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Wednesday, July 1, 2015

Teaching Brains: Semester in Review

Both of the college courses I taught this semester were ones I had taught many, many times before in the US. All I needed to do (will I ever learn this kind of thinking means doom?) was just unpack my old course files from gently mildewed boxes, update the course material a bit, and substitute Korean for Caucasian faces on my powerpoint slides.



Of course, nothing is easy in Korea. I hadn't fully appreciated the challenges of language, for example. I never, EVER got an 'A' on high school speeches because I talk too fast (something my American students also noted). And I hadn't expected that my typical practice of learning all my students' names in the first week doesn't work when I can't even pronounce many of them.
So, I worked much harder than I expected to this semester. But I gradually fell in love with teaching again. How could I resist the chorus of "Thank you, professor!" after good classes; students sneaking up after class to bow and apologize deeply for coming in late; students offering little treats and notes of encouragement. They are marvelously helpful, these Korean students, volunteering to run (!) down the hall for an audio cable, or to erase the board after class. Professors are pretty much treated like royalty in Korea. I like being treated like royalty.  As long as I can wear jeans.


Despite this "love will find a way" path we're going down, only one of my courses was a success. The other was... arg. It was a tiny class of graduate students (we started with 10 and ended with 4) who appeared to not read the text, did not take notes (let alone bring a pen or laptop), and rarely asked or answered questions. My students were friendly (they took me out to lunch!) and their (rare) questions showed remarkable intelligence. But I gradually ran out of confidence in my ability to motivate them to learn.


Sheep brains!
I changed the class time, moved to a better classroom and fixed the technology problems. We (they) built neuron models with candy; they did a 48-hour drug addiction simulation; they dissected sheep brains; they analyzed hunger and pain pathways by doing drawings.When I made the material easier they seemed bored; when I made the material harder they seemed bored. I finally just asked them if they were bored: "No, professor." Maybe they were just being polite?? Eventually I asked if they were overwhelmed: "Yes, sir" (I don't think the "ma'am" concept gets taught here). Further questioning revealed that they'd never had a science lab, knew less about body bits than my middle-school kids, and hadn't had a class in English in years. Ok, ok, But still.


Building neurons!


I came to dread going to class, doing my teaching dance, and avoiding their slack faces. I was a failure. And I felt guilty, like I'd violated the Professor's Oath of Office (ooh - sorry - the "part-time instructor's" oath). Finally, I had one last strategy. A field trip! It would take up a class period, generate an assignment they could handle in English and might result in learning. Yes! But where to go??


Pohang Semyoung Gidok Hospital
(photo from http://www.phgidok.com/)





A few weeks before the end of the semester, an international student who knew I taught about brains asked me about some alarming symptoms he'd been having. My research showed three possible diagnoses, and all of which needed to be checked by actual brain experts rather than someone with mad google skills. After researching which hospital might have a neurologist, I drove him and a translator to Semyoung Gidok, playing the usual "getting warmer, getting warmer" game as squinted at my map and hunted for nearby landmarks. Because that's how a foreigner do (I bow to Ze Frank for this excellent phrase). 

Now, when you live in a land where women use smartphones while sweeping with twig brooms, you never know quite what to expect in terms of modern conveniences. But if you've got your crayons handy today, color me IMPRESSED with this hospital. Semyoung has a full-fledged, top-notch Brain Center. At the end of the visit, I asked the doctor if he would come talk to my university class. His response? No, because his English wasn't good enough. Typical Korean answer.


{And while we're on a tangent, here's another one: While the student was consulting with the doctor, I had stayed in the Brain Center's waiting area, a space with 30 plush green chairs in rows facing the nursing station. I was the only one in the plush chairs, watching patients wander around (note to Americans: Korean hospital patients, dressed in colorful cotton pajamas, wander like stray cats in and out of the hospital, even pushing their own IV poles down the street). While I sat, an older patient came to the empty waiting area and she sat...on me. On my right leg. I had absolutely no response to this in English or in Korean. I just sat, torn between curiosity and, well, dumbness. After a day or so, she got up and walked to the elevators in her pjs. I still have no explanation.}
Where were we, anyway? Oh yes - field trip! We could go to see the doctor at the Brain Center! A student called the doctor with our request and assured him that speaking in Korean would be fine: I would merely serve as the driver (not as professor instructor worthy of respect) and the students would write reports for me (in English!) so I knew what they had learned.

I did not expect this trip to go well given the previous 14 weeks of class. Further, my students were very nervous about whether their limited knowledge of the brain would allow them to understand the doctor or ask good questions (which I insisted they bring because I would be doing none of the talking). But they did GREAT!! The doctor used a laptop and projection system to flip through patients' online files (yes, we could see the names, ages, and gender) to show us a variety of brain images. And despite their nervousness (and mine), the students could easily identify major brain structures, distinguish among types of images, and understand how the damage they saw would affect thinking, emotions, and behavior.
Localized stroke damage.


Seeing so many images of people's brains--damaged by disease, strokes, and accidents--was truly fascinating. And much more interesting (and sad) than just seeing images in a text or online: these were actual patients, people living in our city, trying to cope.
The doctor also took us into the hospital's MRI, CT and MRA imaging rooms. A man with particularly horny toes was getting an MRI while we watched his brain images appear on the computer. In the neuropsych clinic, another doctor showed us very familiar tests (e.g., MMPI, Rorschach, Myers--Briggs) and did a basic neuro-memory exam with one student (he passed easily, to his great relief and mine).


I appreciate that the Brain Center's slogan is in English.  But I still don't understand it.
You can see the good doctor explaining the MRI and other devices to my students.
You can also see (lower right) one of the radiology technicians taking a 3-day tooth-brushing break.
Korean tooth-brushing is a public act - in your office, the hallway, the MRI scanning room.
Where ever. 


A patient's MRA (magnetic resonance angiogram) images show the blood vessels in his brain;
this hospital has THREE MRI rooms.  Amazing.
One student volunteered for EMG (electromyography) to test muscle-nerve communication - I don't think she was
warned that it was painful.... 

Brain damage required part of the skull to be removed
to reduce damage from swelling.


On the drive back, the students chatted animatedly (in Korean, but still - chatting!). I later learned that one student’s mother had had part of her skull removed and refrigerated for 2 months before having it replaced; this was done to reduce the impact of brain swelling subsequent to surgery for epilepsy. We had seen a scan of someone missing part of their skull, and my student now understood her mother’s situation in a whole new way.

Maybe it was a cheap pedagogical trick to slip a field trip in. And probably far too late in the semester to motivate learning. But finally, finally, I saw a light in their eyes, and their reports showed a strong commitment to incorporating brain science into their careers as therapists. It's not quite a Cinderella Story or a Miracle on Ice, but maybe I didn't fail my students after all.