Island Med Student

We had a lecture today on collagen and bone. I learned that if you inject a bunny with something called papain, it breaks down the collagen which holds up their ears and it causes their ears to droop down. This is both sad and fascinating. I happen to really love bunnies, especially like the fluffy one in this pic. If you read this Wally, please know that the fluffy bunnies are only getting fluffier. Power to the bunnies.

I just got back from the beach a few hours ago, where I was working on my tan. It got up to around 85 degrees today. It actually seems like it’s been getting hotter here lately. In reality, I think it’s been exactly the same temperature since I arrived here in August. My guess is that it just seems like it’s been getting hotter, because my body thinks it should be getting colder, and the contrast between what my body thinks it should be and what it actually is makes it seem like it’s insanely hot. I’m definitely not complaining. I’ve always loved the heat. Though, I do kind of miss the change of seasons. Mostly, I think I just miss my scarves. I didn’t pack any of them with me, because I knew it would never get cold enough here to wear them. I also do miss jumping in the leaves. There’s nothing like diving into a huge pile of wet leaves, getting all dirty and sticky, and breathing in the cool smell of change.

Attending medical school on an isolated tropical island has many obvious benefits. When I was trying to decide which medical school would be a good match for me, there were a lot of factors that drew me to the Caribbean. The idea of an international education was very appealing to me. Since I had done very little actual traveling in my life, I saw this as an opportunity to live in a foreign place, where I could immerse myself in a new culture. I also liked the idea of living in a third world country, as I plan on eventually doing international humanitarian work, where I will be living in impoverished areas. I wanted to make sure that I could survive in this type of environment.

In addition, the isolation factor was another major motivator for me. Living in Washington D.C. and trying to attend medical school full-time seemed quite challenging to me. I knew that my friends would constantly be asking me to go out, and that I would always be tempted away from studying by a gallery opening or movie that I wanted to see. Sure, I could have gone to medical school in Iowa, or some other less distracting place, but I would still have had access to movie theatres, and places to shop, etc. While there are many things to do here, the distractions are very minimal. Sometimes I have to walk towards the sound of the waves calling me from the beach, but I can always bring my books with me to the sand.

Although there are many benefits to living here in Dominica, I have also encountered some bizarre drawbacks. The strangest thing about living here is that it’s sort of like a commune. Ninety percent of the people that I encounter every day are medical students attending Ross University, and the remaining 10% are locals who are somehow related to Ross University. Everything is Ross University. It’s very science fiction like. I sometimes feel like I’m secretly being brainwashed by some evil power to become a robot-like doctor, who is being controlled by some malevolent mad scientist. We all watch the same lectures, study in the same library, eat the same food, visit the same beach, and use the same laundromat. Because we are so isolated from the “real world,” it’s very easy to forget there even is a “real world.” All we know is going to medical school, eating at medical school, dreaming about medical school, and talking about medical school.

I’m doing my very best to take breaks from studying, and I’m trying to remind myself that there is life beyond medical school, but it’s not always easy when you’re drowning in it. When I’m really going crazy and need a break, at least I do still have the Caribbean Sea, and an amazing beach, even if it is crowded with medical students.

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In gross anatomy lab today, my group dissected the popliteal fossa (back of the knee). I noticed that the other group had done a crappy job of their dissection of the anterior and posterior thigh and gluteal region. Also, they hadn’t cut off the legs, even though the other tables had. So, I decided to come in this weekend and finish the dissection, and cut off the legs. But, I realized that I would need a hack saw, and they are kept in a locked room. So, I asked one of the prossectors if he could somehow let me into the room to get the hack saw for the weekend. He told me that we were supposed to leave the legs on our cadaver. I told him that I was planning on cutting them off this weekend. He replied, “well, that’s why we keep the hack saws in a locked room – so people like you won’t go around cutting off limbs.” I just smiled.

Today was wonderfully relaxing. Micah and I swam at the beach, hung out with the Ren brothers for a while, and I played with the baby goats again. Also, I forgot to mention the “crab incident” on Friday. I stepped out onto our balcony, and there was a pretty good sized crab staring me down, just a few feet away. I wasn’t paying attention for a few minutes, and then suddenly I realized that the crab had gone into our apartment and was approaching Micah as he lay on the bed. I screamed out to Micah, and he was terrified. After chasing the crab around our apartment with a broom for a while, we finally got the sucker out.

Here is a pic of the crab, and some pics that Rennady and I took today.

One of the goats that lives across from the Ren brothers had babies the other day. Yesterday, I got to play with two of them! Thanks Micah for taking the pics!

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I recently came upon a quote written by Hippocrates, the famous ancient Greek physician who is often referred to as the “Father of Medicine.” He once wrote, “Ars longa, vita brevis,” which means, “Art is long, life is short.” As I read those words, I was immediately stricken by their profundity. It seems that Hippocrates managed to sum up in four words a powerful concept that also conveys my philosophy on life.

After doing my research, I couldn’t find any conclusive evidence about what Hippocrates actually meant when he wrote those words, and it actually doesn’t matter. I know what they mean for me.

I have always been intrigued by the concept of medicine as an art. As someone who possesses both a deep interest in art and science, I’ve frequently found it increasingly difficult to separate the two. I’m not the first person to bring this issue up. Many essays and articles have been written on whether medicine is an art or a science. Not surprisingly, I happen to believe that it is both.

Medicine has certainly come a long way since the time of Hippocrates. The advances we’ve made in medicine and technology are beyond what anyone could have imagined. We now have sophisticated equipment that can perform all kinds of diagnostic tests on the human body. Some people would argue that the science of medicine has advanced so far that the art of medicine has virtually disappeared. I would argue that someone still has to read the MRI, and someone still has to explain to the patient that they only have six months to live, and someone must decide that another round of chemotherapy would do more harm to the patient’s psychological health, even if it would kill more cancerous cells.

I think that the dependence upon the scientific method actually contributes to the art of medicine. One can follow all of the logical steps and perform all the statistical analyses involved in treating a patient, but in the end, it takes the subtle judgment of a human being to decide the best course of action. Not only does the physician apply an artful process to treatment, but the patient does as well. Effective treatment is based on engaging the patient. The healing process is not one-way. It involves both the physician and patient in a synergistic relationship.

I once thought that I had to make a critical choice in my life: to follow my scientific inclinations or my artistic ones. I am passionate about both, and believed that a choice was imminent. And then I found medicine. It’s a field in which one can apply both a rigorous scientific method and a harmoniously applied artistic hand.

As a physician, one has to face life and death on a daily basis. Life is something that is exceedingly precious, yet is something that can be taken away in seconds. Physicians must be able to resolve this seemingly dichotomous dilemma. Perhaps art provides an answer. Art is enduring. It lives and thrives beyond death, in the same way that a person’s lifework can outlive them. Is not a person’s impact on future generations a significant work of art?

Physicians are a most amazing species. A good physician can apply both the science and art of medicine to the treatment of their patients. And in this capacity, they are able to truly appreciate the beauty of life, and the immortality of art.

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Yesterday was an interesting day. To make a long and torturous story short, my laptop’s harddrive is fried. What does this mean for Kendra? It means that I lost a week’s worth of data (including my ever-so-precious lecture notes), which could have been even worse if it weren’t for Micah’s insistance that I backup my files. Secondly, I no longer have a laptop. It’s toast. Why does this suck so bad? Well, my laptop is my life. I use it to watch lectures, take lecture notes, write blogs, surf the internet for medical info, etc, etc. It was an integral part of my life, and my connection to the “real” world. And now it’s gone. I also came face to face yesterday with the one of the cruel realities of living in a third world country: there’s nothing anyone can do here to help. My only option is to mail my toasted harddrive to someone in the states and hope that I can get it fixed and returned back to me in a month or so. In the meantime, the digital umbilical cord has been cut, and I’m on my own.

Ever see that movie Groundhog Day with Bill Murray, where he woke up every day and he’s forced to re-live the same day, over and over again? Well, sometimes I feel like that’s my life. Since I’m used to living in the D.C. area, where I saw different people every day and ate at different restaurants and did different things, my life here has become strangely routine. I’m not really complaining, because I love it here. But I get up every day, walk the same path, see the same people, study in the same library, eat the same food, and even see the same cows and goats and dogs. Different things do happen during the day, but the campus is kind of an eerie place sometimes because we all spend our days in a monotonous microcosm. I do love my dogs, though. I don’t think they have any owners and they follow me home from school every day and I feed them whatever I have. There is definitely some comfort in that, and they always make me smile.

I’ve been reading a lot lately about the issue of teaching the basic sciences in medical school. This is certainly not a new issue. In fact, it began in 1910 with the Flexner Report, in which Abraham Flexner recommended that students be required to have a basic science background before entering medical school, and that basic sciences be incorporated into the medical school curriculum.

Now, almost 100 years later, people are beginning to realize that the pendulum may have swung too far in the direction of teaching the basic sciences, with less emphasis on the clinical aspects of medicine. As a medical student, I can say that we are certainly overloaded with information. We are expected to learn an overwhelming quantity of minutiae. And we are expected to blindly accept that we must know all of this information in the hope that it will make us better doctors. I sometimes feel that we are forced to memorize facts not to help us in medicine, but to prove that we are motivated enough to do so.

In fact, every doctor that I’ve ever spoken to has told me that I will likely use very little of my basic science education in the actual practice of medicine. While I understand that the basic sciences are a good foundation upon which to build your knowledge and understanding of the human body, I’m not convinced that we truly need to know the level of detail that the National Board of Medical Examiners requires.

I also believe that there needs to be more context to our basic science education. All of my professors try to incorporate clinical case correlations whenever possible, but there still seems to be a huge gap between the basic science education and its relation to the clinical world.

Perhaps it’s time to reevaluate the basic science and clinical medical curriculum, and the processes that we use to teach our students. We should also consider whether we are teaching students valuable information that they will use in their future medical practice, or whether we are blindly forcing them to memorize information so that they can pass the next test.

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