Information gets hammered into our heads every day of medical school. Trying to process and comprehend everything is, at times, overwhelming. Some subjects cause more suffering than others. Embryology, for instance, is a primordial stew of agony and misery. Pathology includes 3 of my favorite elements of medicine: a lack of direct patient contact, poor prognoses, and death. Strangely enough, my sincere aversion to these two subjects has generated a new found appreciation of how precious life is.
Learning about diseases, disorders, degenerations, and everything that can possibly go wrong during development (the subject of embryology) has instilled an appreciation of how we are more than lucky to not only be alive, but also be in good health. Embryology is a subject that is based on minutia, which makes it a dry subject and, occasionally, a challenge to learn. However, after studying all of the minutia in detail, it becomes immediately obvious at how many accurate gene transcriptions, productions of proper growth factors and proteins, cell replication, tissue development and migrations, etc. are necessary for every one of our limbs, organs, and overall structure to not only form, but also grow into something functional and capable of sustaining life. In fact, there is so much room for error, it is a minor miracle that more errors leading to birth defects do not occur. As an aside, I propose we rename the expression “miracle of birth” to the “miracle of development leading up to the actual birth.” Although more cumbersome, the latter statement is more accurate, but I doubt it will catch on in the popular vernacular.
Let us look at cleft lips for a moment. This is a very common birth defect of the face (occurring in approximately 1 out of every 1000 births in the U.S.) In 2009 there were an estimated 4,136,000 births [1]. This means 4,136 children born in 2009 had cleft lips. I personally do not even know that many people by name. This is just one example of how easy it is for something to go “wrong” during development, and is a relatively mild example of a birth defect of the face compared to agnathia (a condition where the lower jaw fails to develop and is incompatible with life). Of course there are multitudes of other development abnormalities that can occur. These are just two examples.
It is safe to presume that this article finds its way to fully functioning eyes capable of relaying what they see to fully developed brains that are able to interpret what the eyes are reading, and then translate these pixels in the shape of letters into a meaningful language. Otherwise, nothing that has been written will serve any useful purpose. If these words have made sense so far, it is safe to assume that we have properly developed, successfully navigated out of the birth canal, are capable of surfing the internet, have functioning vision, and a brain that works. The fact that we are here and capable of accomplishing all of this is absolutely amazing. (The ability to read does not assume anything about the function of lower extremities, however). However, there are still a multitude of diseases, disorders, and mutations that can afflict us – ignoring any trauma for the sake of simplicity.
Medicine essentially boils down to studying various organ systems and everything that could possibly go wrong with them. From studying problems, however, solutions are often formed. A perfect example of problem fixers are surgeons from any specialty. Their main goal is to physically remove or repair whatever is causing the patient harm. Non-surgical, medical specialties also have their own methods of treatment as well: if a patient suffers a pulmonary embolus, for instance, they are placed on Lovenox and Coumadin to break up the clot, thin the blood, and (hopefully) prevent any more clots from occurring and mobilizing to the lungs again. A chronic kidney failure patient undergoes weekly dialysis. A patient having a heart attack may undergo an emergency cardiac catheterization to dilate and stent the coronary artery causing the heart attack.
Pathology (and for that matter, radiology), is different in that it offers no solutions, but only diagnoses (and, in later stages of disease progression, offers the cause of death). Pathology is purely a study of disease. The word itself originates from the Greek word pathos meaning suffering. Most of a pathologist’s work relies on tissue sample analysis under a microscope in the hopes of not detecting any abnormal cellular changes. It is astonishing to think how changes on a basic cellular level can lead to systemic changes causing a patient to feel deathly ill. Just one of the processes that can create such a systemic manifestation is cancer. An accurate diagnosis of cancer can only occur under a pathologist’s microscope, and depending on how these cells appear, treatment may or may not be futile. Hence, a pathologist hopes to only see “normal” when given a tissue sample, because “abnormal” findings are quite often ominous. Hopefully this illustrates why studying pathology is not in my top 10 list of things to do.
Pathology is (mostly) a morbid profession. But by studying pathology and learning how many diseases, syndromes, autoimmune processes exist, and how many thousands of things can go wrong with us at any moment, we can begin to appreciate how incredible it is to be free of any such problems. Embryology is and will always be a dry field of study, but by learning how humans develop, we can begin to understand how lucky we are to be alive in the first place. Therefore, by realizing the not-so-simple fact that there are an incredible amount of factors that can cause us harm, death, or prevent us from even surviving birth, we should be grateful every day that we are alive, functional, and well.
As I sit here in my apartment listening to the unrelenting hum of 18-wheelers passing by on the highway, a moment of industry-induced tranquility passes over...
School and education have always taken a precedent in my life, but up until a few months ago, it has always been placed on a tier secondary to the almighty Catholic Church, Sunday Mass, and indoctrinated beliefs in the existence of Christ. Whether I was hungover, sick, had an exam looming the next Monday, or not, I always made Sunday Mass a part of my life (or schedule/ritual -- however cynically you wish to interpret that). And if, for some reason, I skipped out, I was harangued by intractable feelings of guilt (the stereotypical brainwashed Catholic guilt, I suppose).
Lately, however, after seriously beginning to ask questions about life, the Bible, and the organization & motives of the Catholic Church, my Sunday Mass attendance has started to dwindle and so have the feelings of guilt. Unfortunately, Mass has degenerated into nothing more than following a step-wise order of events spelled out by Vatican II accompanied by the annoyance of being surrounded by people who are dragged there against their will and who lack a basic understanding of the Catechism of the Catholic faith. [A big pet peeve: if you are "baptized" into an organization, you had better understand the foundations of its existence. Because if you don't, you have no right to form any opinion -- negative or positive -- about it nor leave it without the least bit of contemplation.]
Religion, especially of the organized variety, is nothing more than a few human beings pushing their interpretations on the general public about a topic that cannot possibly be understood -- and those who claim they do fully understand Providence's ultimate purpose for us, and claim they know how to best follow his plan should be looked upon skeptically. After all, how can a mere mortal be able to understand something greater than him when we barely understand our own universe, much less our own planet, or how to cure certain diseases?
One of the perks of being pope of the Roman Catholic Church is "papal infallibility." This means that the pope cannot say anything in error when he proclaims a dogmatic teaching on faith or morals. In essence, the teaching he presents comes directly from God which is why it can never be wrong. After all, if God made mistakes, we couldn't call him God. But we must not forget that the pope is still a human being and is therefore capable of making mistakes. Another Catholic teaching is that of free will, meaning that God cannot assert his power over any individual's choices. So how can the pope be exempt from speaking in error about important matters regarding faith and morals when free will dictates God holds no direct influence over the individual? Two incongruities: either God does really speak through the pope, negating the teaching of free will; or if free will holds water, then papal infallibility cannot be valid. Unless of course the pope is somehow better than everyone else around him. Although I do recall being taught in Catholic school that we are all equal in God's eye. Just some food for thought.
Upon further analysis, I have grouped Catholics into three general categories. Those who are Catholic in name only (the "Sunday Catholic" would fall into this category); those who truly strive to follow the Catholic ideology in every single part of their daily lives selflessly; and those who claim to be Catholic, but who use that claim for personal gain.
The first group I used to have problems with. How can one claim to be Catholic and not follow the rules? Now I realized that these people know they are not necessarily following every single Catholic doctrine, nor do they claim to be the most exemplary Catholics on the planet. I would throw myself into this category. The second group is fairly self explanatory, and deserves respect for their sincerity.
Religion is, in a sense, a glorified fraternity with an easy three step plan of "initiation, following some laid out rules, being granted eternal salvation." Plain and simple. This last group of Catholics with a hidden agenda is one of the problems of organized religion. They follow the three step plan for no other reason than to get the prize of eternal salvation at the end of their life -- but do so insincerely and at the expense of others. These people are most often insecure, looking for attention, feel the need to prove something, and do so under the guise of being a "good Catholic." They want to make it seem like they are following the rules so that you may be impressed and guilted into following their "good example." These are the people who will "pray for you" in your time of need but take no physical action to help you. A classic example is "praying for those who are less fortunate than us" during Mass, yet being too cheap to throw a dollar into the collection basket. These are also the people who are quick to pass judgment if they catch you "sinning," but who become absolutely outraged if anyone were to point out a fault they may have. These are the people who also make it taboo to question anything related to the Church, and ultimately quell any attempts at individuality within the Church.
Despite everything written so far, I still believe it's foolish not to consider the existence of a divine creator, if only for the fact that it is comforting to believe in something bigger than us that will take care of us in the end -- like Linus from Peanuts and his blanket. [Although this thought was one of the bases of Friedrich Nietzsche's pro-atheist arguments: God is dead and is only a crutch for humanity.] Another simple (and flawed) reason for belief in God: until science arrives at the missing link between the creation of the universe and the spawn of man, we are almost forced to believe in some divine spark that catalyzed our own creation. But for right now, that will have to do.
If I can get one point across, it is this: please take a moment to ask yourself what you believe in and why. If your conclusions leave you exactly where you started, then I applaud you and am entirely envious (one of the 7 deadly sins, correct?). If not, then ask more questions, and perhaps you will eventually arrive at a satisfactory conclusion. Chances are equally good that you won't and will be left with more questions. The thought of uncertainty is indeed a scary thought that many are not willing to even consider, but if you do ask yourself "why", at least you can say you died trying to think for yourself and attempt to understand what is really going on, rather than agreeing with whatever has been laid out before you. And that process of inquiry is much more significant and powerful than any system of belief could ever possibly be.
It has been an atypical holiday for a multitude of reasons. Firstly, everyone in my family approached the holidays with a nonchalant attitude this year significantly lowering stress levels :) This was also the first year our family celebrated midnight Mass at a new parish since our old one was closed down by the diocese in October. It was the first time our family was not together, since my younger brother is currently in S. America (hopefully avoiding malaria and kidnappers). And perhaps spending my first few days of vacation traveling to the east coast to bury my grandfather had something to do with this Christmas season being peculiar as well. After compressing and processing everything that has recently occurred, I was able to figure out why this Christmas was different, and also found out a little something about myself.
Once it is too late, one quickly realizes what could have transpired if the proper efforts had been carried out. Soon thereafter, the guilt of foolhardy sins of omission settles in. It is incredibly easy to take people for granite and not realize how absolutely wonderful they are until they are no longer around.
One skill that I have always had was the ability to passive-aggressively avoid/ignore certain people that, for lack of a better description, I found uninteresting -- meaning I felt they were not worth my time or energy and that I did not wish to maintain a relationship with them, however platonic or intimate in nature. There was always some amount of guilt that followed the initiation of "radio silence," but nothing that could not be sloughed off by a quick shrug of the shoulders.
On the other side of the coin, I have always had this innate tendency to put my friends and family before myself. I have always strived to achieve the noble ideals I was raised on and believe in...until recently. For the past few years, I have been rather narcissistic; this attitude being based on the fact that I have (in my opinion) done enough for others for the time being, and must therefore think about #1 for a change. This mindset, of course, was only supposed to be temporary and consciously controlled. Reading over my last few blog entries, I detected certain pervasive, arrogant undertones. The previous observation conveys to me the fact that my "me" attitude has not only taken over my conscious actions, but also my sub-conscious thought processes. The obvious conclusion is that I have gradually transformed into a completely egotistic person, and have only now been able to recognize this fact in light of recent events –- problem identified.
It is cliché to have these "revelations" around the New Year and babble on about how one is going to turn his life around, become nicer, better, kinder, etc. [I am eating my own words right now because I have definitely done that in the past]. This time, therefore, my seasoned inner cynic forbids me to make any of these types of resolutions. So what is the next step? to formulate a solution to the identified problem. Unfortunately, the solution will not be simple.
This is not a cry for help, nor an "emo" complaint of how difficult my life is, nor a search for sympathy. Rather, this essay is a method to organize my thoughts, and hopefully convey a message to myself and any readers. Quite simply, I am doing my best to keep a positive attitude and to be considerate of others. Deep down I do mean well, even if my callousness and snide remarks suggest otherwise. Hopefully, by realizing my shortcomings, I’ll gain a deeper understanding of how truly wonderful all my family and friends are, and not miss any more opportunities to appreciate their company. On that note, sorry for the long post, Merry Christmas, and Happy New Year.
So I started Ohio University College of Osteopathic Medicine in the first week of August. August is labeled as "Anatomy Immersion" meaning that the entire 120 person class attends gross anatomy lab 4 days/week 3 hr/day for the duration of the month. I enrolled in a gross anatomy course as an undergrad, but in that course everything was prosected (meaning dissected for us in advance) and we were not allowed to get our hands "dirty." Needless to say, our labs so far have involved us getting intimately acquainted with the workings of the musculo-skeletal system as well as our scalpels, hemostats, forceps, and scissors.
I could tell some of us were intimidated by the idea of actually dissecting a real human being. To tell the truth, I had a moment of doubt if I would be able to cut through and in to our cadaver. But the staff and my lab partners are absolutely wonderful. Within the first hour, we were already at ease and enjoying ourselves. I almost didn't want to leave. And now, I am our group's official bone saw "expert."
At the same time, while thinking about my current status and future, everything so far seems surreal yet expected. I have told myself since kindergarten that my ultimate goal was to become a physician. My entire life has been a long mental and academic preparation for a medical career. Now that I am finally here I can breathe a sigh of relief. For the first time I have reached a straightaway on that super winding road of life -- at least for the next four years (hopefully). I can't say that I am self aware or have realized my full potential yet, but everything for the time being makes sense -- even all the vasculature supplying the muscles.
I expected myself for the longest time to simply "get in" to medical school, but there were times, especially over the last two years, where I was unsure if I still wanted to pursue a career in medicine, or if I even had what it takes to get accepted into any medical school. But from the moment that scalpel made the first incision into our cadaver, I knew I truly do belong in medicine, and any self-doubt I had instantly vanished. That moment, and now knowing for certain that I am where I belong is what seems somewhat surreal. Yet for that realization, I am incredibly grateful.
