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The love for ranking and our inadequacies

Monday April 21 2014

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While in the US, I travelled to Cleveland to visit friends and hopefully, meet the Chief Executive Officer of the Cleveland Clinic, Toby Cosgrove

Ever since I read about him in the New York Times, I have associated his name with Cleveland.  An extraordinary man. I did not meet him.  But many people I talked to have listened to him talk and felt that his story must be told widely.  He is a global role model we all need to know and relate to our own inadequacies.

Delos “Toby” Cosgrove was born in 1940, and for most of his education, he struggled to pass with C’s and D’s.  He did not know he was dyslexic until age 32, when he read the New York Times aloud to a teacher he was dating. As he struggled to pronounce some of the words, she put a name to the learning difficulties he had faced since he was a young boy.

In an article titled From C's and D's to Clinic's helm dated Wednesday, June 09, 2004, on Cosgrove, Diane Solov, a reporter for the Plain Dealer writes, “these days, Cosgrove can rely on his assistants for help with spelling and sentence structure. But in his youth, a mix of serendipity, moxie and determination helped him jump one hurdle to the next.  Cosgrove struggled in public schools in his hometown of Watertown, N.Y., and studied hard for D's in college French at Williams College in Williamstown, Mass., his father's alma mater.

He did so poorly on the standardized tests required for medical admission that he credits special circumstances, for getting into the University of Virginia's medical school, the only one of 13 schools that accepted his application.  At medical school, he was no academic performer, but he thrived in the clinical work. In his senior year, during a clinical rotation at Boston Children's Hospital, a legendary surgeon there liked his work. 


He landed an internship at the University of Rochester and a year of residency training before he was shipped off to a hospital in Da Nang, Vietnam. There, the article says, he earned his stripes as a surgeon and a soldier winning a Bronze Star for his medical work, a medal from the Vietnam government for a weekly clinic he ran on the side, and an air medal for flying combat missions to keep busy.

Cosgrove returned home with a newfound confidence that provoked him to apply to top residency programs to finish his training, including Massachusetts General. He was rejected, but wouldn't take "no" for an answer and pestered the department chairman's secretary. His persistence and a brief phone call from the legendary surgeon he had met in medical school got him in.

When he finished his training there, he was told he was No. 13 in a residency group of 13. In the end, as he decided on heart surgery, he became chief resident at Boston Children's Hospital. Then he spent six months unemployed, writing a book on heart surgery before a letter from then CEO Floyd Loop arrived in 1975 offering him a job. He went to the Clinic and opted to stay, despite an open offer from Harvard.”

Today Cosgrove is Chief Executive Officer of the world-famous Cleveland Clinic and a retired cardiac surgeon of international repute.  He has pioneered such procedures as mitral valve repairs and published more than 450 papers. He is an accomplished inventor, with 18 patents, and a relentless workhorse, counting 700 surgeries in the last year of his surgical work, an average of more than 13 a week.


He credits his innovative bent to dyslexia, a reading disorder that he has come to regard as a gift. "We're not very good at the scholastic stuff, but we see other things that are different," he said. "And that's a big advantage." Cosgrove's story is featured in Dr Sally Shaywitz's book, "Overcoming Dyslexia," published in 2003.

At the Clinic, Cosgrove's inventiveness so far has manifested itself in myriad innovations for surgical procedures. His unique view of the work allowed him to spy a solution for a flexible clamp in a bicycle gear and to see an embroidery hoop as inspiration for a ring used to repair heart valves.

Could this story be told in Kenya where we thrive on relative competency over competence?  No. With our educational system, Cosgrove would have been condemned as a failure at Kenya Certificate for Primary Education (KCPE) level.  Let me explain.

Our love for ranking (I am number one, I am better than you, my children are top of their class) is what precipitates the affinity of relative competency and rejection of those who do not make the mark.  That is how we end up with some incompetent people with first-class degrees in work places. 

Cosgrove was a competent surgeon in spite the fact that he was not good at standardized testing (he had the skill, the ability, the capability, aptitude and expertise to do his job).  The system gave him a chance to uncover his competencies.

The cut-throat competition in college admissions and for employment in Kenya, has led most universities as well as some employers to wrongly seek qualifications from as far back as KCPE and reject fairly good applicants.  Paper qualification is just but one aspect of assessing a competent person. 


It is emerging that the psychological effect of being ranked first or better than your peers has far greater implications than we assume.  In some countries, open learning is encouraged allowing the students to uncover their competencies.  Cosgrove deep down knew he had some unexplained capacity that he wanted to exploit and the system allowed him.

Even in relationships, when we make children to believe that they are more handsome or beautiful continuously, we psychologically reinforce false beliefs that have no place in real life.  It is often too late when reality strikes for kids growing up knowing they are better than their neighbours.  Research shows that such children end up marrying late into their lives well beyond their value date. 

Local tracking of high performers in KCPE has shown that not always do they end up performing well throughout their academic career.  It helps when parents help the children understand that their performance is only relative to other kids within the country and not the world.  From my own observation at university, students from national schools often get frustrated when their performance is poorer than those who came from unknown schools.  As Bill Gates said, “Success is a lousy teacher. It seduces smart people into thinking they can't lose”.


A 2007 study by the American Psychological Association asserted that pageants teach young girls “to see themselves as objects to be looked at and evaluated for their appearance”. This often leads to some mental health problems for girls including: eating disorders, low self-esteem and depression, that are fuelled by exposure to a culture that promotes performance-based esteem and a judging criteria that views highlights, fake tan and heavy make up as appropriate for very young girls.

The more extreme parents subject their little girls to botox, facials, implants, hair and nail extensions and fake eye lashes. The Irish Examiner reports that “all this gender socialisation to re-enforce traditional limiting female stereotypes forces little girls into the adoption of a veneer of premature precociousness that is profoundly disturbing.”

Similarly, highly ranked students relative to their peers may experience low self-esteem and depression in a real life performance experience if they were not competent in the first place.  Some competent students sometimes become complacent leading to poor outcomes.  Some empires have fallen because of complacency or a false feeling of invincibility. 

Trouble with Kenyans is the fact that this penchant for ranking has psychologically damaged us to the extent where you hear someone brag to be a better Christian than his/her peers, have a better car than my friends yet such assertions have no real significant relevancy to the comparators.

No one can argue against the fact that Kenya has competent long distance runners.  In this we are the target globally.  If you beat the Kenyans, you win.  When we insist on being better than our East African neighbours, we lose the opportunity to be the best because of the culture of relative performance that makes us complacent.  If we compared ourselves with Singapore or Korea, it gives us reason to think out of the box and do what is necessary to reach a higher target.


The secret of our athletes’ performance has always been collaboration.  The US educational system has a strong collaboration element that allowed people like Cosgrove to barely pass their exams.  Our educational system does not encourage collaboration.  It has made our youth wrecks of unnecessary competition. 

This also impacts on how they work in their respective areas of responsibility later in life.  Most doctors in Kenya for example, do not collaborate as they should.  There is this ‘lone ranger’ mentality that has caused more damage than good when we are all aware that there is strength in collaboration.

The import of this piece, is to urge policy makers to overhaul our educational system.  We need open learning to enable passionate people take up careers they will enjoy in their life and make great contribution as Cosgrove has shown.  Admitting students to university purely on their grade is a mistake.

As the former US President Franklin D. Roosevelt said, Competition has been shown to be useful up to a certain point and no further, but cooperation, which is the thing we must strive for today, begins where competition leaves off.

Dr Ndemo is a Senior Lecturer at the University of Nairobi, Business School, Lower Kabete Campus. He is a former Permanent Secretary, Ministry of Information and Communication. Twitter: @bantigito