Pearls of wisdom, tearing up textbooks, and getting messy

We talk a fair bit about Pearls of Wisdom at the School of Medicine. The last class for the Class of 2016 ended with Pearls, presented by faculty selected by the class. Later this week, during orientation week, Pearls will be shared with our newly-minted class of 2020.

Pearls are succinct pieces of advice, aphorisms or other sage musings designed to guide, caution, or inspire.

IMG_4250
Artist Nancy Douglas (centre) offers suggestions to creative expressions participants at the first workshop in May.

Sometimes these pearls are explicitly stated as “here’s a pearl” as in those two learning events. Sometimes they are shared in a one-on-one feedback session during clerkship; or it’s that certain nugget of wisdom imparted during an FSGL session. Or the gem from an SGL case, or advice from a near-peer in a mentor group.

By their very nature, these Pearls of Wisdom are best experienced – in a true handing on of guidance in the moment, rather than as a bullet-list on a Post-it note. Given that medicine is both science and art, however (as made clear in many Pearls), we wondered if we could preserve these words of wisdom in a more permanent, concrete way while still maintaining the spirit of these fleeting sessions.

With this in mind, last spring, we started a different representation of these Pearls of Wisdom: a School of Medicine collage. Working with Kingston artist Nancy Douglas, participants selected images, situated them on a six-foot long canvass and used collage techniques to bring the images to life. The images came from old textbooks and journals — lots of tearing and gluing and hands-on creativity.

That first session in May was a start, but our collage is not finished!

FullSizeRenderThe second creative session for the collage will take place Monday, September 12 from 4:30 – 8:30 p.m. in the Atrium of the School of Medicine building. Students, faculty and staff from all years of the program are encouraged to take part.

Bring your ideas about medicine, your journey in medical education, and the pearls of wisdom you’ve received from faculty (and others) along the way. Also, bring any old textbooks and journals you’re willing to rip up for the collage! This is hands-on, so be prepared to get your hands mucky. (Collage is a bit like casting – without a broken bone).

This is a drop-in event, so you don’t need to plan to be there for the whole four hours. Please come when you can. Refreshments will be served, too!

Creative Expressions of Learning is hosted by Dr. Lindsay Davidson (Director, Teaching, Learning and Integration), Vincent Wu (Meds 2018), Stephanie Chan (Meds 2019); and Sheila Pinchin (UGME Education Team Manager).

The event is funded by the Creative Expressions Grant from Queen’s Centre for Teaching and Learning.

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Reflections on reflection on reflection

elbow lake reflection2

Hi all:  I’m back from a few weeks at our family cottage near Sudbury. Now for those of you from north of Parry Sound, you know that it’s not a cottage, it’s a camp, but I’m translating for all the Southerners here at the UGME blog.

I find that there’s nothing like total exhaustion from installing a new water pump, sanding and staining a deck, staining 6 new Muskoka chairs, and bringing water by hand, up a steep hill, to the garden which one has foolishly planted up that hill.  I find total exhaustion quite conducive to reflection.  I simply sit and stare at the water.  After awhile, my brain starts to work again, and after solving basic issues like food and water (shades of Mazlow), I can even start to get creative.  I think about what’s gone wrong, or what needs to be better and I plan.  I can plan a brand new cottage (hah!), a new way to pump water (hah!), and even a new garden location.  I can plan things to say to my husband when he says, “These Muskoka chairs are so cheap—we couldn’t build them for this money.  Let’s get 6.”  And then, furtively, because UG at Queen’s is never far from my thoughts, I can even start to reflect on things at UG, and plan to make things even better.

Now this urge to action based on reflection is my favourite perspective on reflection. Unfortunately, I’ve never been one to meditate, or think about the moment, or think about nothing, or “relax”.  (However, I did take Dr. John Smythe’s 6 week course on mindfulness and just to show you how good he and the course are, by week 6, I found I actually could be mindful, focus on an object and poof!  Gone for 15 minutes! I highly recommend it, and I try very hard to put his precepts into practice!)

But generally, I’m a Kolb-ian.  I like Kolb’s model of experiential learning—it speaks to me as a call to action.  He advises, in essence, to act, reflect on the action, take it to other reference points and then make an action plan.  I think I’ve shown you this before, but just in case…:)

kolb_cycle

 

So, on what did I reflect, in my moments of recovery from projects at the cottage?  (Did I mention my perennial and consistent devotion to ridding the cottage of mice droppings as part of my activities?  I abstractly conceptualize that as draining the ocean with a teaspoon. (See Stage 3 above.)

Well, one thing I did was bring a book that I promised I’d give you some feedback on, up to the cottage.  It’s entitled English and Reflective Writing Skills in Medicine by Clive Handler, Charlotte Handler and Deborah Gill (CRC Press).  I took some great things from this, to share with you.  They are reflections and pieces of reflections, morphed into this article, which is something I strongly advice with reflection.  Reflections are private.  An action or a blog article, for example, is something that can be crafted from reflections into a public piece of writing.

One thing that really spoke to me was the list of areas and experiences that can generate good critical reflection especially for learners in medical education.  I think, too, that even for experienced practitioners these questions can trigger reflection.

About a patient:

  • A patient happy or unhappy with their treatment by you or others
  • A question of confidentiality, consent or inappropriate risk
  • Doing something for the first time
  • Communicating with older or frail people
  • Consultations involving more than one person (for example, a relative)
  • Sudden death or deterioration

About you:

  • An aspect of a patient encounter that revealed gaps in your knowledge or skills
  • An even that caused you anxiety or enjoyment
  • An aspect of care that left you surprised, puzzled or confused
  • A patient that challenged our assumptions or whose actions are at odds with your personal beliefs and values

About the team

  • When you feel an aspect of the treatment or management is wrong
  • A dysfunctional team that affects patient outcomes or experiences
  • The actions of a team under pressure

Good medical practice

  • Times you have exhibited good medical practice or found yourself in a situation that may be at odds with good medical practice
  • Times when you have seen medical practice or behavior that may be at odds with medical practice. (pp. 6-7)

What do you think?

Now the authors also tackle the dicey area of marking and giving feedback on reflective writing.  Medical students are often extremely concerned about who will see their reflective writing, and whether that will impact on the faculty member’s opinion of the student.  This seems to me to be quite understandable, and it’s why I mentioned above, that taking a reflection and crafting it into a set of goals or more concretely, an action plan, with some work already done, is often a very positive spin to put onto a problem area that a student has identified.  I used to tell my education students, “It’s not a question of whether any of us will make a mistake or not. It’s a question of how we recover, and deal with the mistake that makes the good teacher.”  I think that is also true of the good doctor.

So…in order to create an action plan the authors advise using the Kolb cycle but changing it slightly to:

  1. Identify and describe a professional scenario
  2. What are the perceived consequences of these behaviours?
  3. What are the implications for professional practice? [Sheila’s note: at this point I would challenge students to walk the walk and provide some evidence from medical and medical education literature to demonstrate the implications and help provide solutions for 4.]
  4. What evidence can you provide to show how you have used this experience to develop your practice and inform your behavior in professional scenarios? [Sheila’s note again: OR What is your plan of action to change the behavior?] (p. 12)

At this point the book delves into how to assess the writing skills of the students and it’s full of good advice about grammar and tons of examples of reflective essays.

Speaking of assessment, I’ve been hearing that some students don’t feel that receiving feedback on the lack of clarity and the amount of spelling and grammar errors in their med ed writing is within the realm of medical education.   Well, it is one of our Curricular Objectives (CM 1.3a: Provide accurate information… in a clear, non-judgmental and understandable manner.) And I can only imagine what you readers are saying to yourselves right now, about the importance of clear writing in transitions of care, etc.

What I do have for you is a row for a rubric I created for clarity of expression.  So should you ever be assessing student writing, and want to use it, feel free.

10 prompts write reflections

Lastly, here are some ways to write about reflections that give a format or form to the thoughts.  Students may find these more enjoyable, or at least more guided.  What do you think?  Do you have others?

  1. So What? Journal:  Identify the main idea of the lesson or incident. Why is it important? Why is it important to others?
  2. Analogy (or Simile):  Explain the main idea using an analogy. (Has the benefit of making everyone look up “analogy”.) OR could be explain this idea as a simile:  It’s as if, or it’s like… Then, folow the thread of the anaology or simile.
  3. Question Stems
    • I believe that ________ because _______.
    • I was most confused by _______.
    • What surprised me was _______
    • A patient (a nurse, a physiotherapist, etc.) would see this incident as _____________.
    • When I read up on this, here was one interesting solution____________
  4. Muddy Moment:  What frustrates and confuses you about this incident?  What will you do about it?
  1. PAS_Double-Entry-JournalDouble Entry Journal: Jot down main points, questions, etc. in left hand column.  In right hand column write about these, including actions for the future
  2. Twitter Post: encapsulate in under 140 characters.
  3. Praise from your Mother (or Father or other person who loves you):  “My son’s (daughter’s etc.) done this_______” (In other words, have someone else brag about you if you won’t.)
  4. Top Ten List:  What are the most important takeaways, written with humor?
  5. Quickwrite:  Without stopping, write what most confuses you.  Use a concept map or other format to try sorting it out.
  6. If I were writing a blog about this ____(opinion, incident, topic), I would write__________________.
(Adapted from “Dipsticks: Efficient Ways to Check Understanding; http://www.edutopia.org/blog/dipsticks-to-check-for-understanding-todd-finley)

Well, those are some reflections on reflections from my time up North.  I’ve also partially solved the mouse dropping problem (all the dishes are now in bins when we leave!)  And I’ve figured out what to say to my husband when he advises buying 6 chairs we have to build and stain:  “You are right, dear!”  (because he was right, and  they look awesome!).  muskoka 1

I’ve also once again realized how rejuvenating short physical projects can be (they have an end! 🙂 and how much I love to sit by a lake and think.  I just have to figure out how to keep this reflective spirit going all year long!  As for the water pump…well, maybe part of the reflection is that some things you just have to live with!

Any reflection on reflections to share?  Feel free to write in!

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Curriculum Committee Meeting Information – July 21, 2016

Faculty and staff interested in attending Curriculum Committee meetings should contact the Committee Secretary, Candace Miller at candace.miller@queensu.ca for information relating to agenda items and meeting schedules.

A meeting of the Curriculum Committee was held on July 21, 2016.  To review the topics discussed at this meeting, please click HERE to view the agenda.

Faculty interested in reviewing the minutes of this meeting can click HERE to be taken to the Curriculum Committee’s page located on the Faculty Resources Community of MEdTech Central.

Those who are directly impacted by any decisions made by the Curriculum Committee have been notified via email.

Students interested in the outcome of a decision or discussion are welcome to contact the Aesculapian Society’s Vice President, Academic, Kate Rath-Wilson, at vpacademic@qmed.ca.

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Malcolm’s Italian Adventure, and the art of teaching through storytelling.

When I first met Malcolm Williams, he was trying valiantly to teach me how to examine the back of a child’s throat without getting bitten or having the patient throw up on my white shirt and tie. He was only partially successful. Over the years, I’ve gotten to know Malcolm well, in various contexts. Such continuing and evolving relationships are one of the real blessings of training, practicing and living in a relatively small medical community. blog91Malcolm is now an Emeritus Professor and former Head of Otolaryngology. He’s also an accomplished musician, traveller and observer of humanity. Moreover, and more relevant to this article, he is a master storyteller. In fact, he’s what you might call a raconteur. Blessed with a resonant baritone voice, impeccable delivery, and personal connections with most of the citizenry of Kingston, he truly spins a great yarn, and can do so anywhere, anytime.

Recently, he told me about an encounter he and his wife Denny (also an accomplished musician) had experienced during a trip to Italy. He mentioned he had written about it, and I asked if he’d agree to me sharing it on this blog. He graciously agreed. And so, in the words of the master…

Every string player knows (or should know) of Cremona, Italy. After all, that is where Antonio Stradivari hung out his shingle in the late 17th century, when Canada was only in its infancy. My wife Denny and I moved to Kingston (now in a somewhat more developed country!) in 1969, without ever having visited Italy. Two years later, the International Congress of Otolaryngology was being held in Venice, so we went.

Venice was extraordinary that June. The sun shone every day, the water sparkled, and there weren’t too many tourists. St. Mark’s Square was filled with music from a dozen café orchestras playing in the open air, just far enough apart to avoid cacophony, and the shops were full of wonderful leather, glass and fashionable garments, which we thought were unfortunately too expensive at several million lire each. We had actually returned home before it dawned on us that the lira was worth so little (at several hundred to the dollar) that we could have purchased that lovely pair of red high-heeled shoes after all!

After the meeting ended, I asked our very obliging hotel concierge to arrange a self-drive car for us. The conversation went something like this:

Concierge: “Where to, Signore?”

Me: “Cremona.”

Concierge: “But, Signore, there is nothing in Cremona!” (This, with much waving of hands and other negative body language.)

Me: “Look, my wife and I are players of stringed instruments, and we are determined to make a pilgrimage.”

Concierge: (with heavy sigh) “Signore, you will be wasting your time, but I see you are quite determined, so please let me advise you on your journey. I will have a very comfortable automobile waiting for you after breakfast. You will drive it to Verona, where you will have coffee at the Amphiteatro, which is very beautiful and historic, so you will enjoy it a lot. After coffee, you will drive along the Autostrada to the Village of Sirmione, on Lago di Garda. The village is inside the walls of an old castle, and there is a beautiful hotel with a terrace bar, which overlooks the lake, where you will sit and have an aperitif before lunch. And you will enjoy it. You will ask to see the luncheon menu, you will decide it is too expensive and go down instead to the Trattoria Verdi in the village, which is owned by my sister. You will have a delicious lunch, which you will enjoy very much. And, after that – if you still want to go to Cremona, go!” (And on your own heads be it!)

We are still glad that Giovanni planned our day so well. We did everything he suggested, including eating a wonderful lunch (trout from the lake and a simple salad, with local white wine) at Trattoria Verdi. We did go on to Cremona, to find only a miserable display of two violins in glass cases in the silent, cavernous Town Hall, where we were the only visitors. The fiddles were nice enough – a Nicolo Amati and an ordinary Stradivarius (if there is such a thing), but there was no display of tools, wood, drawings etc. The attendant spoke little English, and did not even know where Stradivari had lived.

The following morning, we were warmly greeted by Giovanni, who asked about the trip. I said “We enjoyed the day as you said we would – but there is nothing in Cremona!” With a smile and a shrug, he sighed: “Ah, Signore!” as he took my generous tip.

He was not to know that the tradition of violin-making would be revived later in Cremona, including a well-respected school and a very impressive museum! This was brought to light in an interesting documentary on TVO as recently as January 2013, which I would urge readers to look at, whilst noting that the presenter’s style is a little brash and superficial for my taste! I wish we could go back and see it all in the flesh, though.

Venice itself was not a total loss in instrumental terms, however. Half-way up the stairs inside the tower of St Mark’s Basilica is a glass-covered niche in the wall containing the most extraordinary double-bass I have ever seen. It was made for the virtuoso Dragonetti in the early 1700s by Gasparo Da Salo, and is one of only two or three in existence. The ROM in Toronto owns a similar one, and I have seen it, although it is no longer on display there. I have only recently become aware that as Denny and I sat on that hotel terrace in Sirmione, we were looking directly up Lake Garda to Salo, where Gasparo was born.

We have no Italian instruments now, although for years my wife played a 19th-century violin made in Genoa by Eugenio Praga. We do have a well-thumbed copy of the book “Italian Violin Makers” by Jalovec, and also the fascinating “The Violin Hunter” by William Silverman, and we treasure them. My 1849 English bass, which I played in the Kingston Symphony Orchestra for a long time, was sold when I left the orchestra, as it needed to be used professionally. However, I soon realized that I still wanted an instrument of my own to play in The Community Strings, and bought one on eBay! This had been brought through the Iron Curtain in disguise, its varnish covered over with black sticky house paint and its strings tattered and frayed, to avoid confiscation at the border, finishing up in Mississauga, Ontario. Three years and a lot of work later, it has been restored to its former glory, and I am not ashamed to take it out of its bag any more. It sounds good, too.

The Venice connection was reborn recently as well. I was asked if I would lend my bass for a “show” at the Grand Theatre. The last time I did anything like this was to lend my big bass travelling trunk to the theatre as a prop for a murder mystery play, in which it would conceal a dead body. This time, the instrument itself was needed by the very good Venetian group, Interpreti Veneziani. I was happy to see it used, and to find that it sounded very good in hands more expert than mine. Music is alive and well in Venice, Kingston, and, I know, now also in Cremona! Long may it last.

Malcolm has always reminded me of the essential role of storytelling as an educational tool. From kindergarten to medical school, much of what (and how) we learn is delivered as accounts of real life or imagined experiences, expressed in ways that stimulate the imagination, provide vivid imagery, and therefore not only entertain, but embed key messages in our memory to be recollected, re-considered and extended to future situations and circumstances. In the words of the Youth, Educators and Storytellers Alliance of the National Storytelling Network: ”Storytelling is an art, a tool, a device, a gateway to the past and a portal to the future that supports the present. Our true voices come alive when we share stories.”

In medical education, how much of our early and ongoing learning relates to accounts of clinical experiences, formally and not-so-formally passed between teacher and learner, and between colleagues? Our best teachers and mentors are not simply reservoirs of facts and figures – they’re able to contextualize into familiar and memorable accounts, weaving what we need to learn into engaging and memorable narratives that engage and persist in our memory.

Malcolm is one of those people. He reminds us that whether the message is about respecting local culture, maintaining our artistic passions, or assessing pharyngeal pathology, the delivery can be as important as the content, and certainly as enduring.

 

Anthony J. Sanfilippo, MD, FRCP(C)
Associate Dean,
Undergraduate Medical Education

 

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Tartan, threads, and an integrated curriculum

By Lindsay Davidson
Director, Teaching, Learning and Integration

Summer is a funny time – for some, relaxing with family on the dock, for others seeking out new adventures. I’ve been amused as I’ve watched from a distance, as my university-age son embraces his Scottish roots by running in “kilt runs” in Perth and Quebec City. This exploration of his ancestors’ fashion choices has led to a whole new appreciation of tartan in our family. Queen’s University, of course, is home to its own tartan, worn by band members and enthusiastic alumni alike. Just as the tartans of Scotland identify clan membership, the unique pattern of coloured warp and weft threads are instantly identifiable as the plaid cloth associated with our Queen’s.

Over the past year, the members of the Teaching, Learning and Integration Committee (TLIC) have been busy identifying teaching threads for a virtual “curricular tartan”, just as unique and emblematic of our medical school. Integrated threads represent topics that are taught in a longitudinal fashion, spanning multiple courses, terms and even years of the curriculum. These include intrinsic physician roles, some medical disciplines (typically those that do not have an identified course as well as those that relate to multiple courses) as well as other “hot topics”. Last September, the Committee Screen shot 2016-08-08 at 9.10.00 AMpresented the notion of integrated curricular threads to the Curriculum Committee, as well as an inaugural list of 28 threads which are shown here. (The active Integrated Threads list will be reviewed and possible revised by the Curriculum Committee each September).

To date, members of the TLIC and the Educational Development team have worked with course directors, discipline leads and other content experts to identify how these topics are taught and assessed across the length of our curriculum. The exercise has created exciting opportunities to connect teachers across courses and terms and has led to new opportunities for collaboration: a pharmacologist teaching about complementary and alternative medicines in the context of the CARL course, pathologists co-teaching about lung cancer in the Oncology course, Palliative care and Genetics experts identifying how relevant their disciplines are to multiple courses and creating explicit pockets of teaching.

The threads, now identified, are beginning to be woven into an intricate cloth. You can explore some examples of these by searching for a particular Integrated Thread as part of a Learning Event search on MEdTech. We hope that students will benefit from having an opportunity to understand how teaching on these topics progresses over the curriculum.

 

 

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“Have you even read the United States constitution”

This past week’s Democratic National Convention provided many dramatic moments and stirring oratory from prominent national figures. For me, the most poignant and powerful presentation came not from a famous personality or polished public speaker, but from Mr. Khizir Khan.

 

Mr. Khan is not a politician and far from a famous national figure. Born in Pakistan, he immigrated to Boston in 1980 and obtained a Masters degree from Harvard. He is currently a legal consultant living in Charlottesville Virginia. His son, Captain Humayun Khan, is one of 14 HumuyanKhanAmerican Muslims who have died in military service since the September 11 terrorist attacks. Captain Khan died in a car bombing incident in Iraq in 2004, apparently sacrificing himself to save the lives of his comrades. For his service, he received both the Bronze Star and Purple Heart and was buried with full military honours in Arlington National Cemetery.

 

Addressing the convention with his wife standing quietly at his side, Mr. Khan managed, in a few minutes of powerful, simple narrative, to capture both the great promise and great threat to the American system of government.

 

He challenged Donald Trump directly. “Have you even read the United States constitution?” he said, looking directly into the camera and defiantly waving a copy of the document. It was a truly astounding Khizr-Khan-DNCmoment: a Pakistani-born, Muslim immigrant calling out an established, mainstream and powerful figure on the basis of their presumably shared societal values. Amazingly, he topped it with an even more powerful statement a few minutes later, when he said, with the conviction and veracity that can only come from a bereaved parent: “You have sacrificed nothing”.

 

With those four words, he reminded everyone listening that the strength of American civilization has come from the promise provided by the principles and rights articulated in their constitution, and the willingness of its citizens to defend them. Over the centuries, that promise has attracted people from all parts of the world and of all ethnic backgrounds who sought to escape persecution and oppression of various forms and, critically, were willing to not simply work hard, but to sacrifice personally for the preservation of those principles. With those words, he didn’t simply establish the right of so-called minority groups to be part of that society, he actually elevated them above those who have been part of American society longer, but who do not fully understand or truly embrace the founding principles. Full membership requires commitment and sacrifice. Mr. Khan passionately made the point that, like many, he’s paid his dues, but not all have.

 

In the midst of the rancor and extremist demagoguery that has characterized this recent election campaign, it’s tempting to disparage the American system of government and lose hope for its future. It’s worth recalling what actually happened in colonial America in the late eighteenth century, leading up to the constitutional congress, Declaration of Independence and, eventually, American Revolution.

 

Essentially, thirteen British colonies who had, since their initial establishment, become culturally disparate, economically diverse and fiercely independent decided it was in their mutual best interests to elect and send delegates to a series of conferences to discuss means by which they might establish more effective political relationships with Great Britain, at that time the greatest military power in the world. The colonies and delegates varied greatly in their goals and perspectives. Some saw it necessary to achieve complete independence, at whatever cost. Some were committed pacifists (even on religious grounds) who considered themselves British subjects and advocated for continued rule under the King and parliament, but with more refined political and economic ties. To be even discussing these matters was treasonous, and the delegates were taking considerable personal risk, to say nothing of being away from family and home for months at a time.

 

The accounts of those proceedings provide fascinating and instructive studies of what is possible when strong, diverse personalities are united by an abiding desire to promote the common good of their families and peoples. The delegates were certainly committed, courageous, strong-willed and intelligent, critical thinkers. They were articulate communicators, shrewd, sensitive to deception and not easily duped. Many of them were well versed in political theory, philosophy and world history. What ultimately allowed them to be successful and to establish common and effective agreements were two key attributes: they shared an abiding respect for each other, and out of that respect came a willingness to listen, truly listen, to each other’s perspective.

 

And what success they achieved! Although it can be argued that they have never been fully realized, who can argue that the principles set forward in the Declaration of Independence and implemented in the American Constitution are as great an articulation of what an independent and righteous people might achieve as anything that’s been written.

 

The second paragraph of the Declaration sets out the justification and vision:

 

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

 

It continues to set out their intention in clear and unambiguous terms:

 

“We, therefore, the Representatives of the united States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly publish and declare, That these United Colonies are, and of Right ought to be Free and Independent States; that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally dissolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do.

 

It ends with a rather sublime statement wherein they each personally commit to the principles they have declared and, critically, to each other:

 

And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.”

 

In signing the document on July 4 1776 in Philadelphia, those 56 delegates, still British citizens at the time, were fundamentally committing treason, punishable by death. It’s worth noting that, at the time, there was no government, no army and no clear means to do any of things described. This was no arms-length commitment. They were taking unimaginable personal risks. The Constitution, which restates the principles and outlines the form of government that would hopefully achieve these lofty goals, wasn’t signed into law until Sept. 17 1787, and not ratified until June 21 1788, almost 12 years after the signing of the Declaration, and after those delegates and many of their countrymen had endured the sacrifices of the Revolutionary War.

 

The contrast between what those courageous delegates achieved so many years ago stands in rather stark contrast to the fear-mongering and petty dialogue that is currently on display. It also providesH_Khan_Arlington inspiring insights for any government, organization or group struggling to find effective solutions despite opposing perspectives and backgrounds. In the end, we advance not by capitulation, but by thoughtful, informed and respectful compromise. Compromise, in turn, requires an element of sacrifice. As Mr. Khan so effectively reminds us, we earn our place in a free society through sacrifices, both great and small.

 

 

Anthony J. Sanfilippo, MD, FRCP(C)

Associate Dean,

Undergraduate Medical Education

 

 

For those interested in some very readable accounts of the people and proceedings of those constitutional conferences:

 

John Adams by David McCullough. Simon and Schuster, 2001.

Founding Brothers by Joseph P. Ellis. Vintage Books, 2000.

Benjamin Franklin: An American Life by Walter Isaacson. Simon and Schuster, 2003.

Thomas Jefferson: The Art of Power by Jon Meacham. Random House, 2012.

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