Thoughts from the Doc on College and Cholesterol – What’s in a Number?

My eldest son is now in the 2nd half of 11th grade, so a high percentage of thoughts in our household seem to revolve around college.  Where to apply?  What looks like a “good fit” on paper?  What’s it actually feel like when visiting?  Can he get in?  If colleges considered letters of recommendation from applicants’ mothers, I’m sure he’d be a shoe-in anywhere.  But the “holistic approach” to reviewing applications which every college and university currently claims to espouse notwithstanding, a lot of specific numbers come into play.

GPA.  Weighted GPA.  Class rank.  Standardized test scores.  The higher the aforementioned numbers in an entering class, the higher the college/university will be ranked.  And it will be ranked even higher when the number of applicants goes up and the percentage of students admitted goes down.

But what do those aggregate numbers actually say about a college?  And what do the individual numbers actually say about a student?  We all make inferences, whether fair or not, based on certain numbers.  Sometimes the inferences are accurate, and sometimes they aren’t.  They tend to be more accurate when more than one number is taken into account.  And even more so when more information is considered.  There’s a forest to discern from those trees.

When the nurse sticks a needle in the inside of your elbow and fills a few tubes with the red stuff, you’ll soon have a report filled with numbers.  “Good” cholesterol.  “Bad” cholesterol.  Blood sugar.  All kinds of data.  Very occasionally, one number by itself can give you a crucial, relevant, helpful piece of information.  But usually there’s a lot of contextual information that determines how a particular number should be interpreted.

For example, a blood sugar level twice the upper limit of normal must be a big problem, right?  Well, what if it had been three times the limit two hours ago?  Or what if the blood sample had been taken from a vein that had an IV running into it that had sugar in the IV fluid?  Might those circumstances not influence a doctor’s evaluation and interpretation of that one particular number?

An actual visit to a college campus helps a person see beyond the numbers as he meets students, hears how the school presents itself in an information session, and observes the interactions within the buildings and on the grounds.  Reading an essay and holding an interview with a student helps a school go beyond the numbers as the admissions representative sees how a student expresses himself, and the school gets a glimpse of how the student interacts with others.  The numbers can then be integrated back into the pictures to provide more contextually complete representations.

In general, doctors need not to react just to specific numbers, but to take into account the entire clinical picture.  Contextual clues can help guide which numbers and laboratory data to check, and can help indicate an erroneous lab value.   A doctor needs to look at a total cholesterol level, then look at the breakdown of cholesterol subtypes, and factor in her patient’s weight, medical history, and family medical history in order to decide how to interpret that lab data.

I would like my son either to go to a college or university that sees him as more than just a GPA and ACT score, where people care about his development as a person, or I’d like him to figure out a way to find a sub-community of peers and mentors who look beyond the numbers if he ends up in an overall impersonal, numbers-driven environment.

I would hope that people find themselves with doctors who look at them as whole people, who take the time to explain the numbers, and figure out what they mean within the context of the whole person.  Or, I would hope that they can find a medical advocate who can teach them, and empower them to communicate beyond the numbers with their own physicians.  My ears are open if you need me, and I am currently taking on clients in the southern and central parts of Oakland County if you know of someone there who could use my help – just send them to peek at www.practicalmedicalinsights.com.

People are more than numbers.

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