Making Mistakes Teaching Anatomy & Physiology | Episode 63

Making Mistakes Teaching Anatomy & Physiology | Episode 63

February 28, 2020 0 By Stanley Isaacs


>>Kevin Patton:
The late basketball coach and commentator Chuck Daly one said, “It’s discouraging to
make a mistake, but it’s humiliating when you find out you’re so unimportant that nobody
noticed it.”>>Aileen:
Welcome to the A&P Professor, a few minutes to focus on teaching human anatomy and physiology
with a veteran educator and teaching mentor, your host, Kevin Patton.>>Kevin Patton:
In this episode, I talk about how stress turns our hair gray, the discovery of a new type
of immune cell, and making mistakes when we’re teaching.>>Kevin Patton:
If you’ve met me or seen my picture, you know that I have gray hair. Well, not really gray hair. I have dark brown hairs and white hairs which
I call my platinum blonde highlights. But thankfully, most folks stay a polite distance
from my head and the white hairs and brown hairs mix together to produce the perception
of gray.>>Kevin Patton:
Now, I’m 62, so that’s not really unexpected. But I think the white hairs came just a bit
earlier and in greater quantity than they might otherwise have done if not for some
stressful periods in my life. No, not having to learn the Krebs cycle, not
even my stint as an apprentice lion tamer. Those were more fun than stressful, but other
more stressful things I coped with and thankfully survived.>>Kevin Patton:
Famously, some world leaders, including US presidents, have gotten much grayer during
their terms in office. Now, some of that could simply have been from
timing and they’d have grayed a little bit whether they were in office or not, but now
we know of a mechanism for graying of hair through stress. It involves that basic and well known story
of the stress response in all it’s fight-or-flight glory.>>Kevin Patton:
Here’s how we currently think it can happen. As we already know, it’s the melanocytes in
the hair follicle that make the various types of reddish and brownish melanins that end
up in the hair shaft. The pheomelanins and the eumelanins that produce
reddish, or yellowish, or brownish, or nearly black appearances of our hair. The melanocytes come from stem cells in a
part of the follicle called the bulge, which is partway up from the papilla at the bottom
of the hair follicle, which is kind of weird when you think about it. Was there a Latin dictionary misplaced at
the time in place that the bulge was named? What kind of anatomical name is that, bulge? But I digress.>>Kevin Patton:
Getting back to the story, that bulge is full of stem cells that can and do differentiate
into melanocytes. Not all of them at once, just a few of them
at a time, enough that the particular hair being made gets the coloration influenced
by genetics, and nutrition, and other factors. As long as there are some stem cells left
behind, they can divide to make more stem cells, and therefore more melanocytes, But
it’s kind of tricky. The speed of these processes has to be matched
just so. Otherwise, I’ll use up all my stem cells. And darn it, I can’t make melanocytes anymore
and all I can make going forward is white hairs in that follicle. Which is fine by me because it makes me look
much wiser than I really am.>>Kevin Patton:
It turns out that the bulge of the hair follicles receives sympathetic adrenergic fibers that
release norepinephrine. The norepinephrine stimulates the conversion
of more stem cells into melanocytes. That probably doesn’t affect hair color that
much immediately. After all, another coat of paint isn’t going
to have that dramatic of an effect.,Right? But if there’s a lot of stress responses going
on over time, and therefore I release a lot of norepinephrine, then it’s possible that
in some of my follicles at least I’ll convert all my stem cells into melanocytes. And that means when the current hair eventually
falls out, the hair replacing it will have no melanins. It’ll be white, and I’ll be wiser, or at least
look wiser.>>Kevin Patton:
Searchable transcript and a captioned audiogram of this episode are funded by AAA, the American
Association for Anatomy, at anatomy.org. Hey, there’s some new articles posted in the
AAA journal called Anatomical Sciences Education, and I want to mention one in particular. It’s labeled as a viewpoint commentary, and
it’s titled Social Media Guidelines for Anatomists. It’s written by Catherine M. Hennessy, Danielle
F. Royer, Amanda J. Meyer, and Claire F. Smith. And the point they make in this commentary
is a good one. That is when we represent ourselves in social
media as anatomists, we ought to adhere to the professional standards of our profession. Which makes sense, right? In particular, they mention something that
has come up in this podcast before, and that is using human donor specimens properly, and
professionally, and respectfully. Specifically, they propose a practice of anatomists
obtaining informed consent from donors before sharing cadaveric material on social media,
and maybe the image should be accompanied by a statement stating that. To read the whole commentary, just go to the
link in the show notes or episode page or find it at the AAA website at anatomy.org.>>Kevin Patton:
I’ve said this before. Whenever I see a statement that “the textbooks
will have to be rewritten if this study is true”, which I did recently, I always take
notice and I look into it. This time it’s about immunity, which honestly
I don’t cover very deeply in my A&P course. We do most of that in other courses in our
college’s programs, so my job is to just give them some very basic ideas to go forward with. Even in my textbooks I stick with the basic
ideas that will get learners started, giving them just enough to navigate the practical
applications of immunity that they’ll likely encounter next.>>Kevin Patton:
Okay. We all know what T cells and B cells in the
immune system are, right? At least the basics. T cells are another name for T lymphocytes
and B cells or another name for B lymphocytes, and we know that each population of lymphocytes
have various roles in immunity, often communicating and coordinating with each other to attack
antigens or cells bearing antigens, you know, bacterial cells, and cancer cells, and virus-infected
cells, and so on. Except, of course, when things get messed
up, maybe signals get crossed and there are immune attacks on normal healthy cells, thus
producing a disease state. We call this autoimmunity because in a very
simplistic way of looking at it we are attacking ourselves.>>Kevin Patton:
This happens in type 1 DM, that is diabetes mellitus. In type 1 DM, helper T cells direct the killer
T cells to attack the beta cells and the pancreatic islets, and that reduces insulin production. That really up our ability to maintain glucose
homeostasis, which leads to all of the many damaging mechanisms of type 1 DM.>>Kevin Patton:
Okay. So far nothing requiring a rewrite of any
current textbooks. What’s new is that a few months ago researchers
found a lymphocyte that is sort of a weird T cell/B cell sort of lymphocyte that expresses
both the kinds of receptors we see on T cells and the kinds of receptors we see on B cells. It reminds me of my favorite cartoon character,
CatDog. CatDog is part cat, part dog just like this
cell is part T cell, part B cell, has the characteristics of both, which is pretty curious,
huh? So these researchers call them DE cells, which
is short for dual expressor cells or dual expressor lymphocytes. But because they’re sort of a cross of two
well known lymphocyte types, they’re also sometimes called X cells are X lymphocytes. So sounding even more like a cartoon character,
right? The X cell.>>Kevin Patton:
Besides this discovery being both an interesting curiosity and a necessary tool for preventing
us from ever thinking that we have the human body completely figured out, it also helps
us understand type 1 DM better. Why? Well, it turns out that the B cell receptors
on these weird X cells include a special peptide that is not normally found among the highly
varied receptors on typical B cells. And that weird receptor can very, very, very
strongly bind … Wait a minute. That’s three verys. It can very, very, very strongly bind to an
HLA called HLA-DQ8, which is thought to present insulin to T cells and thus trigger an attack. Because that binds so strongly, remember three
verys, so strongly, the likelihood of triggering an anti-insulin attack is that much more likely
than just a small, random skirmish that may not end up producing a disease state at all. But when these weird X cells are around with
their particular form of B cell receptor acting like helper T cells by triggering killer T
cells to attack insulin, well, then it’s a full on war, and that war progresses beyond
attacking the hormone to also attack the pancreatic beta cells making the insulin.>>Kevin Patton:
The researchers telling this new version of the story think this is just the beginning
stages of type 1 DM. And their discoveries, if they pan out to
be accurate in the long run, could give us a way to watch for and monitor the onset of
type 1 DM, something we can’t really do right now. But there really are a lot more questions
here than potential answers. Besides some holes in a more detailed version
of the story that still need filling in, there’s the question of, well, where these X cells
come from and how they develop. I mean, we know a lot about T cells and B
cells and they’re even named for where they develop, but we don’t know that about these
X cells. So nah, not ready for textbooks yet, nor for
our A&P course. Except, I think it might be an interesting
aside to share with students if the occasion permits to let them know that there’s still
a lot to learn about human anatomy and physiology.>>Kevin Patton:
The free distribution of this podcast is sponsored by the Master of Science in Human Anatomy
& Physiology Instruction, the HAPI degree. As educators, I wonder if we always value
education as highly as we think we do. How many of us stop taking courses after we
get that last degree? We head off into teaching often without having
any kind of degree or certificate in teaching. Hmm, I wonder if we’re being the best we can
be with this mindset. Why don’t you check out this online graduate
program at nycc.edu/HAPI, that’s H-A-P-I, or click the link in the show notes or episode
page.>>Kevin Patton:
This segment is all about making mistakes. I listen to a few podcasts that typically
end with a so-called blooper reel in which outtakes or mistakes that have been edited
out of the body of the podcast are played as a sort of comical diversion. I don’t do that. It’s not because I don’t make mistakes. I make more than my share of them, but I just
cut them out as I’m doing my editing. It never really occurs to me in the rush to
get it all done that I should do anything other than delete them. Sorry about that. If you really love to hear bloopers, you’re
not going to. Trust me, my mistakes are just sad. They’re not funny. Well, okay, sometimes they are funny. I actually laugh at them when I make them,
but I never really think about preserving while I’m making my mad dash through the editing
process.>>Kevin Patton:
Sometimes my mistakes actually make it out into the airwaves. Like in the last episode in which I recounted
a previous episode in which I marveled at the examples of how people with no visible
olfactory bulb could still sense odors okay. Except that I stated, and stated consistently
several times, that they could hear despite having the lack of both olfactory bulbs. Despite it being a huge mistake about a very
basic idea, I didn’t catch it as I said it, nor when I edited the segment, nor when I
listened to the processed sound file, nor when I played it the first time in the podcast
player just to make sure that it all got out there okay with the correct episode’s file
and all that. It wasn’t until I let it restart and play
in the background did I notice a mistake. And I hardly ever let it play in the background,
but for some reason I did for the last episode. It’s a good thing.>>Kevin Patton:
So once I caught it, I fixed it in the sound clip for that segment, redid all my processing
steps, and then republished it before very many of them had been downloaded by listeners. Maybe you’re one of the lucky few that has
that rare copy downloaded that has me saying the wrong thing. You ought to say that because someday it’s
going to be … No, it’s not ever going to be worth any money. Don’t save it. Please don’t save my mistake and preserve
it, okay?>>Kevin Patton:
Like any of you, I make mistakes in my teaching, my writing, and, well, in just about everything
I do professionally. In my early career. It kind of shocked me that I never stopped
making mistakes, not the same ones generally. But I had this weird notion that mistakes
stop happening once a person has reached a certain level of training and had some experience
and success in their profession. Yet here I was making it relatively unscathed
through several advanced degrees and becoming very successful in teaching, writing, speaking,
and academic leadership and yet still making mistakes. And the more visible and audible my work became,
the more people could see my mistakes.>>Kevin Patton:
I think that early on I was probably developing what some folks call the imposter syndrome,
which I explained a bit in the word dissection part of the preview episode that precedes
this full episode. It’s not a pathology but a way of thinking
that was first identified in successful professionals back in the late 1970s. Put simply, it’s when a person doubts one’s
own accomplishments and feels somewhat of a fraud in living the life of an expert. It apparently happens a lot in academia because,
well, we’re professional experts, right? Paid to teach and to profess our expertise.>>Kevin Patton:
Depending on a huge variety of wildly different factors, we could feel guilty about not being
perfect. And when we are acknowledged for our success
or our expertise, we could feel that we’re somehow pulling something over on everyone. The thinking behind the so-called imposter
syndrome or other similar mindsets can be dangerous in many ways, not the least of which
is not valuing mistakes. Yeah, mistakes are extremely valuable. I’ll circle back to that notion in a minute,
but first I want to say that whether they’re valuable, or worthless, or a liability doesn’t
really change the fact that we’re going to make mistakes. So of nature, right?>>Kevin Patton:
Lucky for me, I learned that lesson early. And over the course of decades, I think I’ve
learned to live with, and sometimes, not always, but sometimes value my mistakes. When I do value them, or at least don’t dwell
on them, thus letting them generate anxiety and guilt, I’m a lot happier person, a more
productive professional, and in some ways better off for those mistakes, the ones that
don’t actually harm me or others, but sometimes even those.>>Kevin Patton:
The reason I bring this up is that recently I’ve heard and overheard remarks from my peers
about mistakes they’ve made or mistakes they fear making, remarks like, “How can we hold
our students to a standard when we ourselves sometimes slip up and fall short of that standard?” Now, my first thought when I hear these things
is, “Yep. Right? I feel your pain.” But my next thought often goes right back
to those mentors I’ve had who’ve helped me look at these things in a different way, a
way that is more realistic, and more self-accepting, and also more productive and useful it turns
out. And yes, once again, I have some stories from
the olden days from early lessons from my mentors. One story is from my wild animal training
days.>>Kevin Patton:
Before I was an apprentice lion tamer, I was an apprentice sea lion trainer. My mentor, Jim Alexander, was and is a serious
student of wild animal training, and he taught me a lot. One lesson occurred after we’d both gone to
see an educational demonstration that featured trained wild animals. It was phenomenal. As usual, Jim used Socratic questioning afterward
to make sure I learned something from the experience. He asked if I noticed any mistakes in the
behaviors in the show. At first, I couldn’t think of any. Then with some prompting, I remembered some
pretty big flubs where an animal didn’t do what they’d been trained to do. And he said, “But it seemed like it went extremely
well overall, right?” Yeah. Well, he eventually got me to see that the
trainer’s reaction to the mistake was the key. Unlike some other trainers we’d seen together
who’d get flustered when mistakes occurred, this trainer acted amused by the mistakes. He laughed them off and carried on with a
cheerful demeanor.>>Kevin Patton:
Jim pointed out that mistakes always happen, even if you and the animals are well prepared,
and you have to have a strategy to deal with that. Not letting it upset you, he pointed out,
is the best strategy, or at least acting like it’s not upsetting you, to seem as if it’s
all part of the fun. And he pointed out when you do that, it actually
does become part of the fun and the flustered feeling really can dissipate. He also pointed out that some of the mistakes
we saw were turned into moments of laughter. He mused that the trainer was likely to even
try to mold that mistake into a new and amusing behavior.>>Kevin Patton:
It turns out that not long after that I was training a new sea lion for our show and would
bring her out before showtime to both get her used to crowds and to show people how
animals are trained. I was trying to get Yvonne the sea lion to
catch some rings that I was tossing to her. She was really good at it and was quickly
becoming an expert. But all that practice, practice, practice
didn’t seem to help my pitching arm very much. And during a pre-show training demo where
I had several friends in the audience who’d never seen me perform with animals, I threw
a wild pitch that Yvonne could not possibly catch and the audience winced. I probably did too. A mistake in front of a crowd, including some
friends that I wanted to impress. Well, almost immediately, Yvonne, anticipating
a potential reduction in fish snacks, ran over to the ring, and grabbed it in her mouth,
threw it up in the air, and caught it around her neck like she was supposed to. Phew! I remembered my lesson from Jim, and I laughed
it off. And from that day forward, that last ring
being missed became part of the act. Far more entertaining than the original behavior,
and far more enriching for the animal.>>Kevin Patton:
I know it’s sort of a cliché to say we should look at mistakes as opportunities. But once I really started experiencing that,
it started to become a habit, and I’ve gotten a bit better at it. Not yet a master, but better. And at the very least, it’s saved me some
frustration and self-doubt that I’d have otherwised experience. Of course, as we get better at particular
skills, we make fewer mistakes. And that’s our goal, right? And if we try new things, well, it’s just
expected that we’re going to have pretty many mistakes until we settled in. Or maybe just decide to abandon that new thing
and try something different.>>Kevin Patton:
If we let these kinds of mistakes get us down, it’s going to damage us little by little. These kinds of mistakes are learning opportunities
and not reflections of our overall competence or worth. But that cliché of mistakes being potential
opportunities, even though true, is not really the point I want to share today. Really what I’m trying to get at in my idiosyncratic
meandering way is that it’s okay, really, okay to make mistakes sometimes, mistakes
in teaching, mistakes in writing, mistakes in helping students. We all make them, not just beginners but even
those who’ve been doing this for a long, long time.>>Kevin Patton:
Making occasional mistakes is a sign of humanity, a sign of being human, not a sign of weakness,
incompetence, or any level of worthlessness. It’s not that we should strive to never have
feelings of failure, or guilt, or embarrassment, it’s that it’s okay to make mistakes and have
those embarrassed feelings but still not see it as a negation of our professional expertise
or our personal worth. Beyond that, though, is the lesson that our
students will learn if we can face our mistakes in our courses with grace and humility, perhaps
even with some amusement, and show students how true professionals can accept mistakes,
even express some dismay and still keep going, working to avoid future mistakes but not being
done in by the fact that we do make mistakes, and sometimes even make them in public. This lesson of not taking ourselves too seriously
may in the long run be much more valuable towards students than knowing the role of
olfactory bulbs in smell, or hearing, or taste, or whatever. I don’t know. What is it again?>>Kevin Patton:
Marketing support for this podcast is provided by HAPS, the Human Anatomy & Physiology Society,
promoting excellence in the teaching of human anatomy and physiology for over 30 years. Go visit HAPS at theAPprofessor.org/haps. That’s H-A-P-S. I think a lot of HAPS members don’t think
much about the one-day regional HAPS meetings that occur on weekends at various times of
the year and various locations around North America. Hey, maybe today’s a good day to go to theAPprofessor.org/haps
and check out the full list of regional meanings.>>Kevin Patton:
Hey, you probably forgot about that survey that I’ve been taking. I’m asking you now to please take just a few
minutes of your time to respond to that anonymous survey because it’s your experience as an
individual listener that’s important to me. Just go to theAPprofessor.org/survey. And as always, thanks for your support>>Kevin Patton:
Hey, don’t forget that I always put links in the show notes and the episode page at
theAPprofessor.org in case you want to further explore any ideas mentioned in this podcast
or if you want to visit our sponsors. And you’re always encouraged to call in with
your questions, comments, and ideas at the podcast hotline. That’s 1-833-LION-DEN or 1-833-546-6336. Or send a recording or written message to
[email protected] I’ll see you down the road.>>Aileen:
The A&P Professor is hosted by Dr. Kevin Patton, an award-winning professor and textbook author
in human anatomy and physiology.>>Kevin Patton:
This episode should be taken once daily with food.