What the Young and the Old Have in Common

Atul Gawande is the kind of person who makes the rest of us feel inadequate. It isn't enough for him to be a Rhodes Scholar, Harvard Medical school graduate, and surgeon at Brigham and Women's Hospital (arguably one of the finest teaching hospitals in the world). He's also a researcher, a journalist (having written articles for Slate and The New Yorker), the author of four popular books (Complications, Better, Checklist Manifesto, and the recently released Being Mortal), and—oh yes—a loving husband and father to three children. According to his Wikipedia entry, "He enjoys reading." How he finds the time is anyone's guess. In short: he's amazing.

I've always been fascinated by medicine, and there's nothing I enjoy more than curling up with a well-written nonfiction book. So, not surprisingly, I've loved everything Dr. Gawande has written. Being Mortal is his best so far. It is terrifying (because he makes us think about our own mortality), poignant, informative, tragic and brilliant. And, quite unexpectedly, it includes insights into why schools aren't necessarily the best places for our kids to be spending so many hours of their days, so many months of the year, for so many years of their young lives.

Did Dr. Gawande intend for his newest book to be a commentary on our educational system? I'm sure he didn't. In fact, he might not even agree with me. But as I was reading along, I kept coming across passages that I believe apply as much to education as they do to elder care. 

For example, in Chapter 5 ("A Better Life"), Gawande describes how a man named Bill Thomas becomes the medical director for a nursing home with eighty residents: 

"From the first day on the job, he felt the stark contrast between the giddy, thriving abundance of life that he experienced on his farm and the confined, institutionalized absence of life that he encountered every time he went to work. What he saw gnawed at him. The nurses said he would get used to it, but he couldn't, and he didn't want to go along with what he saw." 

This was how I felt on the day I brought my firstborn, barely six months old, to a large daycare facility with cribs in a row and caregivers telling us "we'd get used to it" (we didn't—she cried, I cried, and we left the same day). It was also how I felt when I peered into my daughter's first grade classroom, which was filled with desks in rows and colorful charts. I wondered how my "nature girl" would do when she was no longer able to roam freely through the woods and under the open sky whenever she pleased.

I felt uncomfortable leaving my daughter in a classroom where she would be expected to sit and follow directions all day long. The thought of that confinement and loss of autonomy "gnawed" at me. But I also wondered whether I was just being sentimental and overprotective. Other parents seemed able to ignore their children's clinging and cries when they said they "didn't want to go." Whether they comply out of a sense of virtue or because they feel they have no other options, most parents obediently defer to caregivers, teachers and administrators when they are told "they''ll get used to it." Why couldn't I do the same? What made me ask whether "getting used to it" was something to which I or my children ought to aspire? 

I got a chill as I read about how our elderly were now being told to "get used to" nursing homes because it reminded me of those earlier years when I heard the same words. I thought, if I felt uneasy about asking my kids to relinquish their autonomy for the sake of an education, how much more unwilling will I be to give up my own autonomy for the sake of "safety"? Is the day coming when I will be forced to accept a life that denies me everything I cherish—freedom, independence, choices? I really hope not.

In the nursing home, Dr. Thomas identifies what he sees as the root of the problem:

"In his bones he recognized that the conditions at Chase Memorial Nursing Home fundamentally contradicted his ideal of self-sufficiency. Thomas believed that a good life was one of maximum independence. But that was precisely what the people in the home were denied."

Confined to an institution where decisions were made for them, unable to come and go as they pleased, the residents were "dying of boredom, loneliness and helplessness." Is this so different from a school where all important decisions about what, when and how to learn are made by administrators? Where block schedules and locked campuses confine bodies and limit choices?

When students, not unlike their elderly grandparents, are routinely denied opportunities for self-sufficiency and autonomy, they experience chronic boredom, frustration, and feelings of helplessness. It doesn't have to be this way. Innovative educators (for example, at High Tech High, Big Picture Learning, EdVisions, and The Met) have discovered alternatives.

To shake things up in the nursing home, Thomas decides to try an experiment. His idea is to "bring in some life"—green plants in every room and a garden outside, a playground for children, and a collection of pets (two dogs, four cats, and one hundred birds). It's a crazy plan, and it doesn't go smoothly. There are problems with the animals, complaints from the staff, and many logistical issues. Inevitably and repeatedly, questions about safety arise: "Habits and expectations had made institutional routines and safety greater priorities than living a good life."

Fortunately, Thomas realized that routines were meant to serve not enslave, and safety is not the only goal of living. As Gawande writes:

"Our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one's story is essential to sustaining meaning in life." 

Something similar could be said about how we treat the young and inexperienced. They have priorities beyond merely being safe and getting an education. For them, too, "the chance to shape one's story—and one's education—is essential to sustaining meaning in life."

In the midst of all the chaos in the nursing home, the residents came alive. They laughed at the mishaps, played with the children, and loved being able to care for plants and pets. The nursing home was transformed slowly and with some difficult moments, but the stumbles were part of the process and well worth all the effort.

"For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens."

Now, I'm not saying that being sent to school is exactly the same as being sent to a nursing home, but there do seem to be some striking parallels between the two situations when it comes to how they are administered. There's a similar resistance to change, a desire to maintain order and "keep kids safe" at any cost, and a focus on "getting through a lesson" instead of asking students what sort of lesson they crave. Change is hard, and we can all be forgiven for not wanting to take a chance on trying something new—whether it's homeschooling, part-time attendance, project-based learning, or a brand-new pilot study—scary things that might not work and could even make matters worse.

"The wise course is so frequently unclear . . . When it is hard to know what will happen, it is hard to know what to do. But the challenge, I've come to see, is more fundamental than that. One has to decide whether one's fears or one's hopes are what should matter most."

Homeschooling is scary and feels risky. I rarely knew what would happen or even what to do, but I trusted my instincts and believed in what mattered most: the quality of life I was providing for my family. That alone trumped everything else, and it served as my guiding star. I imagine the same is true in schools where innovators are bucking the system and trying to do what they believe is best for their students.

When I am old and needing care, I pray other people will value my quality of life and not make all my decisions for me. No matter how infirm or feeble-minded I get, I would still like to be asked, "What would you like to do today? Where would you like to go?" And when I reply—if I'm able to reply—I hope others will listen.