But, what will the colleges of medicine and university hospitals do to educate students to function in this new world? What will we do to change the current culture, or must we simply wait til all of the recalcitrant incumbents disappear from the field? In short order, if this discussion is to truly sprout wings, we will have to deeply change the training, content, and staffing models of our current educational institutions.

At any rate, you have described the coming adventure in compelling terms with your wonderful “sound bites”!

And yeah, I’m aware of Kuhn’s book. He also said that science is a fashion industry, where people who have the audacity to say something that’s out of step with current fashion get ruthlessly ostracized. One example was Judah Folkman, “just a surgeon” (not an oncologist) who saw that cancers in the body had thriving nests of blood vessels around them and proposed that the growth of vessels (“angio genesis”) was a fundamental part of tumor growth. He was ostracized, even losing his department chairmanship, but stuck to it. He proposed and even named two enzymes, angiogenin and angiostatin, that promote and stall vessel growth.

Eventually he found those enzymes and proved the process, which become the foundation of perhaps the most hopeful cancer treatments, anti-angiogenesis drugs such as Sutent.

Another example, I’m told, is Robin Warren, the Australian doctor who went against what “everybody knows” and said stomach ulcers are caused by the helicobacter pylori bacteria. He too was ostracized and belittled, but 20 years after he published his paper he got a Noble prize.

I guess history shows that derision by the scientific community is not a reliable sign that something is wrong. We all need to be responsible for our own decisions and for educating ourselves as much as we’re each able.

This is mind-blowing way beyond the usual mind-blows. I confess that at first glance I was put off by Rousseau and Dewey (“Oh crap, this is way smarter than me, it’s an egghead paper, out of my league”), but I’m glad I stuck with it to get to the bullets.

That is REALLY something.

So, now, here’s a puzzle, or maybe not. I’ve always felt that education without enablement (empowerment?) was useless: if I didn’t leave a course knowing how to face problems on my own the education had failed. Is that what we’re talking about here?

What’s the difference between this and “teach me to fish and I eat for a lifetime”?

Great post. Heady.