Wednesday, January 23, 2008

The Call of the Sirens (Part II)

{Disclaimer: From this point on in this series, we will be talking about med school and beyond. There will be blood, guts, dead bodies, poop and other gross things. If this bothers, please don't read. It's not that thrilling and I'd feel bad if you had nightmares. Really. There's plenty of nice things to read on the 'net. No one will think less of you. Especially me.}

The night before the first day of med school found Charles and I (an engagement ring with the teeny-tiny diamond chip still feeling new on my finger) sitting on the grass in front of the house, both in a fog, feeling as though we were poised together on the edge of a cliff with one foot in the air and the other about to follow. We knew, based on rumor, television and novels, that medical school was a harsh, rewarding, soul-stretching, bankrupting, monster-creating experience. We'd been together for four years (not counting that 4 month split the prior winter where we both lost our senses but fortunately found them again) and knew we were bound together, but weren't sure where we were bound for.

Very scary. Very surreal. Very big debt if I found out that I hated it.

Backtracking, in high school I had a friend, Linda, who was in the majority of my classes. Linda, another friend (Doug), and I all wanted to become doctors and decited to re-unite as members of the class of 1991. Linda, indeed, was there and it was lovely to see her. (Don't know what happened to Doug. I heard a rumor that he went into something with finance but who knows?) Also in class was another high school alum, Essie. Essie had gone off to a nursing program in college but decided that her personality was more in line with that of a doctor rather than being the one following the orders of the asshole doctor. Knowing her, this was clearly the case. Essie was never one to suffer fools lightly nor silently. There was this incident our first year when she told one of our instructors not to be such a "fucking jerk", to his face and in front of several others students. I wasn't there, sad to say, but he was, indeed, a fucking jerk and he was less of one after she pointed it out to him.

That first day was of orientation, where we were herded around here and there, given lists for hundreds of pounds of books (literally, as this was in the pre-internet days), talks about what was expected of the behavior of future doctors (including the unspeakable sin of not paying off one's student loans), bowed, cowed, wowed, and photo-ID endowed.

That last ended up being a lesson I've since taken well to heart. See, it was toward the end of that exhausting first day and one by one we were sat upon this tall stool and had our pictures taken. I had no idea how important this photo was but it was to follow us about, displayed on our chests, attached to paper work, sent off to off-site clinics and so on for 4 years. Being strung out and frankly pooped, I didn't show a sparkly smile, but just sat and gazed back at the camera in what I thought was a non-expression. Nice and benign, neutral, trusty-looking. In short, what came out was a face that looked like a cranky, crazed Charles Manson, with bangs, on a touch of Thorazine. There might also have been drool. If there wasn't there should have been.

The next day started the real deal.

What did the first year of med school involve? In short 8 hours a day, 4+1/2 days a week (Thursday afternoons off for good behavior) of sitting on your ass in solid blocks of lecture after lecture, broken up with lab in the afternoons (sitting at microscopes or standing cadaver-side). The lab afternoons were preceeded with an hour or more of lecture before the actual lab work, just so we'd not lack for sitting and drooling. Evenings, nights and weekends were spent studying.

The first year was learning about 'normal', the second year about 'abnormal'. The first year broken up into courses like gross anatomy, biochemistry, embryology, and organ system after organ system of physiology: cardiac physiology; gastroentestinal physiology; dermatologic physiology; neurophysiology (The worst. THE WORST. I could never get more than 2 pages of the damn neurology read at a time without falling asleep or succumbing to a task like scrubbing the bathroom grout for mental relief) and all the rest, ad nauseum. Exams thrown in liberally, of course. After the first anatomy exam we went out and drank ourselves silly, as was only right. Actually, as you will not be surprised, we usually drank after most exams. The better to dump the old brain cells so that they'd not clutter the pathway for the cramming in of the new information. It was all about passing the tests. Test after test after test.

The lecture hall was one of those amphitheater-type things with the speaker down in the pit and the seats arranged in ascending rows with steps going down the sides. All dark grey cement and exposed floursecent lighting. Think industrial chic without the chic. Cold. Ugly. Hard. And yet you were still able to nod off. Most of the lecturers were deadly dull, primarily because most of them were PhDs with narrow interests in their own narrow fields, such as optic nerve degeneration in the hairless rat. The lectures from the few MDs that presented to us lowly first years were usually a breath of fresh air, primarily because they were so much more practical and gave us a glimpse into what we'd be doing in a few years.

What's that? Tell about the cadavers?


Yes. Gross Anatomy. ('Gross' in this case meaning 'large' as opposed to 'micro' anatomy, a.k.a. 'histology' where we used the microscopes to look at slide after slide of tissue, and used them well, although to be honest, most of it all looked like 'spleen' to me.) They gave us the standard 'treat this gift of a human body with respect' chat and all that as we looked around at each other, some laughing nervously, some green, most a combination of both. We split into teams of 4 to a body: Myself, Linda, another friend from college, David, and Mark, who was going into orthopedics to specialize in knees. He was focused, Mark was. We were told the age of the cadaver and the gender (87 year old female), which wasn't immediately apparent as they were completely encased in hard, white, opaque plastic. They looked like futuristic mummies. They would be our companions for 8 months and we would know them intimately. You have to be amazed at the preservatives. The cadavers literally ended up falling apart as they were dissected to bits, but they never decayed. Scary that.

No one barfed. No one fainted. We started with the chest, and over the months worked down through the abdomen, then the arms, legs, pelvis, ending with the back and finally the head and neck. A fun fact: The vessels had been injected with colored latex, which helped greatly. Unlike a non-preserved body, all the colors become dark, muted shades of tan, dark red, deep eggplant, bright lines of red and blue (the vessels) running through, or the creamy white of the bones underneath. We named ours "Emma" after the feisty Fruit of the Loom underwear ad character popular back in the day. A couple of tables over, some more college friends of mine named their male after our despised college organic chemistry professor, Dr D.

The other thing I remember is that, as anatomy lab ran for 4-5 hours at the end of the day, twice a week, I'd end up famished before the end of each session. I'm not saying that I was craving beef jerky or anything, but it was a bit disconcerting: Scalpel, flesh, extreme hunger pangs. The course was proctored by two professors as well as this professor emeritus who was about 150 years old and looked like this tiny, fat gnome with a cloud of white hair. I think he was Dr S. He was frightenly enthusiastic, academically brilliant and had this way of dissecting something so that everything was clear in the field, but the bits o' human would go flying through the air. He'd end up covered with flecks of tissue all over him, especially around his mouth and you'd have to stand there and listen to him, ignoring the gore. He was an amazing teacher, though, unlike the PhDs. I'm guessing he's still there, unable to die, with all the formaldehyde he's absorbed and inadvertantly ingested over the years.

And, oh, that dizzy smell of formaldehyde drifting over all. We all wore neck-to-shin, long sleeved dark green gowns over our clothes, but that provided little protection from the odor and we had the habit of wearing old grubby things for anatomy lab. At the end, the gowns and tennis shoes were discarded as the smell had irrevocably seeped in.

The antomy exams were pretty brutal, too, first the written part and then down to the cadavers, each with tags and pins indicating what you'd have to identify. My favorite was the question on the final that had a jaw bone (mandible) broken in half, inverted, lying on the chest of one of the cadavers with one of the small slips of ripped muscle end tagged to identify. Seemed pointless to me, that question, as the only time we'd be presented with that in real life would be at the scene of a particularly horrific accident, and if that were the victim's jaw, that'd be the least of their problems-- whether or not if I knew the name of that slip of ripped muscle on the shattered half of their jawbone, now sitting on their chest wall. Nope. Not so practical.

So we went through it all. All 90 of us. And you know what? It wasn't as bad as Charles and I had feared. It was often miserable, always stressful, exhausting, frequently boring (yes! really!) intense (but the least intense of the 4 years), brutal, but it was what you had to do to get to where we needed to go. And often it was truly fascinating and exhilerating and even fun.

And, for the first time in my life, I didn't feel like a freak. For the first time ever, I finally felt that I fit in. That it was OK to be smart and to study hard. I wasn't at the top of the class trying to hide the fact that I was doing well. I wasn't the brain. I was in the middle of the class, a class with cool people and dorks and average-type schmoes and we were all OK. I can't tell you how beautiful that feeling is: to finally belong.

I guess I was where I was supposed to be.



Blogger Coffee-Drinking Woman said...

You know, one of the things that first attracted me to your blog (and don't ask me how I found it, because I can't remember - a link somewhere, I think) was the fact that you nearly always said something that resonated with me. This "I can't tell you how beautiful that feeling is: to finally belong." is reasonating so loudly that I feel as if I'm likely to go deaf.

11:41 PM  
Anonymous buffaloons said...

Hi Honey!
You forgot to mention that anatomy professor Dr S also often did NOT wear gloves whilst digging thru those cadavers.
We named ours "Monica" - whe was also very old, but still had her girly parts (Dr C was amazed at that bit of luck). Also the part about yes, being hungry after anatomy lab (which my family found disgusting) but also smelling so horrific, that Greg would barely let me in the apt before requiring a shower of me. That smell permeated EVERYTHING, so studying for anatomy tests was never allowed at home.
I am also amazed at your memory. I don't recall half that stuff. I do remember sitting in the very back row w/ Adam (who was 87#'s dripping wet and only ever ingested coffee or cookies), trying in vain not to fall asleep.

3:08 PM  
Blogger Ambitious Blonde said...

I'm thinking I need something med-schoolish in my educational future, because I find myself envious of your adventures in cadaver-carvery.

But first I gotta get through chemistry. Foul, dreadful, horrible, soul-sucking chemistry. Something tells me that if I'm feeling like this about the class the first week, the next 15 ain't gonna get any better. :(

9:32 PM  
Blogger Dumdad said...


I remember dissecting frogs at school but I'm not sure if I could make the leap to chopping up a human body. Having said that, I'd like to know how the body really works; which bits go where.

Look forward to more medical stories.

4:09 AM  
Blogger Diana said...

Teri- (hug, hug, hug) Hence our twindom. It's such a relief to finally be around a bunch of people who mostly get you. It's sort of similar to our little blog community.

Lisa- Hi Honey! (I was hoping you'd pipe up.) I'd forgotten that he didn't use gloves. I can still recall that smell, especially in the hair. Adam! I miss Adam. He was so the hilarious voice of sanity and reason cloaked in sarcasm. I don't think I ever saw him eat any actual food. Sort of a caffeine-addicted hummingbird.

Melissa- Oh, yes! You so do need to do something of the sort. And just think, you, too, could name your cadaver after your horrible chem prof. If there were more than one horrible prof, well, cadaver could have one or more middle names.

Dumdad- I'm not sure that you aren't being rather generous with the "enthralling" but you are sweet. The human is rather much heavier and, by the time they end up in an anatomy lab, not usually very good physical specimens. Little muscle, much fat. Still cool, though.Our Emma was an ancient, stringy, little thing. Very hard to find some of her muscles. Also, everything sort of flows together in a real body, you really don't get the idea from a picture. Guess that's why there's really no substitute. You just can't adequately learn this stuff from books and films. You need the tactile. You need the 3-D visual. Sadly, you also get the olfactory.

6:55 AM  
Blogger The Rotten Correspondent said...

I am absolutely positively without question eating this up - but I'm sure that doesn't surprise you.

What a great insight into your year. My first thought was that (if your ID badges followed you for four years) the picture of an unsmiling Charles Manson on Thorazine was probably not as far off as you might have liked.

And anatomy? Not doctor's anatomy I know, but still, without a doubt the hardest damn class I've ever taken. Why does the human body have to be so complicated????

Looking very forward to part 3.

10:25 AM  
Blogger listie said...

Whew, I made it through - I who couldn't even dissect a worm without retching (or look at medical texts when they were returned to the library). .What's next?

12:10 PM  
Blogger Mother of Invention said...

A wonderful and interesting account, Diana. It must have been exhausting at times and stressful, but I can tell it is absolutely the right path for you to have taken.

I wouldn't last a second in the lab! My husband took me into their lab to meet his cadaver in 1st year chiropractic college and the smell nearly made me barf and faint at the same time. And it just seemed totaly weird to look at this 94 year-old's body.

I'm glad you found where you fit in so well. I know you are a wonderful doctor and I sure wish you were mine!

2:10 PM  
Blogger PixelPi said...

I'm so glad you're where you are and happy about being a good doctor!

I went to grad school at a medical college (for a therapy degree), and our classes were all over the place. Our Insane Behavior class (or whatever they called it) was right across from the cadaver lab.

The smell made everybody sick, and I made the fatal mistake of entering the lab one day to ask them if they could close their wide double doors to the hallway to keep their evil formaldehyde smell inside.

Then I saw the open chest of a cadaver, and a little bit of hair near the ear on the covered head, and the smell was so intense.....that things just went gray and then black.

I woke up in the hallway with all these gowned/gloved people hovering and hogging the fresh air, assured them I was fine, and ditched class to go outside. Which was downtown Philadelphia. The smell of downtown Philly was amazingly wonderful.

So I'm happy I found where I didn't belong and stuck with crazy people. I fit right in with them.

5:27 PM  
Blogger Rozanne said...

I am loving these med school stories/cautionary tales! I had no idea about being stuck for 8 months straight with the same cadaver. Wow.

You really should write a memoir!

11:48 PM  
Blogger Jocelyn said...

Now THAT'S description. Wonderful, especially the prof with gore around his mouth and preservatives in his every cell.

I am loving this stuff.

2:00 AM  
Anonymous Anonymous said...

This is the first time you have revealed you med-education to me. How wonderful!! I remember going into the anatomy lab with you and thinking that I could do this. Not be an MD, but cut up dead folks. A really special evening for your ole Da.

I also remember you and Charles sitting in your upstairs bedroom reviewing for an exam--I called it "playing doctor". He would name a nerve and you would tell what it did. That much I could pass up on.

And to think how well you seem to enjoy the career field. Cool!!!

The Ole RF-er

12:49 PM  
Blogger Diana said...

RC- Heh. Yeah. Post call from the OB service? Definitely Chas M., but much worse smelling. I just remember trying to come up with all sorts of really stupid ways to try to remember the shit. I still mostly remember this riff I made up to try to get the exit points of each of the 12 cranial nerves to stick in my brain long enough to pass the damn test. Guess it worked.

Listie- See, worms and bugs made me retch. We had to do experiments in college physiology with these Madagascar hissing cockroaches. That was bad.

Ruth- You know, I could yammer on about 'but I knew it would all be worth it' and such, but the reality was that I just didn't see any other path. Just step, step, step along and don't think about the journey, just think about the next task.

PixelPi- Oh, that really sucks! See, we chose it. You chose NOT to do it and still had it inflicted on you. (I hope you didn't hit your head too badly.) It's a great story, though. Even Philly air has its match.

Rozanne- See, you'll never look at medicine the same way, again. No glamour, just tedium. OK, maybe some glamour but mostly tedium.

Jocelyn- I just wish the description could do justice to him.

Dad- It certainly was an experience.

6:15 PM  
Blogger Babs said...

Neurophysiology?? A bore?! What with synapses, axons and all sorts of other wacky business?!

Now see, had you just liked it a TAD more you might have gone neuro; and I might have moved there to let you be my Pinky and the Brain Consult. Silly :P

4:20 PM  
Blogger moegirl said...

Love that story about the cadavers and all. I remember your medical school days! I could not have done what you did.

I took one biology class and we looked at one open chested waxy cadaver. When I saw the indent on his hand where his wedding ring used to be, it made me kinda sick, although our cadaver was very beef jerky-ish and didn't seem real. I am still amazed at how big the human liver is...

I sometime miss those times when the three of us used to hang out all the time!

1:11 AM  
Blogger Dumdad said...

An award awaits you at my blog.

4:44 AM  
Anonymous Dana said...

No way I could ever do this. I read my way through but I was shivering at the thought of the professor with bits of people hanging around him. Blech!

I'm glad you did this though! There are some people who are just meant to do this and I think you and my doctor Deb are two of the best people in the world. Unfortunately not all doctors are like you guys but I'm happy I know you both!

9:28 AM  

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