The English Troika: Part 1

Okay, I’ve been miserably long in posting this (and it’s still not complete) but here is the first installment of a look at U.S. education.

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I recently finished the classic tale of The Brothers Karamazov, written by Fyodor Dostoyevsky (or Theodore Dostoevsky, as it’s sometimes anglicized). If the name didn’t tip you off, he’s Russian, and so are the brothers he writes about. The tale was written in the nineteenth century, about the scandals of nineteenth century life in a small Russian town … and yet I think it’s one of the best books I’ve ever read. It is a masterpiece in every sense.

Once I came to that conclusion, I wondered why it was that my school-age self never got the chance to read him. Was, in fact, forced to slave through stories that were boring and verbose, like Last of the Mohicans, instead. How was Dostoyevsky dismissed (never even mentioned, actually) when Romeo and Juliet was crammed down our throats not twice but three times in high school alone? At least I heard about Tolstoy’s massive classic War and Peace, and Hugo’s Les Miserables, though neither ever had a place on our bookshelves nor in our library nor curriculum. So I began thinking about our education system. I began to wonder, what are students actually learning? When English class rolls around and pupils open their textbooks, what greets them?

From my own school days I recall curricula that rarely wavered from writings of the “Big Three” – the US, the UK, and Ancient Greece – with virtually nothing newer than the nineteenth century except for a handful of short fiction and poetry. It never really struck me at the time how little we read of international authors. Even my university literature classes – open to anything written anywhere, anytime – featured little outside the well-worn paths of American, English, and Greco-Roman classics. Just in case we missed them in high school, I guess. I recall only two exceptions: a piece by Voltaire, a Frenchman; and Metamorphosis, by German author Franz Kafka. For crossing borders, that’s a terribly poor selection. Not that those authors don’t have writings worthy of study, but they were the only representatives of the greater world. I had in fact read Kafka’s famous tale as a teenager without realizing he was not American, which seems an even poorer world lit choice. I expected a great deal more out of my “education.”

I expected my horizons to be stretched; I wanted to be introduced to all manner of thing new and exotic (to me, at least). Growing up in rural mid-America and attending a small public school, I understood they operated under certain limitations. There were few frills – no AP classes, no special college jump-start programs. It was a small school with only a handful of faculty and staff, with mostly older buildings and low district millage rates. It was considered a stretch of our horizons to read Antigone (the story of Oedipus was pretty scandalous for the youth of a town with one gas station, one bank, and five churches). But now our “small” public schools have budgets rivaling that of my university alma mater. So I wonder if the latest crop of students are more well-read than my antiquated little class.

I still live in a rural area, very much like the one I grew up in, and I’m going to use the nearest public school as my model. Its middle and high school sections (with adjoining campuses and shared buildings) serve less than 900 students with more than 100 faculty and major staff (not including higher school officials or secondary staff). The middle school includes thirty-five classrooms; the high school has more, though I’m not sure by what margin; and most of the buildings are less than ten years old. Students can compete in eight different sports and graduate with more than 20 college credit hours. Sounds good, right? So let’s see how they measure up via ye olde standardized testing (not the best judge but the most decent judge I have easy access to).

Let me pre-empt these numbers by noting that very little is available on post-8th grade rankings, and virtually nothing prior to 1998. So, for starters at least, I will have to settle for comparing the 8th graders of 2009 to the 8th graders of 1998 to get any picture of the system at all. Now, on with the show. Since we’re talking literature, tests in Reading and Writing seem the most relevant, and from 1998 to 2009, there was a whopping change in our 8th graders statewide. Writing showed an increase of 5% and Reading showed an astounding increase of … [drumroll, please] … 1%. Wow. Wait a second; let me pull my socks back on before plunging ahead. In 1998, 8th graders in the state ranked 29th nationwide in Reading; in 2009, they ranked 41st. In Writing, their ranking fell from 33rd to 36th. But those are statewide and nationwide numbers, not a representation of my model school. So let’s see what else we can find.

According to 2009 literacy test results, my local high school ranked 96 of 253; the middle school section ranked 102 of 299 – both solidly mediocre. Not bad, not good, but I find it very disappointing given the present funding. Compared to what my former high school worked with, this model school is rolling in money. For instance, my high school had unpaved parking lots, not ideal but certainly functional and low maintenance. The model local school recently spent $1,000,000 on one paved parking lot. Let me repeat that: they spent ONE MILLION DOLLARS to prepare and blacktop ONE LOT so visitors and employees could walk to the main building without getting dirt on their shoes. Never mind the curriculum, crushed rock is hell in heels. But maybe their test scores are fantastic and their budget is overflowing with surplus … which I’m presently researching and hope to include in the upcoming Part 2.

As an interesting aside, I checked the state requirements, and the language arts standards specifically mention only “American, British, and Greek/Latin” literature, with later mentions of “and/or other” literatures. No wonder our school featured nothing else; the Big Three were the only outside sources of literature specifically approved by the state.

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What to look for in Part 2:

Local school results
Teachers’ pay versus test scores
State and National test scores
and anything else I run across that looks juicy

Stay tuned.

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Pat, I’d Like to Buy A Bowel

For today’s consideration I offer up some statistics and information about two cancers common in both men and women, bladder and colorectal, along with some pointers about risk and detection.

For starters, how about a little definition of what exactly we’re talking about. First, the bladder. If you remember anything of biology or health and fitness classes, you might recall that the bladder stores urine until certain signals tell you it’s “full,” and then it contracts to help push the urine down the urethra and out of the body. Secondly, the colorectal area. Since they are connected physically and work in tandem as part of the digestive system, the colon and rectum are often grouped under the collective “colorectal” description. Essentially, the colon is the large intestine, and the rectum is the last six inches or so before the anus.

Okay, with the anatomy lesson over, lets get to the bits that actually matter. Bladder cancer is one of the more common cancers found in men and women but is rarely publicized. According to the American Cancer Society (ACS), in 2009 some 52,810 new cases of bladder cancer were expected in men. Using Census Bureau population estimates, that means any given man had a 0.00035% chance of being diagnosed with a new bladder cancer. Those are whopping odds, I know; and, ladies, you’re numbers are even lower. For 2009, any given woman had a roughly 0.00012% chance of being diagnosed with a new bladder cancer. The 18,170 estimated new cases of bladder cancer in women in 2009 means that men are several times more likely to develop bladder cancer than women are. In fact, the ACS reports that “bladder cancer incidence is nearly four times higher in men than in women and more than two times higher in white men than in African American men.” Sorry Team Blue.

But don’t let the numbers get you down. For men, the cumulative chances of developing bladder cancer remain less than 1% until age 70 and beyond. Lifetime odds are less than 4%. And the odds of dying from it? One-fifth the chance of developing it. Women, as the earlier numbers indicated, have even less to worry about: bladder cancer odds never breach 1% by age group and is only 1.2% over the course of a lifetime. So not exactly a raging pandemic by any means. Which is especially good because bladder cancer has no good method of early detection. The most effective assessment of bladder cancer involves running an endoscope up the urethra and taking a look around. For obvious reasons, this is a procedure to be avoided unless you happen to fall among a high-risk group and or show troubling signs (especially painful urination or bloody urine). For the vast majority of us, this will never be a problem, so don’t concern yourself over it too much.

Colorectal numbers are higher. The ACS expected 75,590 new cases in men and 71,380 new cases in women in 2009, making it “the third most common cancer in both men and women.” Those numbers are also fairly even between the sexes, unlike bladder cancer. However, like bladder cancer and prostate cancer and breast cancer and most other cancers as well, the highest odds come later in life. “91% of [colorectal cancer] cases are diagnosed in individuals aged 50 and older,” reads the ACS statistics release. But it also related that in both men and women, the odds of developing colorectal cancer are less than 1% until age 60. Again, little reason to worry.

But if the 5 – 5.5% chance of developing colorectal cancer over your lifetime have you on edge, there are several methods of early detection. Most of us are familiar with the colonoscopy procedures as described (and sometimes filmed) on TV, where an endoscope is run through the large intestine in search of suspicious lesions or polyps. But if that’s too invasive for your tastes, you might consider a sigmoidoscopy, where physicians examine the rectum and lower third of the colon for abnormalities through a thin device called a flexible sigmoidoscope. It takes about 15 minutes, is less invasive, and can still take biopsies of anything suspicious. It’s recommended every five years and, like conventional colonoscopy, can occasionally (but not commonly) cause bleeding or tears in the intestinal walls, both requiring surgery to repair.

If those don’t fit your fancy, perhaps a double-contrast barium enema (DCBE) would do the trick. Recommended every five to 10 years, it involves a very thorough barium sulfate enema that physicians use to examine the lower digestive tract via x-ray. It exposes the patient to less radiation than a typical CT scan (also called CAT scan) and is somewhat less invasive than colonoscopies or sigmoidoscopies. However, if you don’t mind an enema or the slightly higher radiation of CT or MRI scans, you might opt for the virtual colonoscopy. After an enema, a small tube pumps air into colon (for better differentiation) while CT or MRI scans provide images of the intestinal tract. It’s still less invasive than traditional colonoscopies but does not allow for biopsies or as thorough an internal view. However, it does allow for imaging of surrounding tissues and produces more accurate images than DCBEs.

But if you’re not fond of any foreign materials up the backside, you might just opt for the simplicity and complete non-invasiveness of fecal blood tests. There are two types but both are quite accurate and inexpensive. One type, called FOBT (fecal occult blood test), tests feces for the heme blood component (“heme” as in hemoglobin, part of our red blood cells). The other, called FIT (fecal immunochemical test), is more sensitive and tests for the globin blood component. Pre-cancerous polyps in the colon or rectum often bleed into the fecal matter passing through the digestive tract, which can be detected by these tests. They are simple enough to do at home and are sometimes handed out free of charge at proctology centers, clinics, and other medical service providers. Doctors recommend triple-testing to reduce false positives as the body expels small amounts of blood in feces under normal circumstances. But the tests return positive results for bleeding anywhere between the mouth and anus, so don’t automatically assume colorectal cancer even if there is blood. These fecal blood tests are considered a line of primary identification, as are the similar fecal DNA tests, but for conclusive diagnoses you’re still expected to see a doctor and perhaps choose a colorectal treatment of a more invasive kind.

I think the most important thing to remember is how unlikely these cancers are. And being diagnosed with cancer is a long way from dying of it. So keep an eye on yourself, and get your regular medical check-ups if you like, but don’t waste time and energy worrying about something so unlikely. No matter what you hear on the news.

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Green Shoots

The phrase used by optimistic economists for the last year is starting to come to life. But I’m not going to talk about the economy, or politics, or even Team Blue (which, by the way, needs a mascot, I think … but Blue Devils is taken and I don’t think Blue Balls would go over well for either side, so I could use some input on that). With the Ides of March just around the corner and spring soon to follow, I’m talking about real green shoots, the kind full of chlorophyll that push up from the soil into the sun when the frost leaves and the ground starts to warm.

The resurgence of the “Victory Garden” over the last couple years has been nothing short of amazing. Some seed suppliers are finding themselves overrun with orders and the busy season is just getting started. Widely popularized during World War II, the Victory Garden is essentially a small vegetable patch for a family or similarly sized group of people, providing a source of wholesome food for very little monetary investment. With a less-than-stellar economic situation for millions in the U.S. over the last few years, these gardens have again become popular. For a few dollars worth of seed, a family can enjoy a supply of fresh vegetables for months to come. I’m joining the bandwagon this spring with big plans and elbow grease on stand-by … because one way or another there will be a garden outside my door.

I realized last summer how disgusted I was with the produce offered at local supermarkets. What hasn’t been dropped, crushed, bruised, poked, or otherwise beaten half-unidentifiable costs an arm and a leg. And if it happens to say “organic” on the label, just go ahead and triple the price, no matter how puny, shriveled, or misshapen the items might be. But price aside, that produce has also been doused with god knows what all kind of pesticides, herbicides, fungicides, and – I’m quite certain – people-icides. A few years ago I researched just what went into the classification systems of food products and was astounded at the lack of regulation in what we eat.

To begin with, the vast majority of fresh food in this country is imported, and not just exotics like bananas and mangoes but boring old staples like lettuce and tomatoes. Remember the spinach scare a few years back? Tons of produce tainted with E. Coli were shipped all over America and had to be recalled after people fell ill and some died. It had been imported. The government assured its people that it was an isolated incident. But food marketing in the U.S. is essentially an honor system. If Company A claims its goods are organic, they can market it as such with almost no oversight. Although there are reams of laws and stipulations that should be followed, the chances of enforcement are miniscule. No one is out there testing produce to see what chemicals it has come into contact with. No one is randomly sampling imports (or even U.S. produce) to see if it carries pathogens on its merry way to your plate. Caveat emptor indeed.

And what does all the spraying and genetic engineering and hybridization supply us? Judging from the local supermarkets, rubbish. Most of the produce is picked so green it could sit on display for a month (for those of you who may not know better, “fresh” produce should go off much quicker than that) and has all the subtle flavor of a cardboard box. In an age when I can fly halfway around the world in less than a day, including plane changes and layovers, why is my produce almost old enough to legally drink?

So this year I’m growing my own. Not a lot, but a good variety. And though I’ve a poor history with plants, I sincerely bet the result will be exponentially better than what I find at the store. Surely it can be no worse.

And in an effort to both encourage local business and “stick it to the man,” I’ll be using all heirloom seeds from a small supplier. (Gurney’s and Burpees be damned; I could never get a decent tomato out of them anyway.) When I’ve finalized my plans I’ll post them here just in case anyone should care to join the Victors with a garden of their own.

Oh, and you know what, if you’re tight on funds and worried about getting enough fertilizer for your garden … just use some of that bullshit Washington keeps shoveling at us. Lord knows there’s plenty of it. 😉

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Stick Your Finger Where?!

I last wrote about breast cancer in my informal “medical series” here on the blog so, to be fair, I’ll now address prostate cancer. Unlike the enthusiastic pink-banner-waving breast warriors-of-awareness, prostate cancer’s agents of information fly below the radar with little hoopla, few public endorsements, and no ribbon brigades. But statistically, prostate cancer is just as prevalent as breast cancer and results in about 30,000 deaths annually.

But how about a bit of good news to start? Most guys are familiar with the “probing finger” method of prostate examination, but how many have heard of the PSA blood test that can also be used? Ideally, the American Cancer Society suggests they be used in conjunction to help identify prostate issues, and generally only after age 50. But, fellas, there’s our loophole; you have the right to request the blood test and forego the finger.

Now, back the issue at hand (no pun intended). Prostate cancer, like many other cancers, increases in probability with age. Roughly two-thirds of cases are diagnosed in men 65 and older. And whereas a 40 year old man has only a 0.01% chance of being diagnosed with prostate cancer, a man aged 75 has a 12.5% chance. Which, incidentally, is twice the odds of a woman the same age being diagnosed with breast cancer. In fact, from age 55 on, men are at a higher probability of prostate cancer than women of the same age are of breast cancer. And over the course of a lifetime, men are over 30% more likely to develop prostate cancer than women are breast cancer. I don’t recall seeing any blue ribbons for that in the New Yorker.

And although men make up less than half of the country’s population, they are more likely to develop cancer of any major class but one. Digestive cancer? More prevalent in men. Respiratory cancer? Men. Bone, skin, brain? Men. Lymphoma, myeloma, leukemia? Still men. The only major class not led by men is cancers of the endocrine system, involving hormones. (And I dare say most men could offer an explanation for why women are number one in that.)

So I think we should begin a blue-ribbon brigade, to save the men. They are a minority in the populace, suffer a shorter average life span than women, and are at higher risk for debilitating disease. If that doesn’t deserve a ribbon, I don’t know what does. But I don’t think we can rely on super-aid-celebrities like Bono to go waving any flags for the cause (mostly because I think he needs to grow a pair first), so men, take a stand for yourselves. Wave your own banners and be your own warriors-of-awareness. And women, if you support the pink ribbon then you need to support the blue one, too. We have to fight for equal rights, equal awareness, and equal funding together, breasts and prostates alike.

Go blue!!

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