[00:00:00] Christine Ko: Welcome back to SEE HEAR FEEL. Today I have the honor of being with William Deresiewicz. William Deresiewicz is an American author, essayist, critic, and speaker. He is the author of the New York Times bestseller, Excellent Sheep: The Miseducation of the American Elite and the Way to a Meaningful Life, which was published just this month, May 2024, in a 10th anniversary edition. Some of his essays are published in his recent book, The End of Solitude: Selected Essays on Culture and Society. Mr. Deresiewicz has won the Hiatt Prize in the Humanities, the National Book Critics Circle's Nona Balakian Citation for Excellence in Reviewing, and a Sydney Award. He's taught English at both Yale and Columbia and is currently serving as an inaugural public fellow at American Jewish University. I will put a link to the first essay of his that I read that was in the American Scholar, titled, The Disadvantages of an Elite Education. Welcome to Bill.
[00:00:53] Bill Deresiewicz: Thank you, Christine. Thank you for having me on.
[00:00:56] Christine Ko: As I just said, I'll put a link to the first essay of his that I read that was in the American Scholar, titled, The Disadvantages of an Elite Education. Right now I have a junior in high school. We've been talking about college and where does she want to go? What kind of school, large, small; and so also on that level too your writing is really illuminating to me. I also really appreciate this line that you wrote. I'm going to quote you, "Yet the opportunity not to be rich is one of the greatest opportunities with which young Americans have been blessed." And I've been pondering that because I'm Korean American. My parents are Korean, came to this country, and they didn't come to this country to be rich. I think you talk about this in Excellent Sheep, actually. You talk about how an immigrant family is also a little different. You're from an immigrant family yourself, I think you mentioned. So can you just elaborate a little bit on your quote?
[00:01:47] Bill Deresiewicz: Sure. And I want to be clear, as I am in Excellent Sheep, that I'm not suggesting that young people don't have to think about money. It's different depending what class you come from. And if you are a working class, first generation college student, then you're probably going to have less freedom. But there's no point in pretending that is not the case for many students who go to selective colleges when we both know perfectly well that they have a lot more freedom. So what I'm saying is, and I'm saying this especially to students who graduate from selective colleges, and who tend to, in some ways, feel the most pressure to be rich.
[00:02:19] There was a piece, I believe literally in yesterday's New York Times, we're talking on May 23rd. They focus specifically on Harvard, but it's true at all these schools. You went to Princeton, and I went to Columbia. The percentage of students who go into finance, consulting, or tech continues to be extremely high, and in fact, higher than ever. And if you add in law and medicine, you're well over 50%. All of these fields have several things in common, but the most obvious thing is that they're high paying professions.
[00:02:45] So what I'm saying, when I say the opportunity not to be rich is, we have a middle class. I know the middle class has been shrinking, but we still have a middle class, which means you still have an opportunity, a very robust opportunity, to live a decent life. It's not going to be a high wealth life, it may not be a high status life, but it could be a very fulfilling life. Doing all kinds of different things, including ones that haven't been thought up yet. That's what I'm saying. But I should say that my book is based on not only on ten years of teaching at Yale, but conversations with hundreds, and long emails from hundreds and hundreds of elite college students. They're all so terrified, like, why are they hurting? when the world is their oyster. They're the freest young people who've ever existed in the world, and yet they feel the exact opposite. They feel nothing but constraint, because they've had it drilled into their head. It's a lot of things. It's parental narcissism. It's this status competition. It's the American religion of wealth. But it's all fake. In the sense that nothing's really constraining you. You can walk away from it. There will be challenges, but I always say yeah, you're going to have to give up some wealth and status. I don't like to say, follow your heart, follow your dreams, follow your bliss. I don't even like to say passion or at this point, even purpose. What I'll say is, follow the desire to live a life that feels like it's the right life for you. A life in which you're going to be excited to get out of bed in the morning and start working. That's big. So what I say is, yeah, you're going to have to give up a lot, maybe, to do that. But you're giving up a heck of a lot if you don't do that. And there are a lot of miserable bankers and lawyers. And even doctors. A lot.
[00:04:22] Christine Ko: Yeah, I mean if you just go by this burnout statistic in healthcare, it's more than 50 percent of doctors are burned out. Which is not good for patients. Not good for the system. You do also say that there is a certain amount of stuff that we do need to do in order to sometimes figure out what we really want. My next question to you, because you've written about this: how can I avoid being alienated from the human?
[00:04:47] Bill Deresiewicz: That's a very big question, and I know that the terms are very vague, but I think about this fairly frequently when I think about, for example, how psychiatry has gone from talk therapy to medication or the way various assessment rubrics have forced teachers, teaching to the test regime. If you're teaching an AP course, having a very prescribed amount of material that you have to get through. This kind of bureaucratization of so many areas of our life, especially of our professional life, this kind of managerial mentality that tries to squeeze efficiencies out of everything and tries to install assessment regimes that reduce everything to metrics, including things that aren't reducible to metrics, that aren't reducible to numbers.
[00:05:32] How much has the student learned? Some of that can be captured in numbers. Some of it can't be. And so you end up missing the things that can't be assessed, the things that can't be turned into metrics. This is what I mean when the human is being evacuated from so many things that we do in society, whether it's doctoring or teaching. We're forced to put these protocols before the actual human engagement, and before the actual treating of the person, of the student, of the patient in their full humanity, which again is a vague term. I think retaining or reviving your humanity, if you're a doctor or a teacher, involves to a great extent reviving your ability to treat the other person as human. That itself makes you more human. So now you're doctoring from your full self, or you're teaching, you're professing as a professor, from your full self to another full self. In the time that we have, I'm not going to be able to explore this. It's a hard thing to put your hand on, but I also think it's an easy thing to feel. Because I think we've felt it. I think we felt it from both ends. Doctors are sometimes patients. Everyone who's listening to this has been a student at probably four different levels of education. So we know what this feels like.
[00:06:42] Christine Ko: Yes. I think those are sometimes the hardest things to express, right? What you know instinctually, it's hard to actually put into words. I did write a book called, How to Improve the Doctor Patient Relationship, because there were all these things that had I known earlier, would have been better for me and for my patients for sure. I do get to talk to people on a regular basis in clinic when I see patients, and they're from all different walks of life. Can you talk about how someone with a sort of "elite education" can learn to talk to people?
[00:07:13] Bill Deresiewicz: I think this is a difficult problem. As I say in Excellent Sheep, I think our elites, the people who go to selective colleges, who go on and get advanced degrees, maybe who become doctors, that they've become increasingly isolated from most people in society. I'm hardly the only person to say this, and I think it has a lot of detrimental effects in terms of the way, let's say, this elite or this leadership class, or what's now called the professional managerial class, leads society. So what can you do about it? I think you can't really learn to talk to people any other way except by talking to them. And you have to talk to them as an equal. That's the thing. I think there's no substitute for moving among people, in whatever social context you can as an equal, which means recognizing that you are their equal, and that they are your equal, and that you have things to learn from them. Because they know about things that you don't. They have excellences that you don't.
[00:08:11] The problem is that those social opportunities are vanishingly rare for typical members of the professional managerial class. It's a matter of opportunity, but it's also a matter of attitude. In general, learning how to talk to people, it's mainly about learning how to listen to them. There's one very simple secret, which is you actually want to listen to them, right? If you actually feel that way, then you convey that to people, and you actually make them comfortable. And you do that partly by asking them questions that you genuinely want the answers to, and then they relax, and then you can have a conversation.
[00:08:47] Christine Ko: I think you're exactly right. The key is, I need to ask the patient questions that I really want to hear the answer to. Not just, do you have a headache? Yes. No. Just tell me, yes, no. Some of my questions, I do say to them, I just want yes, no answers. Because part of the problem is there's not enough time really for me to sometime listen to their answers.
[00:09:06] Bill Deresiewicz: This is a huge problem, and if I could speak not as the author of a book, but as a representative of the 330 plus million members of the non doctor community, we're all unhappy about this. Specialists barely look you in the eye. I've had appointments with specialists that lasted probably literally less than a minute. I have a really good primary care physician, and he engages, and we talk. He just doesn't have time. I think my appointments with him are like 15 minutes, and we do the best we can, but he's got to get to the blood work, which, there's not much you guys can do about that.
[00:09:39] I understand this is the way the structure of healthcare system has evolved. I just urge you to do your best. And especially specialists, it's you can just, they're not even looking at you like a person. They're just looking at you like a collection of body parts. It's not just a bad experience, but I also, I've known plenty of people who, including me sometimes, felt like I wasn't even able to communicate what I thought was medically important information because you're just not even giving me a chance to talk.
[00:10:05] Christine Ko: Yes. And I would say, to not be a hypocrite, I've done that. You've also written about failure. Can you talk about failure?
[00:10:12] Bill Deresiewicz: Unfortunately failure has become this very voguish concept in sort of business circles. People at the Stanford Design School walk around with stickers that say, I failed today. Silicon Valley likes to fetishize failure. I know it's become a bit of a cliche, but I talk about it in Excellent Sheep in reference to what I think is one of the most damaging characteristics of what I call excellent sheep. Actually, one of my students used this phrase. So in other words, elite educated, high achieving, hoop jumping people who end up being pathologists and things like that. And that is risk aversion, right? Because the system demands this perfection. We're going to judge you by your GPA, so we're going to take the 4.0 above the 3.9. Even if the difference may not be significant, and even if the reason you fell short of perfection could be all kinds of things that really have nothing to do with your future performance. One of the things that it might be is that you took a risk. You took a class in something that you didn't already know you were going to get an A in. And so you've narrowed yourself. This is a kind of a perfect example of the difference between what we can measure and what we really should value or do value, right? Because getting into a good medical school or getting into a good postdoc is another kind of measure, right? It's some kind of benchmark. It's a metric, but what is it measuring? This is so much of what Excellent Sheep is about is all of these things measure a very kind of narrow band of capacities that we call excellence. But I have to put that in quotation marks.
[00:11:41] A willingness to take risk, there are obvious areas in which it's valuable, like entrepreneurship. And there's a dearth of entrepreneurship coming out of elite colleges. Actually Andrew Yang wrote a book about this a long time ago before he was famous as a presidential candidate. But I think just in any area of life. We want people who are gonna not be afraid to fail. To go back to the word you actually used. This is a cliché, but we do actually learn from failure, and one of the things that we learn is that it's not the end of the world.
[00:12:10] Christine Ko: I agree with what you said about failing being a cliché and everything, but right now in healthcare, we still don't talk about failure. Which, when I talk about failure in healthcare, I mean misdiagnosis. Or really even true errors like giving the wrong medication to someone or the wrong dose or, worst case scenario, wrong site surgeries, things like that. But there's a really high rate of misdiagnosis, like in an emergency room situation, which is lots of stressors and time is short, as high as 15 percent but maybe higher. In a specialty like mine where it's more quiet. I'm in my own office. It's a slide. It's a visual based thing. So maybe there's less data coming at me, it's more contained visually. Maybe the error rate is as low as 1%.
[00:12:58] Bill Deresiewicz: Yeah, listen, this is something that I've also noticed as a patient and talked about with friends of mine, which is that doctors are extremely reluctant to use the words, I don't know. I think it has to do with the doctor's self conception. I think it has to do with the stakes of the medical profession, which can be high. And I think it probably also has to do with the pack of lawyers you have breathing down your neck. But obviously you're not going to be perfect all the time. I agree that we'd like to reduce even a 1 percent error. To a certain extent, there's just going to be an error rate. But you're certainly not going to be able to reduce the error rate if you never talk about it because there's stigma around talking about it.
[00:13:37] Christine Ko: Exactly. Do you have any final thoughts?
[00:13:39] Bill Deresiewicz: To people listening, I'm gonna assume that a lot of them are parents or potential parents, even if they're parents with young kids. And probably they're high achievers, and they want their kids to be high achievers, and maybe their kids are high achievers, and they want their kids to get into one of five different colleges. Kids, whether you know it or not, are made really miserable by this. That's really where the book really came from. I wrote that initial essay, The Disadvantages of an Elite Education, and that's when I got the avalanche of emails, And that's what I learned, how miserable. Because that's the one thing I didn't talk about in the original essay, because I wasn't aware of it, even as a professor who thought he knew his students, was how miserable the system makes people.
[00:14:21] I understand parents want the best for their kids, and there's a lot of anxiety, especially in this chaotic, difficult world we live in. But I would say, trust your kids. More than you probably do. Trust their ability to make their way in the world. I'm not saying kids know everything, obviously they don't, but remember that you were like that once too, and here you are, you're a successful professional, and somehow you made it. Trust that your kid can do that too, trust that they're resilient, trust that they're strong, trust that there's a lot in them that hasn't come out yet, because they're young, but it will.
[00:14:55] Christine Ko: I like that.
[00:14:55] Bill Deresiewicz: Okay. Good to talk to you, Christine.