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David and Goliath

By Nicholas E. Rose, MD

As hand surgeons, we are all in various stages of our careers. Nevertheless, most of us have, will have, or have had children go through the arduous college application process. Dominating the news for several months has been the saga of “Varsity Blues,” the story of a group of wealthy parents who cheated the college application system through various schemes in order to get their kids into elite colleges. Had they read Malcolm Gladwell’s book David and Goliath, the Felicity Huffmans and Lori Loughlins of the world would have realized that their intentions were actually completely misdirected in their hopes of optimizing their children’s futures. For this reason, I feel that this book, specifically Chapter 3, entitled “Caroline Sacks,” is a must-read for all parents. 

Gladwell’s book highlights the ancient battle between David and Goliath wherein, according to legend, the underdog Israelite shepherd boy David defeated the mighty Philistine warrior Goliath in what is considered the greatest upset of all time. However, closer inspection of this 11th century battle reveals that it was not an upset at all. Goliath, a heavily armored foot soldier, fell easily to David, an agile, skilled projectile warrior, as the latter killed the immobile giant with a skillfully slung rock to his exposed forehead. Indeed, David was a slinger, and slingers beat infantry every time. Goliath, with his probable acromegaly and associated poor vision, had no chance. 

David and Goliath is a book about what happens when ordinary people confront “giants,” aka powerful forces or obstacles of any kind. Gladwell’s book explores two ideas: (1) much of what we consider valuable in this world arises out of these perceived lopsided conflicts and (2) we consistently get these conflicts wrong. 

Just as we misread conflicts like David and Goliath, many parents also misinterpret the college application process. Most of us hold the misconception that attending an elite school will best guarantee our child a successful future. Not necessarily. Gladwell’s research reveals that, in the long run, excelling at a good but not an elite school is actually preferable to struggling at an elite school. In other words, it is better to be a big fish in a little pond than a small fish in a big pond. Surprisingly, attending the little pond school (good, but not elite) often maximizes one’s chances of following one’s dreams. 

Chapter 3 chronicles Caroline Sacks, a bright, energetic young woman who grew up loving science and sailed through high school at the top of her class. She applied to Brown (an elite school) and the University of Maryland (a good school) as her backup. Accepted to both, she chose to attend the elite Brown University. 

However, Brown was extremely competitive and Caroline, no longer the smartest girl in her class, struggled mightily in her science classes from the get-go. During her sophomore year, despite her best efforts and hard work, she barely passed organic chemistry. Caroline realized that she couldn’t keep up so she ultimately decided to leave the sciences and give up her dream of becoming a doctor. 

Caroline was a small fish in a very competitive big pond (Brown) and her motivation and confidence were shattered. She realized: “Had I gone to the University of Maryland (the little pond), I’d still be in science.” In hindsight, had Caroline truly wanted to graduate with a science degree, she should have stepped down a notch and attended the University of Maryland.

Whether at school, at work, or in any group, we usually compare ourselves to those in the same situation as ours. Students in an elite school (often their “reach” school) face burdens that strip their confidence – burdens that they wouldn’t face in a less competitive atmosphere. This is a phenomenon known as relative deprivation. In other words, it is better to be a big fish in a little pond rather than a small fish in a big pond! The more elite an educational institution, the worse students feel about their academic abilities. This is the case not just for Caroline, but for all students, particularly those trying to get a college STEM (science, technology, engineering, and math) degree. Gladwell’s statistical research shows that what matters most in determining the likelihood of getting a STEM degree isn’t how smart you are, but how smart you feel relative to your counterparts in the same school. 

While attending Brown gave Caroline the prestige of attending an elite university, it also dramatically increased her chances of dropping out of science entirely. In fact, the chances of someone completing a STEM degree rises by 2 percentage points for every 10-point decrease in the university’s average admission SAT score. The smarter your peers, the dumber you feel. The big pond accepts really bright students and demoralizes many of them, ultimately decreasing their chances of graduating with their desired degree. 

What about once you’re out of school looking to get hired? Certainly, the prestige of attending an elite school must be valuable when looking to get hired. Not necessarily. One would assume that employers look to hire students from elite colleges. Gladwell shows this should not necessarily be the case. Statistically, employers are better off hiring a big fish in a tiny pond (average/good school) than a middle-sized fish from a big pond (an elite university).

Alas, the Felicity Huffmans and Lori Loughlins of the world would have optimized their children’s future (and saved a lot of money, embarrassment, and jail time) had they looked more closely at the “true” value of an elite school education.

On a personal note, my two oldest children have gone through (and survived) the college application process. The oldest attended a great, but not elite, school and this summer landed her dream internship, the same internship she would have pursued had she attended Harvard or Stanford. On the other hand, my middle child will be attending an elite college (her dream school) this fall. I am keeping my fingers crossed. 

Comments (4)
Rita Patterson
June 14, 2019 4:53 am

Great story . Thank you Nick.


Glenn Cohen
June 14, 2019 1:44 pm

Well written advice!


Robert Hendrikson, MD
June 14, 2019 8:17 pm

I like Malcolm Gladwell’s theories, especially his “10,000 hours” theory for developing proficiency in a given field of endeavor. That theory was played out well by the Beatles who played German all night clubs for 2 years every night before their exposure to the world. I am of the opinion, however, that there are many other factors at work than just competition in the theory of elite school versus good school. Mentoring, tenacity, teaching style are just a few to consider. After all, organic chemistry is the same at an elite school or good school. One has only to pass the course. Sometimes the incentive I was given makes the difference. On the first day of class the professor said, “Look to your left, and look to your right. By the end of the semester one of you will no longer be here. My job is to begin the process of weeding out those of you who will not become medical doctors”. That statement was depressing and exciting at the same time. The challenge was accepted.


Fred Corley M.D.
June 27, 2019 7:46 pm

thanks so much Nick
great to hear from you


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