Medical Self-Care: Health Care Education

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PHOTO: RICHARD ALLEN
Dr. Tom Ferguson set up a health care education class for first graders.

Back in my early days on the hospital wards, I was shocked
by the numbers of people who were suffering (and
dying!) from preventable diseases. I felt that by not teaching things like
relaxation, exercise, diet, and so forth, our
culture had let
those men and women down … and would continue to let down
generation after generation of children, unless our
youngsters could be taught to take care of their
bodies.

So, when I later had the opportunity to devote several
months to an M.D. thesis project, I decided to set up a
“good example” health care education class to teach medical skills to first
graders. The regular instructors in my “target” school were
enthusiastic about the program, and soon three co-workers
and I had arranged to work with eight children for
two afternoons each week over a two-month period.

The teachers suggested that we explore areas that the
children wanted to learn about, rather than coming
in with a prepackaged set of goals. So we opened up the
session with this loose definition of the class: “This is a
time for you to find out about your bodies, about doctors,
about what happens when you get sick, and about how to
stay healthy.
Your ‘job’ is to think up good questions
about health. Our job is to answer whatever
questions we can, and help you figure out how to find your
own answers to the others.

What, Me Teach Medicine?

My co-workers and I were all a little uncertain about our
ability to instruct the children in even
rudimentary medical skills. One of the myths in
our culture is that medical information is so specialized
that a little of such knowledge can be terribly dangerous
and that it’s best to leave all the
responsibility for “doctoring” to the experts.

In the course of our classroom experiment, however, we
discovered that It’s all right for people to get
together to talk about illnesses and bodies even if no
one in the gathering is a “pro.” You see, one of the most
important medical self-care skills is the ability to pose
the right question and then figure out how to find
the answer.

We emphasized this sort of self-sufficiency in our classes by helping the young students use the library to
resolve some of their questions, and take advantage of the
other resources that we had available to answer others.

What They Wanted to Know 

As often as not, our class’s questions would lead us into
areas of the children’s personal fears and concerns. “When
my sister had appendicitis, the doctor measured the white
cells in her blood, ” one of our students told us. “What
did he do that for?” We had to respond to such questions
both by providing the technical information sought
and by easing the unexpressed concern behind the
queries, which was often, “Could the same thing happen
to me?”

Organized Group Activities

The children were especially interested in “hands on”
activities, and we presented a number of opportunities for
them to actually feel, see, and listen to the workings of
their bodies. All of our students learned how to take their
own pulse readings, for example (we found that the
under-the-angle-of-the-jaw carotid pulse was easiest for
children to locate). The youngsters also came to understand
the significance of such measurements by
noting the difference in pulse rates before and after a
fast run. That experiment led to a discussion of how
physical fitness affects pulse rate: People in better
physical condition have stronger hearts and slower
pulses, for example.

Since it became apparent early in the class that one
stethoscope and eight youngsters would add up to chaos, we
obtained an inexpensive “stetho” (at a cost of $2.00 to
$5.00) for each of our students. Many good questions and
discussions resulted from letting the children try to find
different sounds with the tools. (They discovered noises
that we teachers had never thought of such as “my
toes wiggling in my shoes” and “my hair”.)

Questions and Answers

Our class discussions often related to the children’s
concern and sense of helplessness about what actually goes
on at the doctor’s office or the hospital. We were asked
such things as: “What happens when they give you gas in an
operation?” and “What happens when an animal dies?”
(Questions about sex and death seemed easier for them if
discussed in terms of animals.)

In responding to the children’s worries, we tried to help
the youngsters explore the feelings that such questions
expressed. It was hard for us to remember that
our students often didn’t want specifically
correct information so much as a chance to share deeply
felt concerns.

Field Trips and Projects

Our schedule limited us to one field trip (I’d
suggest that anyone else conducting such a “special health
class” take more excursions, perhaps to a newborn
nursery, a children’s ward, or a pediatrician’s office).
Our group was offered a choice for their one outing, however, and made what turned out to be an excellent decision:
They chose to visit an animal hospital. We got a tour of
the operating room, a description of common surgical
procedures, and–the real hit of the day–a
demonstration of dog and cat X-rays. The latter fascinated
the children (and helped them understand how their
own “insides” work). We had to just about drag
them away.

Independent (but supervised) student projects–such as
finding out what different bones look like, or how to use a
microscope–also proved to be worthwhile learning
tools. In most cases these involved the students in working
in the library–and with the instructors–to put
together hand-lettered and hand-drawn “books” on a chosen
topic. Again, such activities served to stress the point
that “plain people” can look for and often
find the answers to “complicated” medical questions.

What We Should Have Done

After the classes were over (naturally), we
thought of all kinds of wonderful things that could have
been done. For example, we might have pointed out
bad health habits with a game called “Make
Yourself Sick” in which each child would try to think
of ways to make his or her health worse. (Good
habits would then, of course, be emphasized by contrast.)
We should also have included some means of evaluating the
class. Perhaps a “draw the inside of your body” test or a
“how you feel about doctors” questionnaire–if the
latter were given before and after the
course–would have been helpful in determining the
value of our experiment.

Of course, “special classes” can only reach a few
youngsters over a short period of time. What children need
is a continuing health focus in their daily
school schedules and in the home. If we can find
ways to develop a regular program of medical awareness and
self-care for our youngsters, we’ll be helping to build a
future world of healthier adults. 


In 1976, Tom Ferguson–then a fourth-year medical student at Yale–launched a magazine called Medical Self-Care, which he hoped would serve as “a Whole Earth Catalog of the best medical books, tools, and resources.”  

Well, Tom Ferguson is Doctor Ferguson now, and the medical self-care “movement” — as well as Tom’s magazine — has flourished. People are beginning to assume more responsibility for their own well-being and are eager for information that will help them take better care of their bodies.

So in an effort to provide just such very necessary data, MOTHER EARTH NEWS offers this regular feature by Tom Ferguson, M.D.