Duke University School of Medicine - Aesculapian Yearbook (Durham, NC)

Page 25 text:

The History ofthe Class of l96ll It all began in the austere, stern environment of room M-I ltl. How appropriate a place to commence the study of a profession which is characterized by attention to detail, foresight, and cleanliness. The huge black blades of the window fan were beating out their inellectual refrain- squeak, squeak, squeak. A very unusual fan this, for it was able to distribute odors and cigarette smoke evenly throughout the gloom without moving the air pereeptibly, thus preserving the incu- bator-like quality of the place. The young men and women seated in that room four years ago were to become the class of 1960 at the Duke University School of Medicineg namely, us. All in all, it was a sobering moment. The Dean was the first to speak to us. We appeared to be listening intently to what he had to say, actually we were looking intently, for what an eye-full was this man! He greeted us, told us of the wonders that lay ahead, and in general behaved in a deanish manner. He also complimented us and told us what a select group were were. Actually, in many respects this was the first time in our respective lives that we had been recognized as worthy and significant hu- man beings. It was also the last time that such occurred. The next speaker was the head of the department of anatomy, and he made us a little uneasy for he talked less about the glories of the future, and more about the realities of the present. He even suggested that there might be hard times ahead. We shrugged this off as a likely story and turned our heads toward the first year. The Dean had streaked us out on the agar of the Duke Medical Center, and we had but to grow. Anatomy turned out to be basically the negotiation of a peaceful co-existence with four other people, three living and one dead. The relationship with the latter proved to be by far the most intimate, if not very long lasting. We soon found that there is considerably more to dissection than is readily apparent. Take, for example, the matter of the removal of the skin from the cadaver. To the casual observer, this seems simply a matter of stripping ofi' the skin. much as one would peel an avocado. This, however, is not so, for the skin must come oli in just the exact thickness. We were all rendered tense and tremulous by the emphasis placed on the importance of this, and as a result most of the first specimens removed were markedly fenestrated. Feelings of guilt and inadequacy were heavy upon us. However, we soon recovered and adopted less subtle, more de- finitive methods of skinning. This also cut down significantly on annoying details of anatomy which cluttered the dissection. It was at this point that we learned that in the busy life of the physician, it is sometimes necessary to temporarily lay aside detailed, precise, thorough methods and take short cuts. We had been in medical school for 45 minutes. Although gross anatomy occupied most of our time, there were histology and neuroanatomy to be dealt with. lt was in these areas that those of us with liberal educations were way ahead. Per- haps way out would be a better phrase. One of us was so liberal in his orientation that he soon left school to write the great American novel. More power to him, wherever he is. As the depart- ment of anatomy was the first to view our class, it was also the first to take a dim view of our class. We sensed this, because some of us failed anatomy. Fortunately. most of our losses were not per- manent, thanks to the do-it-yourself course given in the summer. After this less than glorious debut, we proceeded on to physiology and biochemistry with more trepidation. ln anatomy, a new fact was uncovered with every stroke of the blade, but in bio- chemistry the facts did not turn up so easily. For example, after hours and hours of laborious chemical procedures, we were able to look an egg in the eye. and know that it does indeed con- tain cholesterol. At the rate of one fact every six hours, it takes a long time to learn an apprecia- ble amount of biochemistry. The records we kept of our physiology labs sounded more like menus than anything else-frog legs, turtle hearts, rabbit chitterlings, rat kidneys. All these yielded their secrets unto us. And soon the first year was over. Looking back over it we said that in anatomy there were too many facts and not enoJgh thinking, in physiology too much thinking and not enough facts, and in biochemistry too much thinking and far too many facts. It was good to look back on the first year, and it got better. There were other things learned that first year. Very early in the year we discovered that the medical student has much smaller calorie and vitamin needs than do interns. residents. nurses. PAGE Zl

Page 24 text:

'calf 1 . S aw 4 fy If .,.' , .fi ft Xin..-m.x1i','Fx'm:.M.Ib, .lmlx V. Vlulrxrcnc, M.Ir, f'IIRlS'I',X vox Rm-:lsm,. 31.11, III ' - NIL'4li1'iIl1' fU1SfHf!'i1'S5IIlllHyll0I'0I0!jy xlvllllllll PAGE 20 aw. QNX in mm P. XVILI.ET'l', Ph.D Mic'1'ohir1l0g'y ,kmlcs Ti. WYN4:.xAum2N, M.D. W.tJ1,r:NN YoUN1:. J1z,.M.D, M41-clicimg '1'l1m'nCi1' Surgery NWI' l'1f 1'l'Ii11.IP LIQNHX lb. Hxlil-Llc, BLD. NIHN'l'RtlNlCfI.BIUSl11N. I'l1.lF. 01'tlmpf-'lies .XIIHTUIIIX RY I.. lP,lil'1l:Nlllf:lM,I'h.lJ, IC. 1i1's'1'.u'11: Nrawxmxv M.lr. Iliuwlu-l11ist1'y I'xy1'lliz1tl'y I Ic.xxKi'l.II'l'l11xu:l1:1:,MJD, Sl'x'l1.xM fYN'l'lfIIH'IUl l'. l'h,Il,. B f,l'flIU1YL'K1i4' Slll',E1'l'j' BIk'Ilii'iI1l' Ill-:1:w1x f'1lUl'l'Ill,NI,ll. .Manx B. l 1f1c1wr'1-zlc,M.lb. Me-1li1'im' Nl'1ll'Ul02j' Ii,xx'xmNlv'1', llm'1.r:, MM, ,l4rllN Y. S.x1.z,xxn, VILD. Mmlivilw I,llj'NiiDl1l2Qj'lllll1Y,lHll'llll1X 4 l'.HHllI'lS,l'1.'XllIl'1,Pll.IJ.-BLIP. S.,l.W.x1cll.. Pl1.Il. l'l1ysi11lug:y :md l'h:l1'11l:u'olug5y I1im'l11-lllistry XY.xl,'1'l1:1i Iimll-Nlclz. 31.11, .X1:Nm.ln M. W1f11ss1.141z. MJD, Mwlicim- Nli'iliI'iI1k' I .f'lm1f'l' l.UNt6.1l.l?,, I'h.ID, .I.l'1.xn1.l'1Wll1'l'1c.M,l1. l'hysinlngy zlml I'l1:11'1ll:lculu:.fy lW1L'di1'ill0 Kl41NNl1I'l ll S. Mv1'.xl:'1'Y, Ph.ll, ,MMI-is 0. WYNN, M.lJ X liincln-lllis trv A1l'diI'ill0

Page 26 text:

maids and orderlies. Furthermore, warmed or cooked food is injurious to the stomach of a medi- cal student. For these reasons, medical students are barred from the hospital cafeteria. We found that the natural, healthful diet of the medical student consists mainly of aged ham-and-cheese on rye sandwiches, preferably served at room temperature. These could be had in abundance at the Dope Shop, and were usually consumed in room M-110, the ancestral home of the Duke Medical Student. Also very early we became acquainted with the vast, liquid spectacles referred to as medical school dances. Our class seemed to have an inherent naturalness at these affairs, and we always attended in large, loud numbers. lf the first year had been one of bleakness and feeling-as-though-it-will-never-end, the second year was one of adjustment and relative tranquility. We had finally come to the study of human illness and its causes, and it seemed to us that such study was entirely appropriate in the training of a physician. Human illness turned out to be an animal acting in a certain way, its cause was a wheel, and the universe was the biggest wheel of all. We all laughed at the wheels until we began to think seriously about disease, at which point this concept became very useful and strangely modern. Beyond the wheels were the pots, endless pots, pots on the wall, pots on the table, pots on the Hoor. They contained cases. At first glance these were merely foul smelling, hopelessly tangled wads of viscera, but more careful inspection revealed that they could tell a story as clear as any in medicine. Autopsies were interesting, but they would have been more so had we been able to understand our prosectors. Our questions were usually answered with bows, smiles, nods, and perhaps the phrase, smooth and glistening, or passive congestion. In pathology, as the material from the first year was incorporated into the study of illness, we began to see our profession as a unified whole. For the first time, we could site some concrete reasons for choosing medicine as a career. Bacteriology and Pharmacology both contributed large amounts of valuable information to our growing stores of knowledge, they also contributed considerable amounts of useless informa- tion. The latter was entertaining, so it was really not useless. In addition to teaching us their own fields, which they did nicely, the faculty in these disciplines performed the important function of complementing our knowledge in other areas. Thus physiology became much more meaning- ful because of pharmacology, and pathology more meaningful because of bacteriology. Perhaps the most significant thing of all is that we came into contact with the remarkable faculty members who constitute these departments. What can be said of dog surgery? Almost every Duke student looks back on it with a great deal of pleasure, and those in our class are no exception. Everyone scrubbed for fifteen minutes except the professor, and he scrubbed for three minutes. We wisely attributed this reduced cleans- ing to intrinsic asepsis on his part. There was the surgeon whose patient died under the blade, not a Bard-Parker, but a Gillette blue blade. There was the first assistant whose integrity had al- ways been impeccable who crept down the hall with a dead dog, heading for the refrigerator. There was the giggling anesthetist whose patient expired in the midst of the giggles. Then there was the professor. Why do we love dog surgery? Because of the marked reminiscence value. We sadly regret its passing, for it was a time of fun and the acquisition of more than a little knowledge. Hematology sticks in most of our minds as basically a course in cover slip pulling. It was so encouraging to pull hundreds, until at last a masterpiece is achieved, one in which each red cell is exactly 8 microns away from every other red cell. The best part came when the preparation came back graded D minus , it seemed to make the effort worth while. What kind of cell is that? A myeloblast. How do you know? Why because of the nucleus and the cytoplasm. What about it? The texture, man, the texture. Thanks. And so it went. It might be thought that what is learned in the course in physical diagnosis is how to make a diagnosis from physical examination. This is not true at the Duke Medical School, certainly it is not true when referring to the class of 1960. The knowledge that we acquired from this course was on a more basic, perhaps primitive, level. We mastered such things as how to strike the ples- simeter finger with the percussing finger 2 times out of 3, how to avoid shining the ophthalmoscope PAGE 22