Somewhat boring/necessary background unless you’re in my class:
At most schools, anatomy is taught in one continuous block, usually at the beginning of the year. By the time September rolls around, most students can identify bizarre-sounding muscles and tell you which stringy pale thing is a vein and which is a nerve. It’s harder than you think.
Our medical school works differently than most. We learn anatomy in segments, according to whatever physiologic systems we’re covering that block. For instance, this 12-week block, called Homeostasis, includes the heart, lung, and kidney. So we’ve dissected most of the thorax, where the heart and lungs are, and examined normal and abnormal kidneys in pathology lab (I’ve written about this previously).
But we do it in pieces. Sometimes we go months without entering the anatomy lab. Between the middle of our microbiology and microbes unit and covering the heart, we went about six weeks without a dissection.
This is a double-edged sword. On the one hand, it’s supposed to enhance our integration of what we’re learning in the classroom by showing us what this stuff looks like in real life. Theoretically, it should be easier to remember the origin of the lingula when we dissect the lung the day after we learn about it. At least, I’m pretty sure the lingula is a lung thingy. See? Integrative learning.
The other shoe is this: anatomy is a language and dissection is a skill set. By splitting up anatomy lab over the course of the year, it’s tough to develop a true competency in the vocabulary or the physical skills.
Also, you smell like formalin at random, unpredictable times. Sometimes patients catch a whiff of you and stop telling you about their family history of diabetes and heavy periods. (Sometimes this is a blessing in disguise.)
Okay, serious part over. Because our exam at the end of January will include a substantial amount of anatomy, the second-years (who apparently know everything) put on a “practice practical” for us this past Wednesday.
Here is what taking a practice practical is like:
- Enter into anatomy lab with 50 classmates. Grab clipboard.
- Realize you are wearing nice clothes because you came from a meeting with your small-group facilitator. Realize these clothes are possibly about to be ruined.
- Stand near uncovered cadaver with tag next to it and anxiously await the start of the timer.
- When timer sounds, read tag. What is the predominant cellular structure in this tissue?
- Realize immediately that you know neither the tissue nor the predominant cellular structure.
- Write in, “human.” Fist-bump yourself.
- Cycle to next station. Read tag. Identify the structure.
- Identify structure as a pale stringy thing among tens of other pale stringy things near heart.
- Scan goldfish memory for pale stringy things near heart. Come up with the following list of possibilities:
- Vagus nerve
- Phrenic nerve
- The artery that sounds kind of like phrenic but has other words you can’t remember
- Pick one at random. Cycle to next station.
- Make eye contact with classmate. Identify bullets of sweat trickling down classmate’s forehead in the 45-degree anatomy lab in December. Identify stress.
- Thank the lord baby Jesus this is just for practice as you rotate to the next station. ‘Tis the season, says the Jew.
- Feel the holiday cheer as you fail to describe the order of lymphatic drainage from the mammary gland to circulatory return.
- Describe holiday cheer as wanting to lie down under a cast-iron chandelier during an earthquake.
- Consider escaping 11th-floor practice practical in dramatic HALO base-jumper exit. Identify plastic sheets that can be used as makeshift parachute. Reflect on “ninja Batman skills” competency.*
- Score competency as “Entry-Level” and decide against HALO base jumping escape.
- Rotate to final station. Breathe sigh of relief that hour of torment is over. Identify structure tagged by probe. Write in “structure tagged by probe.”
- Drop off clipboard and walk out of lab. Score answer sheet. Score 15/46.
- Debate value of burning unlucky, smelly clothes. Debate value of throwing up. Debate value of medical degree. Debate value of self.
- Rotate to home. Rotate to couch. Rotate to episode of House.
- Identify disease in House.
- It’s not lupus. It’s never lupus.
- Consider day a triumphant success.
*A brief follow up to those who are not medical students at my school: We are constantly self- and peer-evaluating on a scale of “core competencies” like Medical Knowledge, Systems-Based Practice, and Interpersonal Skills. We do this all. the. time. Your small-group classmates evaluate you. Your small-group facilitator evaluates you. You evaluate you. You reflect on your evaluations. You reflect on your peers. You reflect on your life. Ninja Batman Skills is not a core competency.**
**Yet. The curriculum committee is pushing for the change.