries, some in the millions, but the real money in medicine is, as it is in so much of industry, in administration. The managers take care of themselves first.

The current generation of doctors is not self employed. Ninety percent are working for large corporations--Partners, Beth Israel Deaconess, Mass General. They are employees getting W-2 forms. The entrepreneurial doctor, who employs workers and who manages his practice is gone with the dinosaurs. 

This may not be all bad--it's not clear medical care has suffered because it is no longer provided by shop keepers.

But, it is different and the talent has followed the money, however you discern "talent."

NB: All paintings by Gabrielle Munter 

Dumb Luck

 

Sailors, if you can believe Patrick O'Brian, are superstitious. They believe in luck and they believe in things which can bring bad luck. They are at the mercy of storms which seem to blow in from nowhere, for no good reason, and it is understandable they might focus on the uncontrollable. 

Athletes, especially baseball players, are superstitious. In sports where success or failure is more controllable, like wrestling and football, players tend to be less superstitious, but baseball has a lot in it which is not in the player's control. The Phantom played baseball through the end of his sixth decade and he went to the batting cages regularly, and he was able to train himself to hit fast balls, but he could get five at bats in a game and never see a good pitch to hit. But sometimes, there it was, and he could pounce. More than half the time, though, it was just dumb luck whether he saw a good pitch. 

Driving down the road to southern Maryland, with his wife and kids in the car, the Phantom saw a wheel cover detach from a car maybe thirty yards ahead of him, and the wheel spun on its edges, zipping up the banked road side and then wheeling around and coming right back down again, crossing the Phantom's path, traveling underneath his car with a metallic clank. When he got back home, hours later, the Phantom found that wheel cover had lacerated the undercarriage beneath the transmission and what was left of the pink transmission fluid was dripping out and the transmission, and the car was toast. Dumb luck. The fickle finger of fate. God did not want the Phantom to drive a Honda Odyssey.

Every time you get on an airplane, there is that whole world of uncontrollable.

Forty-nine years ago, the Phantom was driving down a country road in southern Rhode Island and along the side of the road was a sort of garage sale, minus the garage and the Phantom spotted a wooden desk chair that looked serviceable and had some character. He plopped down some affordable amount of cash, maybe $25, loaded the chair into his car and that chair moved with him from Southern Rhode Island to Providence, to New Haven, to Washington, D.C, and ultimately to New Hampshire and he uses it to this day, and it still swivels.

                            Gabrielle Munter 

The chair turns out to be a W.H. Gunlocke chair, made in Wayland, New York. This company made chairs for multiple Presidents, for libraries and executive offices from 1902 until 2026, which will be the last year it produces chairs. For 49 years, it has seated the Phantom comfortably, admirably. Just happened to spot it driving down the road, just happened to have cash, just happened to shrug off the wife's objections to buying that old piece of junk.

Dumb luck.

Real History

 

Reading Jill Lepore in the the New Yorker about plans for the Bicentennial, has given the Phantom pause to think about his prior bumps with historical commemorations.

In 1976, the Phantom and his new girl friend walked from the East Side of Manhattan to the wild and wooly West Side to see the "tall ships" sail up the Hudson, and then fireworks. 

The war in Vietnam was over by then, and the Republic seemed safe enough, apart from Cold War threats. But nobody was talking about the end of democracy or the collapse of the rule of law or apocalypse.

History seemed to have moved on.

Years later, the Phantom got into the habit of listening to the Lyndon Johnson tapes, which played on public radio as he drove out to the nearest batting cages in Drainesville, Virginia, along Georgetown Pike, past the CIA campus in Langley.

Listening to those tapes, to Johnson's voice was living history, a backstage view previously unavailable to the Phantom, and it confirmed the inferences the Phantom had drawn about LBJ: He was just as clueless and unsophisticated as he appeared on T.V.

He had one conversation which stuck with the Phantom, as LBJ spoke with the one person he clearly trusted and liked, Richard Russell, a deeply conservative Dixiecrat. LBJ was thinking about his options about pulling out of Vietnam or trying to push the war to a victorious conclusion. He actually said he was afraid of becoming the first U.S. President to lose a war, as if Madison had not actually lost the war of 1812. On the other hand, he did not fully trust the rosy assessments of his generals, and he wondered how long the North Vietnamese and the Viet Cong would fight on.

"Well, you know, Mr. President, Russell told him, "You don't want to stay in Vietnam forever."

"No, Suh," Johnson said. "We don't do colonies. I just want to get the Hell out.  Maybe do some business later."

"Yup" LBJ concurred. "I want to get the Goddamn Hell out."

 Russell said. "Get the Goddamn Bejesus out of that cesspool."

"Yup."

"Well, those Cong, them boys in Hanoi--they know that, too."

And I thought, "Yes! You dumbass. It's obvious. So get out." Of course, this was twenty years after the conversation. Johnson was dead. Russell, too. And I'm just driving by the CIA campus on the way to the batting cage, listening to history.

But then, on the other hand, there was a phone call from some young guy who had been sent to find out what was happening with a farm bill LBJ was interested in.  The young guy was out of the White House, some legislative liaison office.

"Well, you see, Mr. President, they are arguing over 3 cents a pound for beef and it's holding up everything. I mean, 3 cents! And neither side will give in, and the whole farm bill is being held hostage to these beef farmers, over 3 cents a pound!"

"Well," LBJ rejoined, "A head of cattle weighs maybe two thousand pounds, so that's $600 a head and you got a herd of 1000 head, that's $600,000, which is not chicken feed to a rancher."

When I saw my father I mentioned the tapes to him.

"I mean, LBJ sounded just dumb as a brick, when he's talking about Vietnam, but when it came to that farm bill, he was much sharper than this young staffer they sent over to Congress."

"Oh, Johnson was very bright," my father said. "I'd say maybe even brilliant."

"What? How would you know?"

"Well, they sent me over to brief him once, before a press conference, where they knew he was going to get grilled at length, and in detail, about some legislation concerning older workers, who, it turned out, were actually less likely to miss work, and who were more productive than most of the younger workers everyone was so eager please. And the thing is, older people vote.

And he listens and I keep pausing, so he can take some notes on his little index cards, but he writes nothing down, and just says, 'Yes, keep going.' So, I keep going, and fifteen minutes later he says. 'Okay, got it.' And he goes out to the podium in the press room and they grill him, and he hits them with everything I had just given him, no notes,  like it's all stuff he knows backwards and forwards. Mind like a steel trap. He was no slouch, mentally."

"Wait!" I stopped my father. "You went to the White House?"

"That's where he hung out. Sure. Had to go through all these tunnels with guys asking my name ever fifty yards."

So, it was no surprise to my father LBJ knew farm bills and anything else not foreign to his world.

But you take a guy who knows Texas ranches, cattle, domestic programs, and you put him on an aircraft carrier off the coast of Vietnam, and he is, figuratively speaking, lost at sea. He is just not smart enough to know what questions to ask, not widely enough read to think about a foreign culture.

When the Phantom picked up his wife at Logan airport upon her return from her holiday in Vietnam, forty years after the end of the American war there, she handed him her bag and she did not say, "Oh, good to be home!" or "I missed you!" 

She was, actually, the same woman with whom the Phantom had watched the tall ships celebrate the Bicentennial in 1976.

She said, first words out of her mouth, "There was no way in Hell we were ever going to win that goddamned war!"

Well, nice to see you back, too.

She had been given a tour of the underground "tunnels" outside Saigon (now Ho Chi Minh City.) Tunnels is a gross misnomer: These were several stories deep, with hospitals and ammo dumps and plumbing and venting and HVAC and whatnot. They spread out in concentric circles for 20 miles surrounding Saigon. Those underground facilities were mute testimony to the determination of the Vietnamese to prevail. They had nowhere else to go. They lived there.

And they knew Americans weren't going to stay. 

As Richard Russell told LBJ, "You know that. And they know that, too."

The Monster and the Beast: Raising Boys

 

There wasn't much to watch, if you were from New England, during last night's Super Bowl, but the half time ads were something.

The one which struck the Phantom most was an ad showing a boy, maybe six, maybe eight, who was giving a pep talk to his stuffed animals, a talk he had clearly heard from an adult male who coached his youth football team. The ad was sponsored by the National Football League, a sort of recruitment piece, like the Army's "Be All You Can Be," ads.

"I am a monster!  I am a beast!"

This prepubescent boy was telling himself, "I'm a monster! I'm a beast!"

He was performing a self stoking ritual of dominance. 

He was parroting what he had heard from an adult male. A coach. He had been told about aspiration. 

What struck the Phantom was how very prepubescent this boy was. Clearly, his muscles had not seen a lot of testosterone yet, nor his larynx either. 

It made the Phantom think of how he had caught football fever as a six or seven year old, seeing football on TV and going out to a field with a boy, his only friend in the neighborhood who reliably wanted to throw and catch and run a football any time of the day. He would kick or pass the Phantom the ball, and the Phantom would run it at him, and he'd try to tackle the Phantom,  and the Phantom did the same for him.

The difference between lamb and mutton is puberty and neither the Phantom nor his friend were powerful enough to do much harm.

Later, post puberty, the Phantom joined his high school's wrestling team, where they built strength by having the wrestlers pull themselves up a twenty-five foot rope to the ceiling of the gym, using no legs, only arms, hand over hand. Of course, all the boys pumped iron, lifted weights in the off season, building muscle mass and power.

Wrestling is a contact sport, and in fact it is constant contact, violent, scientific and fast. You cannot be successful as a wrestler without a modicum of muscular strength, although flexibility is probably more important, but aggressiveness, tolerance for pain and relentlessness are helpful.

One of the  Phantom's sons started wrestling at age 7, which the Phantom did not encourage, but an adult--oh, those adults!--who wrestled in college, was organizing a wrestling club and he picked out this son. "He's got something to prove," he told the Phantom.  That son proved to be a hundred times better wrestler than the Phantom ever was, in part because he was trained and drilled, from age 7, by someone who actually knew the science of wrestling. 

Domination

"I really love destroying those super jacked [muscular] guys, who look so  nasty," this 15 year old told the Phantom. "They step out on the mat with this smirk but I wipe that off their faces."

The Phantom remembered that feeling. After one wrestling season was over, the Phantom had to return to regular physical education class, and the unit he returned to was wrestling. The physical education teacher, not the brightest bulb, stood in the middle of the mat with his students sitting in a circle around him, and he announced that a well trained wrestler could take a bigger, stronger opponent because of his training.  

He then told the Phantom to stand in the middle of the mat, and he pulled up Mack Shuff, a fearsome looking giant, who had a five o'clock shadow by 2 PM, a brow ridge of a Neanderthal, already balding at 17,  and he was the defensive tackle on the football team, 220 pounds, well over six feet tall. The Phantom was 145 pounds, but he was a varsity wrestler.

Of course, the Phys Ed teacher was right about one thing-- training mattered--and the Phantom pinned poor Mack in fifteen seconds. 

But what that teacher was too dim to consider is that drubbing might not be received cheerfully by Mack, who demanded a re match the next day. The Phantom could see immediately how much this meant to Mack, and it meant nothing to the Phantom, so he just rolled over and allowed Mack to win.

The Phantom, at that point, had nothing to prove.

The Phantom knew the truth, and likely so did Mack, so what was the point?  

The fact is, the real athletes, the boys who were potent and trained, and who knew what real combat demanded, did not stalk around telling themselves they were monsters or beasts.

Another son did not wrestle, but he did white water kayaking.  We lived hard by the Potomac River and this son spent summers at a camp run by members of the U.S. Olympic team and they quickly saw something in this kid, age 10--he could flip his kayak and pop it upright without using a paddle, something which usually takes adults many lessons over weeks to accomplish and many never can. Even using a paddle, it's not easy. But more amazing, he could do a "combat roll" which is to say he could go under and pop up in class 4 rapids.

The Phantom was not at all happy about this son's choice of sport. Wrestling was agonizing enough to have to watch, but you could easily die kayaking on the Potomac.

He expressly forbid his son to go off Great Falls, which is something 15 year old boys were daring each other to do, and people regularly died trying that, but, of course, one day the Phantom found on his desk a framed picture of his son doing exactly that.

Great Falls, Potomac River

Neither son ever strutted around the house barking, "I am a beast! I am a monster!"

They needed enough  testosterone and likely the encouragement of their friends.

Now both sons have children of their own--both have daughters, no sons.

Watching these girls grow up, the Phantom is struck by how very different they are from little boys. 

They rough house with their fathers and they are wonders to behold, but they are clearly not boys.

They never call out, "I am a monster!" or "I am a beast!"

The Profit Motive In Medicine

A vascular surgeon at Portsmouth Regional Hospital mentioned in his profile in the catalog of doctors that he had "trained with Dr. DeBakey," which caught the Phantom's attention. Everyone else listed their medical school, residency and fellowship training program but for this guy saying, "Baylor, Houston Methodist" would not do, as he may have thought that wouldn't mean much to New Englanders, but that DeBakey name would.  This particular surgeon became locally famous for never doing surgery. Mostly, he did not respond to consult requests, but on the rare occasions he did respond, he declined to operate. This can get the attention of the ICU staff when faced with a patient with a cold blue leg needing an arterial bypass. At his two year review, it was pointed out to this surgeon he had done only two surgeries and that did not justify the expense of his salary, and he disappeared.

That sort of extreme desultory behavior is unusual in medicine and, in particular, in surgery, but it is likely the sort of story administrators love to trot out to show how important it is to have administrators riding herd on doctors who would otherwise not show up to work.

In the Phantom's own department were two other doctors and one, a woman with two kids below the age of three, saw patients Monday through Thursday but on Friday she showed up in scrubs (rather than a white coat and dress) for her "surgical day," during which she did thyroid ultrasounds and, when necessary ultrasound guided needle biopsies of thyroid nodules. On those days, she saw only about four patients, rather than the usual 20-25 and she was home to her kids by noon. She missed days when her kids got sick and she was out for 3 months after the birth of one child. So, at her two year review it was pointed out that the number of dollars she generated compared to that of her two colleagues was substantially less and her salary would be cut.

She immediately resigned, in a huff, having stayed 3 years at this practice and she moved on. In that, she was in the mainstream of her cohort--many if not most young women physicians moved every three years when they learned they would not receive a raise in pay.

So, yes, the Phantom is aware that not every doctor is driven and a work horse. The idea that we are workers like any other sort of workers, and we move from job to job, from patient panel to patient panel based on the dollars is now accepted as a fact of life.

On the other hand, there are instances where the profit motive drives medical practice into dark places. 

The hospital in Portsmouth was run by a for profit corporation. It was set up as most systems were set up in those days: the hospital itself was flanked by two office buildings with doctors' offices which contained practices covering most medical specialties: including neurology,  rheumatology, oncology, endocrinology, and primary care. Unlike cardiology and gastroenterology which have lucrative procedures to bill, these "cognitive" practices broke even or even, some years, lost a little money in billings v overhead. 

The general concept is that the office practices "fed" the hospital, sending patients to the ER, to radiology, to the laboratories and all the other "in patient services." While doing so, the office practices provided care for the communities which surrounded the hospital.

But on day,  the administrators in Nashville looked at the corporate offices and they shut down the break even practices and saved a lot of overhead--office rent, staffing, phones, supplies. Primary care physicians were replaced with nurse practitioners and physicians' assistants, who cost less and could be booked for a patient every 10 to 15 minutes.

It turned out, the hospital could be "fed" by a few Urgent Care Centers placed in neighboring towns and the volume of hospital business pumped along just fine, with no drop in ER visits or radiology studies or lab studies ordered.

Mad Cow Disease

The administrators who did this were not bad people, certainly not monsters: they were simply doing their jobs, which was to increase profit, to increase the value of the corporation for the shareholders. They were, we heard later, "heroes" back in Nashville for having cut all that overhead.

Of course, all those patients with arthritis, diabetes, cancer, chronic lung disease back in Portsmouth, New Hampshire and in the surrounding communities were now bereft of care, but that was not the job, the mission of the administrators in Nashville, whose job was to increase profit. 

One day, a patient showed up at the Phantom's office with a letter from his insurance company informing him they would no longer cover the cost of his insulin pump and its supplies. His type 1 diabetes had been spectacularly well controlled for five years on his pump, with HbA1c levels, which measure overall blood sugar control in the normal range. But that did not please the insurance company. Somewhere, someone in the insurance company, reviewing the medical records we dutifully supplied the company, saw these normal numbers and said, "Oh, these numbers are all normal! We do not need to continue to pay for someone who is now normal, who no longer has disease!"

As if "tight glycemic control" is actually "cure."

The Phantom tried to telephone "the company," between patients but got nothing but the "your call is very important to us, please hold on," and he assigned a medical assistant who wound her way up the line of clerks and "patient care facilitators" and "community health advocates" and kept asking for a doctor for the Phantom to speak to--a "peer to peer," exercise where one doctor talks to another, the treating doctor and the insurance company doctor. It turned out the patient's insurance company had subdivisions and the part that insured the diabetes might have been different from the rest of his health insurance--it was never clear. In the end, by the time the Phantom's medical assistant went home at five p.m., having not been able to attend to any other patient that day, leaving the Phantom to call in prescriptions and do all the clerical stuff she usually did, and slowing down the machinery of the office that day so patients were kept waiting impatiently, there was no solution to the problem.

Delay, deny, desist. 

So, the health insurance company, like the company which ran the medical practices at Portsmouth, was profit driven. Private enterprise, devoted to reducing costs and keeping a tight rein on the budget. 

There may be other services which are not best run by private enterprise in search of keeping their organizations lean and mean: power companies, water companies, highway and bridge maintenance, meat and food inspections, fire fighting, police, coast guard, the Navy--things where cutting costs undermine the basic provision for the common good.

But somehow, all these other "public services" are accepted as better organized to service the public good rather than to serve profit. 

Alexandre Yersin, Conqueror of Plagu

In America, health care not for profit is communism, socialized medicine and a sign of impending doom.

And, oddly, the very people most likely to rail against socialized medicine benefit from their own socialized medical care:  military medicine, VA medicine and health insurance for US Congressmen and Senators (which is provided through an insurance so generous as to be basically government owned.)

So, we beat on, boats carried by the current, rudderless, drifting past riverbanks, headed toward the sea of oblivion.

The Imaginary University

 

Should you be fortunate enough to be admitted to the three year Phantom University,* and insane enough to matriculate, your course work will vary according to your major, which you may construct for yourself, or simply follow as outlined by the various academic departments, but  whether an engineering, pre med or philosophy major, you will be required to complete satisfactorily the three year course, "Introduction to Nothing In Particular," and the reading list is long, although entertaining. 

Phantom University

Woe be to any student who arrives in class having not read the book for discussion, because AI and Cliffs notes or Wikipedia will not save you. You will be called upon in class to comment on a particular remark, passage and you won't have time to Google it. Attendance is mandatory. Class participation is mandatory, may be excruciating, but that is the point. Education at Phantom University requires engagement, or "l'engagement" as the French would say, which means exactly the same thing but sounds so much cooler in French.

Humanities Quad

So here's the list, to be picked up, hopefully second hand, at the bookstore, or on Kindle, or signed out from your library online. How you come by the texts is of no concerned to Professor Phantom--did I mention Professor Phantom, the President of the University, teaches this course without teaching assistants?-- the only concern is that you have actually read the piece under discussion.

Library

Semester 1, Year 1: 6 weeks  (Female in a Man's World)

1. The Prime of Miss Jean Brodie, Muriel Spark.

(Extra credit: See the Maggie Smith movie, compare and contrast)

2. Play It As It Lays, Joan Didion

3. Memoirs of an Ex- Prom Queen, Alix Kates Shulman (Extra Credit: Living My Life, Emma Goldman)

4. Final Payments, Mary Gordon 

5. The New York Ride, Anne Bernays

6. The Last Picture Show, Larry McMurty

(Required: See the Movie directed by Peter Bogdanovitch)

Semester 2, year 1,  6 weeks (Origin Story)

7. The Adventures of Huckleberry Finn, Mark Twain

8. Silence At Appomattox, Bruce Catton

9. Animal Farm, George Orwell

10. The Guarded Gate, Daniel Okrent

11. Goodbye to Berlin, Christopher Isherwood

Extra Credit: Movie, "Cabaret"

12. Before the Deluge, Otto Friedrich

Semester 1, year 2, 6 weeks: (Quiet Desperation)

13. Looking for Mr. Goodbar, Judith Rosner

14. Little Big Man, Thomas Berger

(Alternate: The Movie--Dustin Hoffman)

15. The Pawnbroker, Edward Lewis Wallant

(Alternate: The Movie--Rod Steiger)

16. Miss Lonelyhearts & The Day of the Locust, Nathaniel West

17. The Bell Jar, Sylvia Plath

18. Slouching Toward Bethlehem, Joan Didion

Semester 2, year 2, 6 weeks (The Grand Sweep and those Swept Up)

19., 20. A People's History of the United States, Howard Zinn

21.West with the Night, Beryl Markham

22,23., Dark Continent, Mark Mazower

24. War Is A Force That Gives Us Meaning, Christopher Hedges

Semester 1, year 3, 6 weeks (Class, Society &  Self)

25. My War Gone By, I Miss It So, Anthony Lloyd

26, 27. Battle Cry of Freedom, James McPherson

28. White Trash, Nancy Isenberg

29. Lady Chatterly's Lover, D.H. Lawrence

Required movie: Laure de Clermont-Tonnerre director

30. The Wire, Season 1

Semester 2, Year 3 (Alienation by Fire)

31. The Wire Season 3

32. The Wire Season 4

33. The Paranoid Style in American Politics, Richard Hofstadter

34. If I Die In A Combat Zone, Tim O'Brien

35. The Stranger, Albert Camus

36. Parachute Infantry, David Kenyon Webb

* Phantom University offers BA, MD and JD degrees. The undergraduate program is 3 years, as are the graduate programs, following the British model, which seems to produce better educated individuals in 3/4 of the time it takes American universities. 

The campus is located above the 41st parallel, as the Phantom, its founder, believes no university located below this latitude can provide enough adversity to be a real university: To wit, the universities at Santa Barbara, New Orleans, anywhere in Florida are just too amenable to homo sapiens to foster any sort of honing of survival instincts. It's a variant of "I walked 5 miles through the snow to school." 

The buildings and architecture are neo-Hogwarts and the faculty is aged, sometimes decrepit and hand selected by the Phantom on the basis of actual, true, brain certified scholarship. 

For example, the Dean of Students, and head of the Department of What Matters is a graduate of the University of New Hampshire at Keene State and is the most thorough going scholar the Phantom has yet met--she never fails to read the footnotes, the references and the references within the references. She asks embarrassing questions whenever possible, and is simply the smartest person in the room on every occasion, and she has been in the room with Larry Summers, Bernie Sanders and Scott Brown. She denies knowing Jeffrey Epstein but cannot recall if she has ever met him.

Admission requirements are so exacting and discriminatory that no student has yet qualified for admission, but the Phantom remains hopeful. 

SAT's and ACT's are optional, but won't impress anyone. Starring roles in feature length films will be considered as part of the admission portfolio, but applicants are warned that the film criticism department has been known to make Pauline Kael look like a shill for People Magazine, and they will review your performance. 

Applicants who are certified in plumbing, HVAC, electrician services may be granted full scholarships on a work/study basis. (The buildings are old.) Auto mechanics, same deal.

Military veterans will be considered on a case by case basis, or on a war by war basis, whichever applies. 

Athletes are welcomed, but the university competes in no leagues and has no stadium.  

Swimming, baseball, wrestling, crew, tennis, rugby, football, golf are supported, in that order, but there are no coaches. 

State of the art gymnasium, weight rooms, swimming pool and fields are supported just as soon as we find rich patrons to write the checks.

Theatre arts, film making and film criticism are highly valued and may be your ticket into the school, just as soon as we get Spielberg, Geffen or Tom Hanks to write the checks. 

Music is a high priority, but the university has refused to support faculty until it can offer enough salary to make it worth their while. So far, Josh Redmond, Herbie Hancock and Susan Tedeschi have not been approached because we could never pay them what they would be worth.

Painting, sculpting and such like are allowed, but not supported. Rooms may not be heated, although northern light is provided.

 

A university infirmary is available just as soon as Elizabeth Warren gets the bill through Congress, with prevention of sexually transmitted diseases a priority. We know the demographic we are dealing with here. Also contraception.

The university does not embrace "diversity" although it's happy when it happens in our classes, but we are not talking about race here, to which we are indifferent, but class. "Inclusion" is a given. If you are admitted, you are in, or included or whatever you want to call it. "Equity" is discouraged, as people who decide to read all the assigned stuff will be treated way better than people who fail to engage the assignments, who will be expelled for non participation. 

Geographic distribution is not a priority. Race is not considered. If we find ourselves with a class of 400 Asians or Blacks or Blonde Caucasians, we will be happy if we think these are the best individuals we can find. 

 

 

Interviews on campus are required. Transportation to campus will be paid for by the university, just as soon as we can get Delta airlines to buy in. 

All rooms on campus are singles. 

Grades are recorded for each student for each course, but not shared with the student. 

Faculty are not required to write letters of recommendation for students, but if you are any good, they typically don't mind.

Students must vacate the campus the day after graduation and are never allowed back on campus and cannot contribute to the university thereafter.

The university will certify students have graduated but otherwise wants nothing to do with you once you are gone from campus.