Since 8 AM on January 2nd, I’ve been engrossed in a new semester. My three readers (hi Mom, Dad, and Dan!) may have noticed, not coincidentally, that I’ve posted only once since the new year. You can imagine that the course directors who wanted me back in the class at the crack of dawn after New Years Day probably don’t much care about my complaints that they’re sucking time away from my blogging.
The new course combines embryology, anatomy, physiology, and radiology into one glorious package. It’s the dopest. I learn how the heart forms, what the heart looks like in my cadaver (hi Judith!), how the heart does what it does, and what the heart looks like in blurry x-ray images all at once. It really is a blast, but it’s taking up way too much time.
As I while away my weekends with books and flashcards spread out all over my apartment, I thought it would be nice to revisit the time in my life when I made the decision to start a medical career. That occurred five years ago when I found myself in the South Bronx, locked in a classroom with three dozen six year olds and one terrifyingly under qualified assistant teacher.
The kids were great, and stories about them will follow later. The assistant teacher, however, defies description. Let’s give her the briefest of introductions and then try to paint a more complete picture with a short vignette.
Though she’d never married, Mrs. W always introduced herself as “Missus”. She was fifty-some years old and had been teaching in some capacity for several years, though she'd never earned credentials or undergone a formal observation by the school administration. At least two or three students in my class read at a higher level than she did, and the class routinely taught her our first grade math content (on the first day, I kid you not, they taught her how put the numbers one through ten in numerical order). She referred to make-believe stories as “friction,” a line that’s level to the ground as “horizona,” and the tusked marine mammal from the arctic as a “walrusaurus.” From day 1 until the end of the school year, Mrs. W called our one Chinese student “Ching Chong.” To be fair, she didn’t remember the actual names of any of the students. But this particular student’s name, Jackie Chen, should have been easy to remember.
One day, Mrs. W was reading to the class from a story called Three Friends Together. The story was about a penguin, a whale, and a seal who were the best of friends. But, as the three of them played together day after day, one of them invariably felt left out. One time it was the whale, who couldn’t play with the penguin and the seal up on the ice floes. Another time it was the penguin, who couldn’t hold his breath underwater as long as the seal and the whale. And then, if I remember correctly, the seal upset his friends because he wanted to hug the penguin’s sister inappropriately. It’s a good story.
When Mrs. W finished reading the story to the kids, she closed the book and declared, “I like that book. It makes me think of when I was a little girl trying to learn to roller skate with some of my friends.”
If you’d ever seen Mrs. W improvise a lesson, you’d understand how worried I was at this point. Undaunted, she continued.
“You see, my friends were all real good at skating, but I never skated before. So they all got up and were skating around real well, and I couldn’t go fast at all.”
What’s this? Did Mrs. W grasp the moral of the story she just read? Did she make a meaningful connection between the text and her own life? Is she not even going to mock the children?
“So, we was skating. And all my friends was getting father and farther ahead of me, and I was getting farther and farther behind. And they all made it to Manhattan and back, before I left my neighborhood in the Bronx. And I remember, I was so sad. I went to tell my dad what had happened. And he said not to be so sad. He said that all my friends were good skaters and that I was just learning, and that soon, I’d be able to skate to Manhattan and back with my friends. And you know what? I never learned to skate.”
Ta da! That’s the stuff!
So thank you, Mrs. W, wherever you are. Even if your roller skating story never truly inspired the students, it continues to motivate me on a daily bases. Every time I feel exhausted or overwhelmed, I recall the emotions I felt upon the conclusion of that tale, and I enthusiastically return to my piles of reading with a renewed sense of purpose.
Sunday, January 28, 2007
Sunday, January 14, 2007
Stranger in a Strange Land
Medical school’s a strange place for an English major. It’s not just that I’m grossly underprepared for a basic science curriculum (though that’s no small part of it), but the comfort and familiarity with English prose that I’d developed as an undergrad is absolutely useless in medicine.
I’d been told that a medical curriculum is primarily about learning a new language, but I rarely listen to what people tell me (I’m going to be a great doctor). Maybe I hoped that my doctors didn’t just sound like they knew what they were talking about, but, in fact, had some substantive, applicable knowledge that they could use to cure me of whatever disease might come my way. It appears that medicine involves a healthy mix of both comically abstruse language and a useful breadth of real knowledge.
I knew that learning the science would be tough, but I didn’t anticipate the difficulty learning the language. I like it when authors use as few words as possible to describe something, and I’m just not accustomed to wading through drawn out prose. In some cases, my anatomy text employs a perfect economy of language. For instance, the artery that turns behind your shoulder and then wraps around the bone of your arm, that’s called the “posterior circumflex humeral artery.” Terrific! I can remember that. It’s the goes-behind-then-around-the-arm-bone artery. Beautiful! But then, just when I’ve reconciled myself with medical language, I come across this:
“The articulations between the superior articular surfaces of the lateral masses of the atlas and the occipital condyles, the atlanto-occipital joints, permit… the neck flexion and extension occurring when indicating approval.”
Now I’m not complaining about the unfamiliar words in the first part. I know that there are lots of names of lots of body parts that I’ve got to learn. My concern is with the stuff that follows the ellipses. If these authors are unwilling to lower themselves to using the two-word phrase “nodding yes” instead of “the neck flexion and extension occurring when indicating approval”, can I trust them to clearly describe the thousands of other anatomical phenomena out there? Unlikely.
Geneticists are one group of folks who are trying to take these erudite physicians down a few pegs. They’ve found a back door into the clinician’s lexicon, and they’re doing some tinkering. It turns out that (for the time being, anyway) geneticists have free rein to name whatever genes they discover. Typically this begins in some non-human organism like the zebra fish, so the geneticists will name a gene something clever like, say, “one-eyed pinhead.” Once the equivalent of the “one-eyed pinhead” gene is found in humans, well, nobody really wants to go through the effort of renaming the gene, so they just hang on to the old name. This makes it really difficult for clinicians who are forced to discuss genetic abnormalities with their patients. Imagine listening to an obstetrician discussing a newborn child’s severe facial malformation with the child’s parents. The obstetrician would have to explain that their child’s condition was due to an improperly functioning Sonic Hedgehog gene.
Other genes out there that may make their way to the clinic have names like “faint sausage,” “fear of intimacy,” and “lunatic fringe.” Anyone out there who thinks it’s a good idea to let geneticists name their own genes, generate the neck flexion and extension necessary to indicate approval.
Over the next four years, I’ll have to learn to make sense of the elements of this awkwardly cobbled language: the concise Latin terminology; the unnecessarily verbose phraseology of textbook writers; and the sophomoric jokes of lab scientists. I’m not worried, though. I’d guess that a patient would understand perfectly well if I told her that a piece of her DNA’s garbled, or if I told the victim of a car accident that his goes-behind-then-around-the-arm-bone artery was nicked in the crash. That would certainly make more sense than if I pointed out a patient’s fully functional fear of intimacy or his appropriately sized faint sausage.
I’d been told that a medical curriculum is primarily about learning a new language, but I rarely listen to what people tell me (I’m going to be a great doctor). Maybe I hoped that my doctors didn’t just sound like they knew what they were talking about, but, in fact, had some substantive, applicable knowledge that they could use to cure me of whatever disease might come my way. It appears that medicine involves a healthy mix of both comically abstruse language and a useful breadth of real knowledge.
I knew that learning the science would be tough, but I didn’t anticipate the difficulty learning the language. I like it when authors use as few words as possible to describe something, and I’m just not accustomed to wading through drawn out prose. In some cases, my anatomy text employs a perfect economy of language. For instance, the artery that turns behind your shoulder and then wraps around the bone of your arm, that’s called the “posterior circumflex humeral artery.” Terrific! I can remember that. It’s the goes-behind-then-around-the-arm-bone artery. Beautiful! But then, just when I’ve reconciled myself with medical language, I come across this:
“The articulations between the superior articular surfaces of the lateral masses of the atlas and the occipital condyles, the atlanto-occipital joints, permit… the neck flexion and extension occurring when indicating approval.”
Now I’m not complaining about the unfamiliar words in the first part. I know that there are lots of names of lots of body parts that I’ve got to learn. My concern is with the stuff that follows the ellipses. If these authors are unwilling to lower themselves to using the two-word phrase “nodding yes” instead of “the neck flexion and extension occurring when indicating approval”, can I trust them to clearly describe the thousands of other anatomical phenomena out there? Unlikely.
Geneticists are one group of folks who are trying to take these erudite physicians down a few pegs. They’ve found a back door into the clinician’s lexicon, and they’re doing some tinkering. It turns out that (for the time being, anyway) geneticists have free rein to name whatever genes they discover. Typically this begins in some non-human organism like the zebra fish, so the geneticists will name a gene something clever like, say, “one-eyed pinhead.” Once the equivalent of the “one-eyed pinhead” gene is found in humans, well, nobody really wants to go through the effort of renaming the gene, so they just hang on to the old name. This makes it really difficult for clinicians who are forced to discuss genetic abnormalities with their patients. Imagine listening to an obstetrician discussing a newborn child’s severe facial malformation with the child’s parents. The obstetrician would have to explain that their child’s condition was due to an improperly functioning Sonic Hedgehog gene.
Other genes out there that may make their way to the clinic have names like “faint sausage,” “fear of intimacy,” and “lunatic fringe.” Anyone out there who thinks it’s a good idea to let geneticists name their own genes, generate the neck flexion and extension necessary to indicate approval.
Over the next four years, I’ll have to learn to make sense of the elements of this awkwardly cobbled language: the concise Latin terminology; the unnecessarily verbose phraseology of textbook writers; and the sophomoric jokes of lab scientists. I’m not worried, though. I’d guess that a patient would understand perfectly well if I told her that a piece of her DNA’s garbled, or if I told the victim of a car accident that his goes-behind-then-around-the-arm-bone artery was nicked in the crash. That would certainly make more sense than if I pointed out a patient’s fully functional fear of intimacy or his appropriately sized faint sausage.
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