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Tiberius arrived with a young man in tow five minutes before my office was scheduled to close. He always brings me the most difficult cases. Difficult cases tend to be the most interesting though, so I ushered them into the exam room when I finished with the last of my regular patients.

“Doctor,” Tiberius maneuvered his ward between us. “This is James.” I shook hands with each of them.

At a glance I could see that the boy had a sore thumb — to me it stuck out like a dangling participle. “What can I do for you, James?” I asked.

He looked at me, then at Tiberius who nodded encouragement, then back at me. “Hopefully, you can help me to better read and write words and do maths,” he said brightly. Or what I’m sure he thought was brightly anyway.

I offered my most reassuring smile and handed him a pad and pencil. “Write down this sentence for me,” I said. “You’re too kind to your two kids for their own good.” I observed the way he wrapped his fingers in a virtual strange-hold around the defenseless writing instrument — that explained the thumb. He stuck out his tongue at some apparently specific angle and hunched over the pad of paper as though protecting a small animal.

He only asked me to repeat the sentence once. That was a more encouraging sign than I had expected. When he finished scratching at the paper he handed it back to me. His eyes held expectations far out of proportion to his ability.

I examined the product of his efforts. “UR 2 KYND 2 UR 2 KIDZ 4 THERE OAN GUD LOL.” It was heartbreaking.

“That’s fine,” I handed the paper back to him. “Now, if you add up all the numbers in that sentence, what do you get?”

His tongue returned to its working position and then he muttered, “Two and two is four, and two is six, and four is ten, and one is…” He held out the paper again. “Eleven!” he announced.

A generation ago any doctor in my position would be arranging to have the boy sterilized. Back then the mottoes were, “Genetics yes, phonetics no,” and “If you can’t add, you can’t multiply.” In our more enlightened age, I am duty-bound to try and help him.

“Thank you, James. Tiberius and I need to step outside for just a moment, okay?” I unwrapped a lollipop and handed it to him. Part of me wanted to explain which end went in his hand and which in his mouth, but I figured that if there’s anything he can do on his own it is probably sucking.

I grabbed a clipboard and an IEP manual as Tiberius led the way to the now deserted reception area. “We know he needs some physical rehabilitation for the way he holds the pencil,” he began. “And remedial work in spelling and grammar… and the maths….”

“Dammit, Tib,” I hissed, “I’m a Doctor of Education, not a miracle worker!”

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In honor of all those teachers and students returning to classrooms this fall here is an update of a story I published on another site a couple years ago.

I’m wondering what it would be like if we saw our teachers more like we see our doctors… young children would receive some basic instruction in numbers and letters like inoculations. Beyond that families [if they can afford it] would choose an education-care provider with whom they schedule regular check-ups. That provider may prescribe any number of lessons or refer patients to specialists. There would be emergency rooms and critical-care facilities when an individual becomes acutely aware of an educational shortcoming and they would receive intensive remediation. Best of all [really!], employers would routinely provide ignorance insurance [Blue Cross/Blue Shield might develop a Yellow Pencil/Red Pen division] to underwrite the cost of continuing education.

Johnny arrives fifteen minutes early for his appointment. He fills out [well, mostly fills out and most of that illegibly] three pages of forms and then sits in the waiting room. Thirty minutes later he is ushered into an examination room where he is given a pop quiz by an EdTech [Educational Technician].

“You have ten minutes,” says the EdTech, as she writes the time, date, and her name [let's say... Ms. Amy] in neat, block letters on a dry-erase board in front of Johnny.

“Miss,” Johnny raises his hand, “I don’t have a pencil.”

Ms. Amy hands Johnny a sharp #2 pencil [for which he will be billed $5.00] and with a sigh and slight shake of her head makes a note on his chart [his PERMANENT record...].

Johnny bends over the quiz paper and answers most of the questions [again, mostly illegibly] and embellishes the page with stray doodles. At ten minutes [timed to the second, of course] Amy reaches for the paper. “Time’s up!”

“Miss, do you count off for spelling?”

“Only when it’s wrong. The teacher will be with you shortly.” Amy leaves, placing Johnny’s chart and quiz in a plastic bin on the wall.

Johnny stares blankly at the wall and chews idly on the pencil. A few minutes later the teacher [let's call her Dr. Brennan] enters.

“Good morning, Johnny! Please sit up straight.”

“Good morning, Dr. Brennan.”

She flips quickly through his chart, frowning at the pop quiz results and stealing a side-long glance at the pencil wedged again in his teeth. Johnny notices and guiltily drops the pencil to his lap.

“It’s not time for your regular check-up, Johnny. What’s up?”

“It’s the maths.”

“Can you be more specific?”

“It’s just all of it. I was looking at my bank statement last week…”

Problem with balance, Dr. Brennan notes in his chart.

“…and I was trying to subtract all the checks I wrote…”

Doesn’t know the difference.

“…and I just got all confused…”

Thank God he’s not multiplying — oops, that’s for another visit!

Dr. Brennan flips back a few pages in the chart. “I see we’ve treated you for this before.”

“Yes, Ma’am.”

“I gave you three sample problems and a workbook?”

“Yes, ma’am.”

“Did you finish them?”

“Well, mostly. But then I had to work overtime for a few days and my car broke down and I slept late and my Mom didn’t wake me up and –”

Dr. Brennan holds up a hand. “I get the picture. We can repeat the treatment, but it won’t do any good if you don’t complete it. I hesitate to send you to a specialist… since it wasn’t a failure of the treatment but your failure to follow instructions it falls under the pre-existing conditions exemption clause and your insurance won’t cover it.”

“How much will it cost?”

Test for comprehension of irony during follow-up she noted… “A private tutor can easily run $300 an hour; group sessions can be arranged for as little as $100 an hour, but there might be as many as six people in the group.”

“Six people at a time! How can one tutor help six people at a time?”

“Well, obviously you’ll get less individual attention, but they’ve been very successful even with severe cases. They are highly-trained professionals, after all”

“Doesn’t matter. I can’t afford either of those, especially if insurance isn’t going to cover it.”

There may be hope for you after all….

“Can I have another workbook?”

“Do you mean, ‘May I have another workbook, please?’”

“Yes, ma’am. May I have another workbook, please?”

“Promise me you’ll finish it and schedule a follow-up appointment in… let’s say two weeks.”

“I promise.”

“Okay, Johnny. Ms. Amy will be back in just a moment. She will give you the workbook and schedule your follow-up. And here…” she holds out a jar of candy.

“A lollipop. Thanks, Dr. Brennan!”

You can call it that. I call it a sucker…. “Bye, Johnny. See you in two weeks.”

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