7:18 AM

Expertise and the Fix

The New York Times has a blog post today on some programs operating in rural India that aim to reduce significant health problems, such as neonatal deaths, without the use of doctors.

Here's the problem:  in many developing countries, such as India, doctors are highly educated in their fields, but then are lured away by countries in the global North (like us here in the U.S.) because they can be paid so much better.  This "brain drain" may sound like not such a big deal, but the ripple effects in society are huge--the home countries not only lose the investment they made in educating the doctors, but they also end up with a weakened health care system generally, which affects social fabric, economy, well-being...on and on.

One possible solution, according to the blog post, is to train not more doctors but more community members who can provide basic care.  One woman trained in this way, for example, travels the village weighing babies and giving new mothers basic advice on how to care for their children.  In some cases, these programs are having significant impacts on infant and child mortality rates.

I'm reminded of when I gave birth to my two children--we had doctors, of course, and nurses, but we also paid "doulas," women who were not necessarily medically trained but who were trained to understand the rhythms of birth, care, and comfort.  In our first birth, the doula averted an unnecessary c-section with her patience and willingness to try alternative methods to encourage the baby to descend in the birth canal; in our second birth, the doula delivered the baby, with a nurse, when the doctor could not reach the hospital in time.  Both women also taught me how to care for myself and the baby after the birth, which I needed.

Don't get me wrong.  I was really, really glad to have hospitals and medicine and all of that.  In my case, I needed them after both births.  But the two doulas--who were not recognized as experts by the doctors and nurses at our hospitals--made a huge difference in my experience and in those early days of motherhood.

So, what does this have to do with science communication?

Well, I'm thinking about the nature of expertise, I suppose.  After reading your blogs for a few weeks now, I think one of the things that is separating the very successful blogs from those of you who are still struggling is perhaps your relationship to expertise.  My hunch is that some of you still feel you need to be like the classically trained doctors described above--finished with your education, established experts in the field, respected and unchallengeable.  You may be worried that readers will think you're stupid and comment on your stupidity, or even laugh at you.

Then there are those of you who are more like community health workers or doulas.  You know that there is plenty you don't know, but you're jumping into the muck, talking to people, learning as you go, and bringing others along with you.

If you are worried about being an expert, or worried that others might think you're stupid, what might you do in the next few weeks, before our next evaluation, to shed your fears about expertise and to instead get your hands dirty with communication?  What fears do you have about showing your ignorance?  What experiments can you run to test your fears?  How can we get past these fears together?

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