Tuesday, May 05, 2009

Why *Sophie's Choice* makes for the perfect lesson plan

So, not wanting to spoil the plot for anyone who might want to watch the film or read the book. Let's just say, Sophie's Choice is a novel by William Styron that was turned into an Oscar winning film starring Meryl Streep. A work of fiction where a doctor in a concentration camp forces a mother to make a choice.

So, as a phrase - a '
Sophie's Choice' is a tragic choice between two unbearable options.

So, where did this lesson plan inspiration come from?

If I'm honest I tend not to get most of my ideas for English lessons from fictional Nazi doctors. Or novels about Nazis in general.

I've yet to choose an extract from a Sven Hassel novel as a comprehension exercise. As much as I used to enjoy his stories of Wehrmacht heroism on the Eastern Front when I were a lad, they're not really part of the syllabus these days, for some weird reason. Of course that's not to say that Nazi based fiction and Hitler documentaries aren't popular. The History Channel may as well be called The Nazi History Channel. But quite why Nazi-based entertainment is still as popular today as it was 20 years ago is quite another question. The simple answer might be that they did utterly hideous things, but wore great iconic uniforms while they did it. And they were European so we're left thinking - how different were they from us? Where they all evil, or were some of them just misguidedly doing as they were told? And what would I have done if I had lived in Germany then?

I like to think I would have been a heroic resistance fighter or been sent to fight on the Eastern Front with Sven Hassel and all the other commies, criminals and rejects - but who can say for sure. What would I do if faced with an impossible choice? I'm no hero, as far as I know.

But before I get carried away - allow me to back track to last Thursday night. A familiar Thursday night spent leafing through books on grammar and trying to fill in my lesson plan for Friday afternoon. Surfing through my favourite English Teacher Resource websites to see if I could get any inspiration. Thinking, gahhhhhhh, can I be bothered? Can they be bothered? Will anyone turn up? It's Friday afternoon, it's a bank holiday weekend. Hmmm. Yawn.

I clicked on a lesson plan called 'The Doctor's Dilemma'. Apparently it would be ideal if you wanted to encourage students to digest and assess information, whilst also giving them an opportunity to do a bit of a group presentation and get some public speaking practice.

Fine, I thought - they're busy writing, thinking, discussing - I get to wander around a bit, dispensing my wisdom, guiding their learning and all that stuff. And look, we did apostrophes and pronouns last week and then I made em write about their childhood. Enough with the writing for a week - let's have a lesson where it's mainly just debating and forming reasoned coherent arguments. Valuable life skills they are. Everyone enjoys a good argument, right? British democracy. And these days of course Barack Obama is everyone's role model - so speaking and debating is cool. Public speaking really is the new rock'n'roll - or the new performance poetry at any rate...

So. 'The Doctor's Dilemma' lesson plan. What does it involve? Here's how it works. There are 30 patients with a fictional disease and only money enough to treat 2 of them. Students have to do a preliminary sorting exercise to find the top 10 patients that might be best qualified for treatment.

How do you decide? Someone healthy - that will survive the treatment - is an obvious first criteria. Something that British doctors consider when deciding that smokers or obese people can't have or - don't deserve? - heart operations.

How else do you decide? The students got to discuss it and were keen to treat all applicants fairly and rationally. On their merits. Before they got into it they were sure that emotions would not be a part of it.

But as part of the exercise they would be representing certain patient's cases - ones they had chosen to put forward to the vote. People who they believed most suitable and most deserving of treatment. Presentations and speeches followed in favour of a war hero, a premature baby, a mother of 3, a professor of toxicology, an athlete, a key witness in a criminal case etc. If you were a postman with no kids - you weren't going to stand a chance. You needed an excellent CV. Generally it was like having a job interview to save your own life - apart from the babies...

Here is where the arguments started. A baby, someone argued - could grow up to be a Prime Minister or a drug dealer - how can a baby get special treatment? Should a child take priority over an adult with an active, vibrant life and a family of their own depending on them?

It is a terrible exercise if you think about it too much, but the central idea is not dissimilar to the decisions that some doctors probably have to make every day. Doctors working in Africa who don't have enough drugs to go round. Who do they choose to treat? Is it just first-come first-served or do they make rational decisions based on other criteria? Which AIDS patients do they decide to save? When we're doling out flu medicine we give it to the weakest in society - on the rationale that the rest of us are strong enough to survive. But what if we weren't? What if the next flu - the next one after swine flu - super horse flu - is capable of killing us all - who gets the vaccine then. Perhaps a lottery would be the best idea - but even then the rich and people with important jobs would have to have priority.
"'We don't use the word rationing - we call it priority setting,' said the official at the Department of Health."

And the other, perhaps unremarkable factor, was that all the female students all wanted to save the premature baby. The majority of the male students thought this was irrational. There were more deserving cases - patients that were more likely to survive. Was it worth wasting the treatment on a baby that might die anyway? The debate all got a bit heated. The males were ready to make the tough decision, the women weren't. Some of them are mothers, some of them aren't, but even the idea of fictional babies suffering was too harrowing for them.

But they're all adults, and no one actually cried. I'm not an evil puppeteer, am I........? It's fiction, people! It's an exercise. You're learning to debate; learning about democracy and making difficult decisions. I think you need a mature and sensible group to use this lesson plan with but it touches on so many questions of ethics and rationality and ... ummm, life stuff. You could have the same sort of arguments about abortion, contraception, adoption, IVF or stem cell research. Who gets to play at being God and how do they decide?

This week - back to adverbs and gerunds I think.... Whatever a gerund is.


  1. As soon as we have the ability to make decisions we play God to a greater or lesser degree.

    At one end is the doctor; an obvious one.

    But what about the interviewer deciding on who gets a job? The effect will change the lives of all concerned.

    The MP voting whether or not to go to war?

    The policeman deciding on whether or not to give a ticket? The recipient may lose his/her job which could have all sorts of consequences - could be a doctor!

    The wife deciding on whether or not to leave her husband?

    Or a decision on whether or not to jump that red light? or keep to that speed limit? or avoid a road when school is turfing out kids?

    I wonder how often I have made life and death decisions and not even been aware of it.

    It's a question of being aware of the possible consequences of our decisions. The doctor is obvious. But there are many others.

    Like you say; best not to think about it too much - except in theory as we are here.

  2. Very few of us have to make decisions that hugely affect other people. The interviewer choosing a candidate can rest assured that the unsuccessful candidates will more than likely get another job. Deciding to leave your husband is a matter of being better off with or without him, it's not a situation whereby both outcomes are equally good and you have to reject all outcomes bar one based on "worthiness". Yes, decision making is always tough, but for the majority of decisions there is a clear best choice.

    To save one life over another is not a clear choice and any of us that never have to make that choice for real are her fortunate.

    All of the female students saving the premature baby is surprising. Chances of survival are quite poor, and the baby is a baby, it's not a personality with aspects to be missed as a part of people's lives. That isn't meant to sound heartless, it must be diabolical to lose a baby, but it is an unknown entity. That's like the mother/child thing, in childbirth I would always save the mother, the mother can have another baby, the motherless baby can't have another mother. So, I'm with the illogical side of that argument. That's not to say that it isn't right to battle to save a premature baby in regular circumstances, but in a 2 in 30 ratio, their priority is low.

  3. Making life changing decisions on the behalf of others is a job best suited to those whom we elect to power. Simple. Then no mistakes can be made and we can exonerate ourselves from any blame/repercussions.....

    Oh dear....

    Now... what's plan B :)

  4. Trust an elected politician before an unelected surgeon???

    Nice one.

    He he :)

    I think plan B too, whatever that is.

  5. Canadians have done an absurd amount of hand-wringing over the state of our healthcare system. One line stuck with me, though, and it fits in this context: "one person's provision (of health care) is another person's deprivation."

    In other words, health care resources (doctors, MRI machines, the $$ to pay for same) are finite. Saying "yes" to one person's heart transplant means saying "no" to someone else - someone's hip replacement, maybe.

    btw: I'm sure you don't get _all_ your lesson plans from Nazi novels ... but have you seen (or read) The Reader? I thought it was an interesting psychodrama.