IN RESPONSE TO MY IDENTIFICATION WITH THE HUMAN SCIENCES PROGRAM
MY THESIS ADVISOR STATES HE HAD THOUGHT I HAD ABANDONED THE Ph.D.!
Glenn - I too think that Peter Hotez's initiative is pretty exciting. However
I have been rather assuming that you have abandoned the Ph.D. quest, since the
last thing I have from you is still the document from last March (or is it May?
- the other version is at home I think) which would make a good and interesting
article but does not tell us what the dissertation is supposed to do that is
more or different, something we have been asking you to give us (as chapter
outlines) for lo these many months if not years. I don't know how far the patience
of the graduate department of the Columbian College of Arts and Sciences can
be pushed. Have I missed something here? Let me know! Cheers,
Peter
>===== Original Message From Glenn Geelhoed <msdgwg@gwumc.edu> =====
Dear Peter:
I was very excited to see the proposal for the Certificate Program in a GWU
Scholars Program in Medical Humanities. As I had said to Ray Loomis---"I
cannot imagine anything more directly down the middle of my strike zone!"
As you know, I am very much involved in the Human Sciences Program, having maintained
a registration each semester for the past nine years as a Ph.D. candidate graduate
student, having completed all the Comps and requirements four years ago in May,
and presently "ABD" for the degree, which I must secure within the
next eighteen months.. I am an advisee of Alf Hiltebeitel, who has been, until
the rotation of the assignment, Director of the Human Sciences Program, and
my thesis advisor is Peter Caws, University Professor of Philosophy. I had worked
closely with Prof. Nasr on his interest in a "sacred science" and
with Prof Schaffner in the course work leading up to the thesis committee stage,
and had previously achieved the International Affairs degree from the Elliot
School in the global relationship of interest to Prof Rosenau.I had taken several
seminars with Amitai Etzioni for a clean sweep of our University Professors
in being at least one of the few who could appreciate the resources across a
narrow street from a Medical School situated on a major University Campus
I am the presenting soon in a special seminar at the University of Virginia's
Institute for Bioethics in the coming months in Charlottesville, now directed
by our own GWU Ph.D. ethicist Jonathon Moreno. I have been collaborating with
Dan Wikler, bioethicist chief at WHO Geneva, and a prior candidate for one of
the GWU University Professorships before he left the University of Wisconsin
on leave to his current International position. Another member of my thesis
committee is a campus regular on the subject of bioethics, Prof. Harry Yeide
who might have useful input, and the last member of my committee was also director
of my anthropology thesis, Alison Brooks, coincidentally mother of my junior
medical student advisee, Elizabeth Yellen.
I am even more enthusiastic about the potential of this program on a re-reading
of the brochure and would like to help support it in any way I can,
especially if I add my overdue credentialing completion in the collaborating
program
I am in accord with the philosophic background statements regarding the erosion
in medical education's academic standing as a learned profession over
the devalued trade school model, such that the term "Medical Scholar"
has come to have an oxymoronic ring to it---for a generation with respect to
the
humanities, and within the last decade, even from the perspective of a bench
laboratory scientist. I attach an article from the NYT that might be symptomatic
of the devaluation of the professional scholarly stature of this learned "human
science", with "diversity" meant to imply only the narrowest
of foci.
I have attempted to focus on the numerator value of what we can contribute in
humanitarian value rather than the denominator of what resources are expended
in health care--a surrender to the dismal science for evaluation of our intellectual
and compassionate efforts. I have become something of a resource for the disgruntled
and disillusioned among health care workers who have felt abused and diverted
by a system error into activities for which they have not been prepared and
in which their efforts are found to be not very rewarding. One such individual
heard me in a presentation last month before the American College of Surgeons
Clinical Congress in New Orleans and wrote to me (attached Nov-A-5) sensing
a joy in medicine he would like to recapture in the volunteer foreign service
to the needy I had suggested.
I would like to discuss further with you the application of this proposal to
some of my alumni organizations---such as the last to carry the name "Clinical
Scholar" when I was the Robert Wood Johnson Clinical Scholar here at GWU
1975--1979. Other sources come to mind: Commonwealth Fund, Pew Charitable
Trust and Mac Arthur---and for these suggestions I would like to discuss the
re-extension of the invitation to Paul Farmer to come as our guest and advise
us at GWU how to make some of these Global Medical Diplomacy outreach efforts
sustainable.
Thanks!
GWG
>----- Forwarded Message -----
>From: Student Soc&Intl Health <REUSUNS@YORKU.CA>
>To: REUSUNS <REUSUNS@YORKU.CA>
>Subject: American medical life?
>
>Hi all,
>
>Here is one recent (somewhat depressing) cover story from The New York Times
>Magazine......a look at American medical life.....
>
>> Doctor Feelbad
>> Time was when doctors were at the pinnacle of our society -- with the
>Mercedeses and country places such status merited. Now, buried under
>paperwork, their income chiseled by HMOs, their power and independence
>eroded, they feel like any other employee. It's enough to make you sick.
>> BY STEVE FISHMAN
>
>> "Vacations? Are you kidding?" Mark Fox is a physician. he's
got a
>handlebar mustache, a sharp widow's peak, a bright tie, and his own private
>practice in Scarsdale. He's 53, in the prime of his career, and just now,
>seated behind the desk with a life-size plastic nose on it -- he's an
>ear-and-nose specialist -- he is recalling how he used to take vacations.
>"Every winter and every summer," he says. Photos of high-mountain
camping
>near Mount Rainier hang on his office walls. First the summer vacations
>disappeared. "Haven't had one in five years." This year he skipped
the
>winter vacation. Fox's own doctor has urged him to take some time off. He
>doesn't disagree. "I have increased stress, high blood pressure,"
he says.
>He's so wound up by the time he gets home from the office that his wife
>won't talk to him for an hour afterward. He's watched a couple of physician
>friends undergo open-heart surgery. Still, he's reluctant. His income
>dropped 25 percent in one recent year. And if he's not working, he's not
>only losing income. "I'm still paying for the overhead," he says,
and it's
>doubled in recent years. So what does he do? "I tighten my belt and
get a
>headache," he says.
>>
>> Dr. Bernard Schayes, a 43-year-old internist on the Upper East Side,
is
>the kind of doctor who puts his cell-phone number on his office answering
>machine. He likes to be available to patients. Of course, when he was
>starting out, availability was easier -- he lived around the corner in a
>two-bedroom apartment. But he had two kids and private-school bills of
>$30,000 a year. (He also owned a Mercedes and a Jaguar.) Then his income
>dropped. "There's no way to live in the city anymore," he says.
He moved to
>Roslyn, Long Island, where his children attend public school. Now he wakes
>at 5 a.m. and gets in his Acura, occasionally fielding phone calls from
>patients on the way. First, he heads to his part-time job at a nursing home,
>where he works before his own office hours begin.
>>
>> Not long ago, doctors had it all. They did challenging work -- they
saved
>lives! -- and didn't have to worry about money: They earned tons. They
>regularly visited the Mercedes dealership. They island-hopped on vacation.
>They owned the best real estate. Their kids went to private schools.
>Everybody wanted to marry a doctor. Or be one. Half a dozen years ago, most
>doctors -- three fourths in one survey -- were happy.
>>
>> No longer. Doctors still say it's a privilege to be a physician, to
>intervene in people's lives in times of need. "But there's a gloom
now,"
>says one family doctor. "A lot of sitting around the dinner table and
asking
>each other, 'Where did we go wrong?' "
>> --------------------------------------------------------------------------
>------
>> "The general population decided we weren't worth all that much,"
says Dr.
>Bernard Schayes. Or, as he sometimes puts it, "people decided they
wanted us
>to drive Acuras."
>> --------------------------------------------------------------------------
>------
>>
>> Doctors have lost ground. Insurance companies have ganged up on them.
"I
>have anxiety about staying in business," says an internist who's put
his own
>money toward payroll. The trouble isn't just financial. Perks, privileges,
>esteem (self-esteem too) have all been hit. Many physicians work longer
>hours. And now, it seems, all kinds of people -- including clerks! -- are
>telling them what to do.
>>
>> Now, announces the New England Journal of Medicine, "many American
doctors
>are unhappy with the quality of their professional lives." The literature
on
>this reads like the intake form at a depression clinic: "increasing
>marginalization," "discontent," "confused," "angry,"
"insulted." (Is it any
>wonder med-school applications are down again this year?) Yes, the doctor
is
>in, but in case you haven't noticed, there's a good chance he's seething.
>"It's no fun being a doctor anymore," is the way one puts it.
>>
>> Medicine hasn't always been a path to privilege. For most of this century,
>doctors might have been stars in high school and college, but they were
>solid upper-middle-class earners, a notch above your general contractor,
>maybe. Then, starting in the sixties, Congress enacted Medicaid for the
poor
>and Medicare for the elderly. The number of paying customers per doctor
>eventually quadrupled. "That was the goose that laid the golden egg,"
says
>Dr. Jerome Breslaw, a Manhattan gastroenterologist who began practicing
in
>1973. Doctors bought themselves Mercedeses, Cadillacs, Beemers. They went
>from upper class socially to upper class financially. Even in the eighties,
>when family doctor Mark Horowitz attended medical school, he thought,
>"Doctors are rich people." Mostly, he was right. Society's bargain
with
>physicians seemed to be this: Spend ten years training, then you'll be taken
>care of. Shortly after Dr. Schayes, the Upper East Side internist who owned
>a Jaguar and a Mercedes, left his residency, he worked hard -- including
>nights and weekends -- but in the early nineties he earned upwards of
>$300,000 a year.
>>
>> By the mid-nineties, circumstances had changed. "The general population
>decided we weren't worth all that much," says Schayes. Or, as he sometimes
>thinks of it, "people decided they wanted us to drive Acuras."
>>
>> Actually, it was business that first made that calculation, since in
large
>part business footed the bill for double-digit medical-cost inflation.
>Managed care was one result. This insurance scheme was sometimes hailed
as a
>way to encourage preventive medicine and ensure quality, but its initial
>intent was to trim costs. Doctors could once charge as much as they
>wanted -- a rare thing in business. In medicine, the law of supply and
>demand didn't seem to hold. No matter how many doctors crowded into one
>area -- like Manhattan -- fees seemed to do nothing but rise.
>>
>> One way managed-care companies attacked costs was simply to reduce
>doctors' fees. "Where a fee was $1,000, now a doctor is getting $300,"
says
>Andrew Kleinman, a plastic surgeon in Westchester County. Once, patients
>were responsible for the shortfall. In managed care, physicians swallow
the
>loss. "The insurance industry has created a slave workforce out of
the
>doctor," says Moshe Rubin, a gastroenterologist at Columbia. That may
be an
>overstatement, but no doubt that's how it feels. And as if reduced fees
>weren't enough, insurance companies have sometimes, willy-nilly, not
>reimbursed anything. "We're fed up but we're taking it," says
Kleinman. Not
>always. (Recently, a group led by Kleinman went to the New York State
>attorney general's office, which threatened to sue before Aetna settled.)
>>
>> Reduced revenue is only part of doctors' new burden. Managed-care
>companies also created all kinds of paperwork, tons of it, which they, using
>the jargon of the day, outsourced. In this case, they outsourced it to
>doctors. Suddenly, physicians had to beef up their staffs. Steven Fochios,
>an internist, has one employee who handles almost nothing but the referrals
>required by managed-care companies. Ten years ago, Fox had one assistant;
>now he has four staffers to deal with the 64 different insurance plans he
>takes, most of which have different rules. His overhead accounts for almost
>60 percent of revenue.
>>
>> Reduced fees and increased expenses put pressure on income, especially
of
>primary-care doctors and pediatricians -- the doctors most of us see most
of
>the time. "I never expected that as my career progressed, my income
would
>contract," says Mark Horowitz, a family doctor. "In the mid-nineties,
it was
>easy to save and invest. Now there's less money in the kitty at the end
of
>the month." These days, after eight years of training, a 30-year-old
>pediatrician can expect to earn $95,000. Starting internists probably earn
>$100,000 to $110,000. Not bad, perhaps. But the first year at one of the
>city's better law firms -- that's after just three years of law school --
>will bring you close to $150,000. "And I can be on vacation and I'm
always
>available to my lawyer friends," points out Adam Stracher, an internist
at
>Cornell Medical Center. "And they have secretaries. They have expense
>accounts. You think we get tickets to Knicks games from our firm?"Lately,
>lots of doctors have to pick up work on the side. Horowitz works as a
>medical consultant at Juilliard. One doctor got involved with a dot-com
for
>a few years -- which was the last time he flew business-class. Some
>physicians augment their incomes by selling herbs, food supplements,
>cosmetics, even household cleaners in their offices. Schayes sells vitamins.
>"I buy wholesale and sell retail," he says. "It was kind
of embarrassing at
>first. But at the end of the year it makes a big difference." Last
year,
>Schayes, an M.D. approaching the height of his earning power, earned about
>$120,000 -- which doesn't come close to buying what people once thought
of
>as the M.D. lifestyle. Soon, Schayes figures, his wife will have to go back
>to work. She hasn't worked in five years while the kids grow up. "She
>doesn't want to, but I'm making her," says Schayes. "Besides,
she's a
>lawyer. Her earning potential is greater than mine."
>>
>> Income isn't the only factor squeezing the fun out of doctoring --
and
>maybe not the key one. After all, doctors earn about $160,000 on average,
>which makes them affluent, by any measure. "I actually believe the
biggest
>issues are not economic," says Dahlia Remler, an economist at Columbia.
>>
>> Once, as Ed Salsberg, head of the Center for Health Workforce Studies,
>explains, "everything in health care revolved around physicians. They
were
>king of the hill." Accordingly, they were treated in a kingly fashion.
Every
>50-year-old nurse remembers fetching coffee for a doctor, giving up her
>chair so he could sit down. The hidden curriculum of medical school is that
>the doctor is the decision-maker, the brain, the star. But these days, most
>doctors are just another member of the team. Teamwork is emphasized. Health
>care is thought to be a system, not something one person does to another.
>And so doctors have got a new title: health-care provider, a category that
>includes nurses and lab techs. That alone drives doctors crazy. It's like
a
>demotion. "I'm no health-care provider," says one NYU doc testily,
sounding
>like McCoy from Star Trek. "I'm a doctor."
>>
>> Along with power, doctors had autonomy. But now the insurance companies
>behave like supervisory adults, like scolds suggesting -- implicitly, of
>course -- that doctors can't be entirely trusted. "You used to have
a
>conversation with a patient and come to agreement," recalls Breslaw.
Once,
>for instance, doctors could prescribe as many MRIs as they felt necessary.
>Managed-care companies, however, now insist they have to approve such
>expensive tests in advance.
>>
>>
>> These days, physicians have to get on the phone and plead their case.
And
>with whom? "Now if I need to order a scan, I need to call not a nurse,
not a
>doctor, but an uneducated technician," says Rubin, the Columbia
>gastroenterologist. Of course, no one in the industry doubts that too many
>unnecessary expensive tests were prescribed in the past -- especially when
>doctors happened to own the CT or MRI scanners. What's more, as Christine
>Cassel, chair of geriatrics at Mount Sinai, says, "if you look at the
>literature on quality of care, there were huge divergences."
>>
>> Different diseases are treated differently in different places with
>different results. Doctors haven't always taken responsibility for making
>sure quality is up to snuff. Still, doctors' pride hinged on a belief that
>the decisions they made mattered. Now, at every turn, insurance companies
>generate standards of care, templates that ride herd on them, as if they
>were unruly kids. "It is an insult, it's infuriating," says Rubin.
"Though
>after a few years you stop taking it personally."
>>
>> It's not just insurance companies that now oversee -- and subtly
>undermine -- doctors. At one time, most physicians were their own bosses,
>entrepreneurs who set up their own small businesses. That was part of the
>fun. "Now," says Fox, who is just such an entrepreneur, "I'm
a dinosaur."
>There has been a vast, largely unnoticed change in the organization of the
>medical labor force. The solo practitioner, the one most of us grew up
>trusting, is nearly out of business. From now on, doctors will be employees
>like everyone else. Just 4 percent of new doctors in New York say they plan
>to open their own practices. As an employee, the doctor has a fixed
>retirement age and a set lunch hour -- not that physicians ever take
>expense-account lunches. (This isn't the business world!) As employees,
a
>lot of physicians won't have secretaries anymore, not their own anyhow.
At
>Mount Sinai, specialists who once had assistants now have answering
>machines. Yes, there's a receptionist, a billing department. But they work
>for the administration, just like the doctor. "I can't hire or fire
>secretaries," explained one specialist at Montefiore. "I have
no control
>over staff." Sure, you can always write up a secretary for misbehavior,
but
>then a receptionist can write you up, too. "If we say one wrong thing,
they
>go to the compliance office," said one doctor who was reported for
raising
>her voice. "Apparently, I have to be on perfect behavior."
>>
>> The world has changed on the middle-aged doctor. And, to add insult
to
>injury, the younger generation doesn't seem quite as upset. "We're
less
>insane with it," says Stracher, 37 years old. "Our expectations
are
>different. We didn't know a different way."
>>
>> Making sure patients actually get better is still the responsibility
of
>physicians, as malpractice insurers remind them. (And despite complaints,
>there's scant evidence that quality of care has decreased in recent years.)
>Still, these days, other values besides quality guide doctors through their
>day. Efficiency, productivity: That's what physicians hear. And just like
>factory workers at the beginning of the century, doctoring has been
>rationalized to increase productivity. In many practices, the system, even
>the building, has been redesigned to push the pace. Doctoring has been
>broken down into its component parts. Assistants take blood pressure. Nurse
>practitioners take histories. Physicians show up for the flourish, to review
>the treatment plan, as one puts it.
>>
>> "This does not signify inferior care or second-class citizenship!"
doctors
>Bruce Yaffe and Ronald Ruden felt obliged to alert their patients in a
>handout. The current system conserves the doctor's time. And time -- this
is
>the point -- is limited. Increasingly, salaried doctors get paid based on
>how many patients they see. Even at academic institutions, the elite centers
>where research and teaching have thrived, docs now have monthly quotas of
>patients. If they don't make their numbers, they're called in to explain
>why. "We are the new factory workers," says one gynecologist.
She may be
>right. "I have the feeling of being squeezed to see more patients to
gain
>the same income," echoes a colleague. Extraneous activities -- that
is,
>non-income-producing -- are less possible these days. Those, for instance,
>who'd like to devote more time to research increasingly look to drug
>companies. "You can't do that on the academic side anymore," says
Dr. Rajiv
>Patni, who recently took a job at Pfizer. Teaching, too, is valued less.
>"The Department of Medicine must reduce its budget," explained
a blunt
>letter to one Montefiore doctor, whose teaching salary was cut by a
>significant amount.
>>
>> Maybe doctors once felt like kings of the hill. These days, a lot feel
>"like interchangeable parts," as one physician-employee put it.
"A
>businessman looks at you and sees a medical license that he is going to
plug
>into a slot in his organization," complained one physician. Of course,
one
>reason employers can treat doctors this way is simple: There are too many
of
>them. Doctors traditionally gained power by controlling supply and demand.
>No longer. In the past ten years, the number of docs has increased by 30
>percent. (That doesn't even include physician assistants or nurse
>practitioners, who sometimes run independent medical offices. "In the
future
>your doctor may be a nurse" is the warning issued by the American Nurses
>Association.) And as far as demand goes, doctors have never been overly
>worried about bringing in new groups of patients (like the 40 million
>uninsured Americans).
>>
>> The oddest part of all this may be that though doctors feel harried,
>though they feel pressured to see more patients, studies actually show that
>patients spend more time with their physicians than they did ten years ago.
>Dr. Edward W. Campion, deputy editor of the New England Journal of Medicine,
>suggests office visits only seem short. The reason, he believes, is "because
>there is more to do, more to think about, and more that is expected."
Has
>medicine simply gotten to be a tougher profession? Consider that one third
>of primary-care physicians believe the scope of their practice has increased
>in the past two years. And, alarmingly, one quarter say it's greater than
it
>should be. Your internist, the doctor you saw when something -- you weren't
>sure what -- ailed you, was once the person who organized, who managed,
your
>care. Now look: "The notion that the internist commands the field is
>absolutely gone," says David Rothman, a professor of social medicine
at
>Columbia Medical School.
>>
>> From the doctor's point of view, it can get worse when a patient is
>admitted to the hospital. Now hospitals have their own doctors working the
>case -- a new category called hospitalists. "It's easy to get forced
out of
>the loop. You're not always part of the team," says Gerald Leventhal,
a
>Manhattan internist. You have to be pushy. The sicker your patient, the
more
>you're excluded. If a patient ends up in the ICU, for instance, specialists
>and subspecialists take charge. "And nobody even calls you to tell
you your
>patient had a coronary last night," says Leventhal. "Then when
you arrive
>the next day and the family asks what happened, you look like a jackass."
>>
>>
>> People tell pollsters they still trust their doctors more than just
about
>anybody else. (Patients in general don't seem to share doctors' discontent.)
>At the same time, patients increasingly act as if one physician is pretty
>much the same as another. Lots of patients fork over nothing but a co-pay,
>the mandatory cash outlay that can be as low as $10, or even $2. "What
do
>you value a physician at if you pay $2?" asks Stracher, who says that
>sometimes, for that amount, patients blithely skip even bringing along
>money. For two bucks, patients sometimes don't show up. Or they get the
idea
>that -- guess what? -- doctors are only worth a few dollars. Fox recalls
a
>patient with a $10 co-pay. She had a small tumor in a lymph node and wanted
>a second opinion on surgery. She was upset and nervous, and Fox spent more
>than 30 minutes calming and examining her. In the end, he assured her, she
>didn't need surgery. "That's the best $10 I ever spent," she gushed,
leaving
>Fox nonplussed. To the patient, he thought, "that's what I'm worth."
>>
>>
>> --------------------------------------------------------------------------
>------
>> "Doctors are lumped in with hospital colleagues as "health-care
>providers," which rankles. "I'm no health-care provider,"
says one, sounding
>like McCoy on Star Trek. "I'm a doctor."
>> --------------------------------------------------------------------------
>------
>>
>> The stable doctor-patient relationship, the building block of every
>successful practice, is pretty much a thing of the past. Once, doctors
>attended patients' bar mitzvahs and weddings. And doctors will tell you
that
>following a patient over a long period actually makes for better care. These
>days, though, patients are attached to insurance companies that shuffle
them
>around based on price considerations. You save the lives of two members
of
>their family, then their insurance company changes because they change jobs,
>and they switch doctors. "It's like I used to go to Macy's to get pots
and
>pans; now I go to Bloomingdale's," says Breslaw.
>>
>> Some patients don't mind. One of the rights they've recently asserted
is
>the right to convenience -- their convenience. Now they find your name on
>the Internet and head your way because your office is close to theirs. Some
>doctors have already adapted. Horowitz knows that patients near his Wall
>Street office will call their internists back home in Westchester only to
>learn the next available appointment is in a week. What if they're sick
>today? At Horowitz's office, anyone can be seen the same day.
>>
>> Patients are demanding in other ways, too. These days, they want to
be
>partners in their care. They trundle into the doctor's office with a sheaf
>of printouts. Never before has so much information been available. They've
>got answers, or challenges. Many doctors like an informed patient. Still,
it
>may be true, as Rothman argues, that the doctor's monopoly of medical
>knowledge is disappearing, particularly, he points out, with regard to
>young, well-educated, upper-middle-income women. Some time-pressured
>physicians clearly don't appreciate another demanding voice in their ears.
>"Suddenly they ask for records," explains a New York allergist.
"But
>patients can't understand records, and now they need an explanation. That's
>not part of what I have to do. I don't have to be in a position to interpret
>records to patients."
>>
>> Badgered on all sides, physicians seem to have come down with an
>old-fashioned case of alienation, the kind hourly workers used to suffer.
>"There's a sense they are doing this to us. They are the insurance
>companies. They is the government," says Cassel.
>>
>> As Fox explains, "I don't have any clout." Insurance companies
have clout,
>institutions have clout, even patients have some. And so, just like any
>disgruntled worker, doctors -- doctors! -- are turning to unions. "We
get
>more calls than we can handle these days: otolaryngology groups,
>orthopedists, groups that used to be fat and happy," says Bruce Elwell,
an
>organizer for the Doctors Council, which is affiliated with the Service
>Employees International Union and the AFL-CIO, the same organization that,
>it's worth noting, represents hospital maintenance workers. Lately, Fox,
the
>Scarsdale otolaryngologist and lifelong Republican, has become an organizer
>himself. But Fox has signed on with the AMA's newly formed union -- he's
on
>the board. "The anger is still with me," he says by way of explanation.
>>
>> Some doctors encourage their children not to be physicians. Some doctors
>say they wouldn't do it again. And some are actually leaving. Robert Aldrich
>has been a cardiologist for 22 years in Morris County, New Jersey, an hour
>from Manhattan. Or at least he was. On July 1, in the midst of his prime
>earning years, he bought an inn in Vermont. It's not retirement, exactly.
>"We have to earn a living," he says.
>>
>> But that will be a pleasure compared with what he's leaving. "I
feel in
>charge again," says Aldrich, who dreamed of a career in medicine from
the
>age of 9. "I feel free again, released from prison."
Peter Caws
University Professor of Philosophy
709F Gelman Library
The George Washington University
Washington, DC 20052
phone and voice mail (202) 994-8685
fax (202) 994-4571
Dear Peter:
I agree I had been rather discouraged and slowed in my thesis process. I have been puzzled, being knocked down several times over in what should be the most compatible part of my Ph.D. program in thesis writing. I had earlier passed all the course work requirements and Comps in May four years ago (a date that is easy to remember, since it is the date of birth of my first grandson--May 9, '97. Now there are three grandsons--one set of twins--and a grand-daughter, and I am still at the same stage!)
The thesis phase should not be much more difficult than the preceding units of the program, especially given my research and writing interests and prior and continuing experience, but the futility of the derailment of my first nearly finished work on the first thesis had hit me rather hard, and made me somewhat uncertain of what I was doing wrong compared with what I saw as comparable thesis proposals of classmates going through to completion.
Now I just wanted to be done, perhaps to continue the elaboration beyond the basic skeleton of the graduate thesis process in what I thought might be further thesis efforts in the post-graduate phase. I did not want to be done by simply abandoning the program in its later innings, after putting in the effort and re-registering every semester as work in progress.
The patience of the Graduate Program was expressed to me in a letter, stating I had two years to be finished, which puts a deadline on the process, meaning there can be no further balking at bat. This next proposed thesis has to go the distance with no tolerance for another abort or re-routing. For that reason, I have gathered in a large amount of grist for the mill, but need a sharply limited focus, since I cannot put forward anything that will be knocked out again.
I would like to have some help in advising, less on how many different avenues of interest might be pursued in my research and development, than how to be finished satisfactorily and expeditiously.
Thanks!
GWG