Thursday, December 4, 2008

And reflection sessions aren't all bad...

Jonathan Story
EOM1 – Reflection Paper
21 October 2008

Twelve Down – One-Hundred and Ninety Eight to Go
The ventilators in the anatomy lab broke last night, saturating the air with the gaseous counterparts to formalin and other toxic embalming fluids. This morning I had to bang out of lab early and left the building tired and frustrated, with a headache I could only attribute to a thoroughly pickled brain. I walked a few hundred yards to the ocean, where I baked in the sun while talking on the phone with old friends. I learned that my girlfriend, Kate, and another 3rd year intern were skipping their afternoon rotations to fly to a crazy old doctor's island hideout. An old roommate told me he was moving to Portland's West Coast counterpart with a dozen of his closest friends. He asked me how med school was going. I told him about today's dissection: the tedious tracing of tiny nerves all the way from finger tips to cervical roots.
"We follow the digital nerves under the flexor retinaculum where they emerge to join the palmar branches and become the median nerve proper which follows the anterior forearm before diving under (or is it passing over...) the bicipital aponeurosis and meeting up with the 3rd section of the axillary artery with whom our nerve will travel intimately - wrapped together in a satin sheet of shimmering white fascia – all the way up the inner arm. When they finally go their separate ways, the brachial artery will have matured, becoming the subclavian, and splitting our nerve in two: the lateral and medial cords. These join with a dozen other nerves of the upper limb and 2 divisions of the posterior cord before forming three distinct trunks which then split into five cervical roots before joining with the spinal cord, the brain, and maybe the soul."
And, there – in the warmth, the sun and the sea air – I felt infinitely privileged to be in medical school.

Two months ago the sun had stamina, but tonight 7 o'clock might as well be midnight. My brain is tired. My body aches.
This week is the deep breath between classes slowing and exams gearing up. And, despite the gray, it makes for some good people-watching amongst my peers – none of whom seem to be on the same page as anyone else. For some, this week is an exciting opportunity to start the race early and get ahead before anyone else realizes the gun's gone off. For others, it is a time just to get their bearings. Some are making reservations at the cozy seaside B&B in Kennybunk, while others stare down from the high dive, squinting to find the bucket they're supposed to dive into. I keep having that dream where my car is careening out of control but no matter how hard I press, the brakes just won't work. Okay, that last part about the out-of-control car was a lie. It would have worked well with the theme, though, right?
The point is, medical school is a gnarly mass of tangled green anatomy twine, used chewing gum and stray mystery hairs. We unwind the layers, salvaging what we can and cutting out the most hopeless knots, all the while gleaning the small treasures we find along the way: Dr. Norton's microcirculation rabbit-ear video, Dr. Schuenke's sacral nutation demonstration, realizing in Foundations of Doctoring that I have conductive hearing loss... Fuck.
In Foundations of Doctoring and Osteopathic Principles and Practices we get snapshots of where all this science is supposed take us. While we don't see patients very often, our sleep habits dictate that we will at least be patients at some point this year: giving, I'm sure, some other doctor a great deal of job satisfaction. Medical school is, as it turns out, brimming with equal parts wonder and cynicism.
And, here – in this chilly October darkness – I feel privileged to be in medical school. But, I also understand the cost.

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