Nail-biter

I sit here awestruck as I realize that an entire block had already come and gone. A block that's designed to weed out the weak, test your limits, and beat you raw. It's a class that puts every student in their place- it makes you humble. In fact I recently read that the anatomy block is when the majority of medical school dropouts occur... and I passed! I feel accomplished like I never have before. I'm in a class with the best of the best, I'm competing with the elite, and studying a subject that's extremely intense and arduous... and I passed... I keep reminding myself, motivating myself and moving forward. I've dissected an entire human body- the delicate and extremely small muscles of the hand that allow an artist to make fine touches to a masterpiece and a neurosurgeon to cautiously remove a tumor from a risky area, the uniquely detailed skull with numerous holes and indentions purposefully located to allow the passage of nerves which will give rise to action, the two slit-like vocal cords that powerfully give rise to language and song, and so much more. It was a life-changing experience. I find that when I eat- I visualize the food as it courses through the ever winding gastrointestinal tract. And when I look down at the scars from my most recent knee surgery, I envision the scalpel and each cut that was made in an attempt to create three new ligaments (all of which I have handled in my own two hands). I think differently. I have more details to occupy my mind and I have more pieces to solve the puzzle... I have a real perspective of the human body, of where things go and how things fit together. I can understand the synergy. I've touched it, ran my fingers between muscles that once flexed and relaxed with perfect timing to allow for graceful movement and along arteries that at one time warmly coursed through a living body feeding every inch of flesh with relatively large and supple blood cells. I've removed organs only to replace them after observing deeper structures and I've vigorously removed the calvarium (top of the skull) to reveal the powerful organ that controls our every emotion, thought and movement- the brain. I already feel like I've come along way, but I'm still only one step passed the starting line. I have the whole marathon left.

As I sit in this uncomfortable black seat in an attempt to stretch my stiff knee and update my neglected blog, I watch my fingers fluidly and swiftly type my thoughts onto the screen. My fingers looks fatter than normal.... fluffy and short. Then I realize that they only look this way, because I've been biting my nails. I've never had this problem....

One week ago, I began a new block: Genetics and Neoplasia (cancer). It's intense to say the very least. It's a 5 week course in which we learn everything there is to know about genetics, genetic diseases, all the processes involving DNA and RNA, cancer, birth defects, inheritance patterns and so much more. FIVE WEEKS...! I took multiple semester-long genetic classes in undergrad and we didn't even cover this much detail. We have multiple lectures, one right after the other, and with each one the subject becomes more difficult and detailed. Various doctors (MDs and PhDs alike) rotate between lectures, each passionately teaching their field of expertise and often their life's work. Their pagers (which was initially associated with an antiquated picture in my mind, but more recently has developed into something more profound) go off loudly and methodically. The doc nonchalantly reaches down and tilts the small rectangular screen in his direction. He takes his time, moves slowly and processes. Never flinching, but instead smoothly stepping out of our lecture hall and quietly returning the call or he has another professor in the room return the call for him. A doctor's pager- it can be a patient's lifeline, a call for help from a frantic resident, a sign of an emergency and a need for back up, or simply a spouse to say she's running late. A doctor's pager is attached to their hip and they vigilantly and visibly carry it on their dress pants or slacks. One day... very far from today... I will have a pager like that. What a small thing to look forward to... Doctors are important people, each call and each page is important. It's a concept I can't even grasp. Our cell phones go off in class and we quickly shuffle through our back packs, turn it off, turn bright red and apologize multiple times. But our doctor and class lecturer continues on without skipping a beat or losing his place. He's focused, so we move on naturally and accepting of the whole situation. We understand.

I used to get upset with my sister for chewing her nails as short as physically possible. She used to sit in front of the TV as a kid and bite at her finger nails sometimes until they bled... One time, before her senior prom, she went to a salon to get her nails done. The poor lady struggled because my sister didn't leave her much to work with. And now here I am 23 years old, and I've adopted a new habit... I nervously chew at my nails.... I'm not even sure when it happens, I just look down and they look terrible.

One of our lecturers and a doctor in the area stands at the front of the room, tall and lanky with a monotone voice, dry humor and a depth of knowledge that I can't imagine ever being capable of, but knowing I must be one day. He explains the clinical manifestation of a disease... we jot down notes, follow along on our printed powerpoint handouts and listen intently. When he explains that Fetal Alcohol Syndrome is often characterized by unique creases in the palm and fingers, I notice many of my classmates look down at their hands, some without even realizing it and others as if they're truly concerned. I smile- because we all have those moments. A few weeks ago, I was convinced I suffered from nasal polyps, because I had multiple nose bleeds as a kid, and I have a torn rotator cuff, because of the way I fell of my bunk bed at church camp in the 9th grade and I couldn't lift my arm for quite a few days. We have a dangerous amount of information-it's too sparse and underdeveloped to understand the whole picture. I can't wait until we start learning about mental health and my colleagues take it upon themselves to diagnose their friends with mental illnesses. It should be interesting what people come up with. I'm convinced I'll have a slight case of Obsessive Compulsive Disorder :)

We're also currently learning how to conduct a physical exam. I'll never forget the day the 8 people in my Foundations of Clinical Practice class sat in our cramped room. We all stared at our new instruments without a clue how to make adjustments, what to use them for, or even how turn them on! I felt like a mechanic assistant and the mechanic asking me to hand him the monkey wrench and I give him a screw driver. My oto-opthalmoscope was like a foreign object that made a pretty light and I could use to find my way to the bathroom at night, but it was more. It was a tool that would one day allow me to diagnose intracranial pressure and otitis media (an ear infection). My stethoscope was heavy duty, purple and shiny brand new! More importantly it was gonna listen to heart beats and lung sounds- it was gonna listen for pathology. It will often be the first step in the healing process. I was flabbergasted... med school does that to me often.

At the end of the day, I realize I'm a med student. That is what I AM. It's my identity and my purpose for this long moment. For this reason, I have come to love my classmates- they understand me. They are my safe haven and I understand them. We have a camaraderie that could not exist with anyone else. All we are capable of talking about is medical school- it's all we do and all we know. We can't help it. It's a brother/sisterhood and each day we grow closer. We need each other. I can't say I've ever had this before. I was recently made aware that while watching the UFC fights, my med school buddies and I made medical jokes that no one else at the table understood. We're weird... but we're weird together :) So at the end of the say my hair will go uncombed, because I want to spend those last few minutes reviewing the inheritance of Marfan's Syndrome, I'll feel guilty every minute I didn't study, my backpack will be my new best friend, and my nails will suffer. I'll bite them to the core. I'll polish them in attempt to cover the damage... but in the end I'll still be a medical student. This is who I am for the next four years. I slowly accept my abrupt new lifestyle more and more...