Who Needs Orgo Anyway?

NYU, Organic Chemistry, and the End of the Ancien Regime

© photo by Noa Bregman

The best doctor article of the week by far was published Monday on the front page of the New York Times (below the fold, but still): At NYU, Students Were Failing Organic Chemistry. Who Was to Blame? 

Well, just in case you’ve been hiding under a Twitterverse rock, the answer, of course, is the professor. 

And not just any professor, but Maitland Jones, a bigshot in the rarefied world of chemistry and premedical curricula. Before retiring to NYU, Maitland taught Orgo at Princeton - kind of like a Premier League soccer player moving to the MLS in the twilight of his career. 

Maitland literally wrote the book; a 1,300-page tome that we in medicine know and love, and which he named, with all the creativity and flair characteristic of the field, Organic Chemistry, 5th edition.

According to the article, the course was really hard, Jones was really mean, and the students were really bummed. Some of them, afraid that their poor performance might dash their chances of getting into med school, signed a petition against him. 

The petition said, in part, that their grades did not reflect how hard they were trying, and that a class with so many low grades and withdrawals, “reflects poorly on the chemistry department as well as the institution as a whole.”

Perhaps afraid that any such reflection might make it tricky to charge parents $237,924 to provide their children with an undergraduate education - or perhaps because they agreed with the students? - NYU fired Maitland Jones.

Let me take you through one representative boomer doctor’s five stages of grief in response to this Gen-Z rebellion.

Denial

There must be some mistake. Maybe it’s one of those New York Times articles that sound so well-researched and authoritative - unless you know a little something about the subject and realize that it’s not.

So I did a little independent research, including digging up the original text of the petition, and confirming that there were no outstanding charges of abuse or molestation hanging over the professor’s head. 

Now, anyone who knows anything about denial will tell you that facts are a poor antidote - after all, by definition denial is an irrational, psychologically motivated belief that flies in the face of facts.

But in this case, it worked. My denial cracked: NYU had indeed fired a professor because his students complained that Orgo was too hard.

Anger

Guys! Do you really want to dumb down Orgo? The crown jewel of the premed curriculum? The experience that is to premeds what Hell Week is to Navy Seals - a rite of passage that if it doesn’t kill you will make you stronger?

Newsflash: there are no participation trophies in Orgo - it’s a weed-out class! The whole idea is to try really hard, fail anyway, and realize that med school was probably a bad idea.

Orgo is like that poster at my neighborhood gym (before it burned down under mysterious circumstances during the pandemic) of the sweaty woman hanging from the pullup bar: “The hard is what makes it great!”

Orgo is designed to crush your dreams!

Bargaining

I once read that a good negotiator should always try to understand the other side, so here it goes.

The New York Times article quotes a colleague of Dr. Jones, a certain Dr. Kirschenbaum, who had this to say in defense of Jones’ high standards and rigorous demands:  “Unless you appreciate these transformations at the molecular level,” he said, “I don’t think you can be a good physician, and I don’t want you treating patients.” 

This literally made me laugh out loud.

I’ll admit it right off the bat: Orgo is useless. The moment you put down your pencil in despair after taking a stab at the last question on your Orgo final, is the last time you will ever need to know Orgo to be a doctor. 

Well, maybe that’s not entirely true. You need to remember some of it to pass the MCAT, and it may help to know a little here and there in the first year of medical school. 

Still. I recently googled some sample Organic Chemistry problems just for fun. The squiggles and arrows and lines did evoke a glimmer of sickening familiarity - kind of like passing someone in the street who might have been that kid who bullied you in grade school. But I had zero recollection of how to approach the problems.

The bottom line is, if you really need to know Orgo to be a good physician, then I guess there must be very few good physicians.

Furthermore, given all that, should Orgo really be the class that weeds out pre-medical students? 

If anything, the complaint I usually hear is that doctors are not understanding enough, not compassionate enough, not human enough. I’ve never heard anyone complain that their doctor was not scientific enough.

To use a Star Trek metaphor, if the world of medicine is divided into Kirks and Spocks, then we already have too many Spocks. Orgo only makes the problem worse by weeding out more Kirks.

So here’s a modest proposal: let’s get rid of Orgo altogether and replace it with a liberal arts requirement. Something that demands critical methods of inquiry derived from an appreciation of human values and the human spirit. Something like English, History, or Philosophy (continental, of course, not analytic).

Depression

To be honest, I didn’t pass through this stage.

Maybe that’s why Elizabeth Kubler Ross’s five stages of grief paradigm is rejected by experts as unscientific, inaccurate, unreflective of most people’s experience, and actually not even meant to apply to the bereaved….

Acceptance

Wait, what just happened? Did I just argue myself off of Team Boomer and onto Team Gen-Z? 

Now I’m getting cold feet. 

If NYU dumps Orgo, what will take its place? As much as I love English, I’m afraid it might not be up to the task. It’s not enough of a hoop to jump through, is it? Not exactly a stumble course. Maybe we should be less radical, more transitional, and go for something more Orgo-ey.

It should be hard but not too hard; irrelevant but not too irrelevant; anachronistic but yet foundational.

It should have a technical name and nickname, with its own jargon, acronyms, and mnemonics - something that the average patient will be impressed that you know, even if neither of you is quite sure why.

Hmmm….

Here’s an idea. I know it takes us back to high school, but what about trigonometry?