...and Medicine

>> Thursday, January 21, 2016

Sifting and sorting through my junk--because hey, let's be honest, I have a LOT of it--I came across the take-home, midterm exam for my "Psychology and Medicine" class that I took all the way back in January of 1998. I actually came across it this past summer (2015), and thought it was notable given the references to the health care system under President Bill Clinton. Several months later--after reviewing it again--I find it notable for how much more difficult it was than my Public Health class last semester. For instance, if we had essay questions like the ones in this exam, the entire class probably would have flunked.

Psychology and Medicine J Term 98 Exam 1

Choose Five of the seven items. Answer each question accurately and in such a way that it is clear you know and can apply the information from the readings. Be specific in your answers and do not waste time by rewriting the question or offering rambling platitudes. Your answer should be no longer than three pages, single spaced print.
Yeah, you read that right. Pick 5 items and write a maximum of 3 pages, single spaced, which means your entire exam could reach a maximum of 15 pages, single-spaced print. If I remember correctly, I could only get up to 10 pages of regurgitation. And, oh yeah, we had a little less than 48 hours to write these.
1. Martin Seligman, President of the American Psychological Association, calls you on the phone and says, “I understand you have studied what research in clinical health psychology needs to do more of or differently in order for psychologists to play a part, and get paid for that part, in the changing health care financial and decision making environment. What, specifically do clinical psychologists need to do in their research and treatment practice if they want to be included in health care as it is currently changing?
Didn't answer this one, but it's still interesting thinking about the question. Kind of. Actually, I take that back. This phrase--"the changing health care financial and decision making environment"--is just more proof that we need a single-payer health care system. How much time should health care providers be spending on things like that rather than spending time with their patients/clients? Less than what it is now no doubt.
2. No sooner have you finished your report for Dr. Seligman, than the phone rings again. President Clinton’s chief of staff and asks if you would be willing to talk to the President. You cordially agree and then are placed on hold for a few moments while the president finishes playing with his dog and practicing the saxophone. After you listen to a few strains of “Hail to the Chief” while you wait on hold, the President himself comes on the line and in his friendly Arkansas voice says, “Hey. I hear you are a student of my friend Brian Baird and you know something about health care issues. As you know, the last time I tried to do something about national health care it backfired. You’ve had half a semester of Psychology and Medicine now, so I was wondering, based on the articles and class discussion thus far, what specific steps would you take and why if you were designing a health care system and determining how financial resources should be allocated for the country. Please be specific now and let me know what articles you got your information from because remember I have to run this past Congress to get their approval. Oh, By the way. I need this in two weeks for the State of the Union address.”
Yup. I answered this one. And to think that health care is still a HUGE issue. It hasn't gone away since 2008. I would much rather have some sort of single-payer system than having to fork over almost $200 a month for health care that I rarely--hopefully and never want or need--to use.
3. After two weeks of arduous work, you have just completed your response to President Clinton. You settle back for a moment, impressed by how a lowly psychology student can actually make an impact on the political scene. Then, the phone rings again. You think it might be a close friend asking you to go out, but you are surprised to hear a foreign voice. Turns out its the UN Secretary General, who says, “Good morning, I just heard about your great work for President Clinton. We were wondering how decisions about health care expenditures would be different if the population under consideration were the entire world, not just the US? Again, be as specific and refer to particular articles because I have to run this past the General Assembly.”

4. You have just completed your work for the Secretary General when who should call but Bill Gates Jr., who says “Hey, I just heard about the great work you did for the UN and for President Clinton. We have been considering whether or not to implement a health promotion program for Microsoft employees. I have two questions for you. Based on you understanding of the literature and issues, and considering all of the costs and benefits (which I hope you will discuss) do you think we should do it or not? If we do proceed with a program, what should it include and what steps should we take.
#4 is almost ironic, isn't it? This exam was written in January 1998, and the Gates Foundation was formed in 2000. If this exam was written today, I'm pretty sure that #3 would be about the Gates Foundation interacting globally. I'm not sure if #4 would be still written the way it is above. Microsoft could still be used as an example because my alma mater is in the Pacific Northwest.
5. Wow, all that work has sure been stressful hasn’t it? Based on your understanding of the literature on stress and illness, what effects do you think that stress might have had on your health and just how might we measure how much stress you have experienced? Be specific about the processes involved and the data that lead to your judgements.

6. It turns out that in fact, your stressful lifestyle has cause some problems. Indeed, in response to advertising that promised you would feel better and look sexier if you smoked, and in order to biochemically cope with the stress of producing all those high profile reports for those high profile people you took up smoking. Now it’s time to try and quit. From your understanding of the literature, how did smoking help you feel better about stress, how might it actually have increased the adverse physiological effects of stress, and how the heck are you going to stop?

7. Oh great! So you decided to quit smoking and start exercising as a way to get healthy. Trouble was that all the time you spent sitting at the keyboard typing all those reports made your back ache. Then, when you tried to carry the ten thousand page tomes to the printer you threw your back out. Now you are receiving compensation for your injury and you can’t even help out around the house anymore. Fortunately, however, you have read a number of articles about pain and pain behaviors so you can describe a model of what is happening and propose a couple of ways that you might better be able to deal with the situation.
These last three could have almost been used on my Public Health final. We covered back pain a little bit at the beginning, and smoking got a special focus on the end. I'm still surprised how in-depth these questions are asking me to write as opposed to what I had on my Public Health exam. God, I cannot describe in detail how much that class took what should have been a very interesting subject and turned it into such dull matter. Death and disease should ALWAYS be interesting!

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