Rethinking Medical Education

The ThinkerQuestions, observations, and recommendations toward reform of the process and content

A "dangerous phrase" (and a tribute)
Grace Murray Hopper, PhD (1906-1992)
Some observations about change and innovation from an authentic pioneer. I first wrote this piece on the birthday of one of the people who helped invent the modern computer: Grace Hopper was born in New York City in 1906. She began tinkering with machines when she was seven years old, dismantling several alarm clocks around the house to see how they worked. She studied math and physics in college, and eventually got a Ph.D. in mathematics from Yale (hardly a common event for women of that era).
   When the US entered World War II, Dr. Hopper wanted to serve her country. Her father had been an admiral in the Navy, so she applied to a division of the Navy called WAVES, which stood for Women Accepted for Voluntary Emergency Service. They turned her down at first, saying she was too old, at 35, and that she didn't weigh enough, at 105 pounds. But she wouldn't give up, and they eventually accepted her. With her math skills, she was assigned to work on a machine that might help calculate the trajectory of bombs and rockets.
   Dr. Hopper learned how to program that early computing machine, and wrote the first instruction manual for its use. And she went on to help write an early computer language known as COBOL — "Common Business-Oriented Language." She remained in the Navy, and eventually became the first woman promoted to the rank of "rear admiral."
   In her work and her thinking she displayed an attitude that is relevant to those of us who teach and shape the learning process. Many medical faculty members who are engaged in curricular planning and educational decision-making seem to have adopted the belief that educational approaches that have been used for many years must have proven their worth and deserve to be perpetuated. The best shorthand response to that assumption was provided by Grace Hopper, who said (slightly edited by me): "The most dangerous phrase in any language is: But, we've always done it that way."
   Another quotation that has also been attributed to Grace Hopper, which is also relevant to innovators, especially in some organizations: "It's easier to ask forgiveness than it is to get permission."
   Also credited to her, in the domain of goals, purposes, and risk-taking, is the quote, "A ship in a harbor is safe, but that is not what a ship was built for."

A small side story of possible interest: Admiral Hopper contributed a frequently used word and concept to our language. In the 1950's, working on one of the first EINIAC computers, she and her colleagues were stumped when it suddenly stopped working. After all regular diagnostic tests provided no help, she crawled inside this room-size computer, and deep in its innards found a moth that had died, short circuiting two connections. From then on, whenever anything went wrong with a computer, she referred to the problem as being a "bug" in the system. We should thank her, and maybe smile a little, the next time we find a use for her word.

For more information on Grace Hopper, please see her Wikipedia page.

   Hill Jason
Hilliard Jason, MD, EdD
First posted: 12/3/08
Revised: 1/25/12


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