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Page 20 text:
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NOTES OF BIOLOGY WATCHER: OUT OF THE CHRYSALIS — THE METAMORPHOSIS OF STUDENT INTO PHYSICIAN Jay Barry Azneer, DO. Abstract: Completion of medical school is accompanied by a mental condition that may best be described by the term quandary . The student finds himself with a collec- tion of garbled memories of voices and images from the past, a sense of insecurity concerning the future and a sud- den propensity for deep introspection. He recognizes his own dissatisfaction with the past but looks hopefully to the future. He realizes that his education has left many ques- tions unanswered but expects that time and time alone will bring many of these answers to him. However, the ache of the unanswerable lingers. We came innocently those first few days into the institu- tion that was to be a home to us our four years through of medical education. It was not long, however, before we dis- covered that our home was not a place of humanity or hu- mility, where we would be taught independence and where mutual respect would be the currency of interpersonal rela- tionship, but rather like a cave full of stalactites and stalag- mites. A place where our teachers loomed in the dark shad- ows as if ready to pounce and destroy, capriciously if they chose, and yet capable of great beneficence — to allow us to become physicians. It was not so very long ago — a mere whisper in the giant halls of time — a lifetime removed irom us, of memories — and we see the parade of personalities, a rubber glove, danc- ing pieces of colored chalk, a pair of spectacles, two pairs of spectacles, a vision of a Teutonic warrior like some great Nordic god staring blackly and blankly into space, dismem- bered, disembodied vertebrae dancing in mid-air about the hoary figure of an old man bent under the weight of a sack of human bones slung across his back — taken all in all the remnants of those who brushed against us in passing — like things that go bump in the night. And the words — so many words — of warning and ad- vice, but mostly of fear: Keep your nose clean. Keep your mouth shut. Don ' t cut the Cat. No moustaches below the angle of the mouth. Don ' t make waves. Times moves onward slowly, but nonetheless, steadily . . . and the dark hours of one night becoming morning melt into the sunlit noon of day after day of exam after e.xam, as though sheer weight of discipline could replace lack of substance of pedagogy. But the days do pass through week and month, and even surprisingly, blessedly, through year. The stuff of school goes on unceasingly, almost unwitting- ly. The questions — innocent or malicious by turns — What is Camper ' s Fascia? What are its boundaries? Name the vessels of the anastomosis around the elbow. Where is the verumontanum? Derive Schroedinger ' s equation and explain its significance. (2 points) The lectures — words end on end, mile after mile, pounds of them, a ton, perhaps. A voice makes itself heard noisily out of the past, That ' s not medicine! Here, just know the good notes; that ' s all you have to know . . . and then sinks into the mire of the forgotten — lecture and lecturer. Reams of paper and gallons of duplicator fluid — I need a typist for Tuesday afternoon. Physical Diagnosis. Won ' t anyone take notes for Monday, O.P. P.? The lectures missed, unmet, ill-prepared — unprepared; empty hours, days of them, weeks, even months. Physical Diagnosis is cancelled this week. Attention! There will be no lab in Physical Diagno- sis next Tuesday afternoon. Metabolic Diseases has been called off today. There will be no exam in Ob-Gyn this term. The Surgery final has been cancelled by the col- lege office. Distribution during lunch nos. 4,5,7,13,15,16,21. Registration will be held Tuesday at 12 P.M. in the Auditorium for the Sophomore class. Make sure to attend and have your checks readv. But even old ways, entrenched and glorified, give way to change and old walls groan and crumble under the weight of all our common enemies — year upon year. Yet even as the old walls of faded, fading, empires crumble amidst the cries of wizened old men, cracking head mirrors, and speculae bent asunder, new ones rise to take their place on the foun- dation of old GMT tables, empty bottles of Celestone, and once fond hopes and withered dreams. ..a vision of a woman, young — youngish, her belly fat, protuberant, breasts ripe and full, her eyes full of pain and fear and expectancy. Next to her a young physician sits — pen and paper in one hand, the other resting lightly on the abdomen of the woman; his eyes not on her but on the clock on the far wall — his face a mirror of resignation and disap- pointment — knowing that this may be as close as he may ever get to touching the young life that struggles, inches from his hand, to enter this world. And thus it is that insidi- ously, invidiously, a new empire effects to build itself upon the ruins of foregoing follies. But even out of all of the unhappiness and disappoint- ments of the process called medical education, that was not truly an education, but a long and painful detour, there be- gins to emerge something which is neither unhappy nor dis- appointing. The detour ends and education haltingly begins. The long journey into night after night and day after day begins to reap a harvest — a whirlwind of excitement, un- certainty, and fear. A gripping fear that wells up from deep within us — from the bottoms of our souls. We see . . the parade of oung and old, straight or bent over, infirm, crip- pled in body or in mind, and behind them the grinning, leer- ing spectres of the twin victors in this game of life; the two partners who are destined to dance with everyone on the
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Page 21 text:
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floor — Disease and Death. And suddenly we learn what our supposed teachers never brought themselves to tell us. that we really have no answers, and that Death and Disease are the ultimate winners, and that our job is only to prolong; the game; to make the dance so enjo able that we forget our aching feet or swollen ankles or the gasping ith which we draw our every breath. And what do we sa to those who come to us like Pinoc- chio to the Blue Fairy for the gift of life, itself ' : ' What do we sav to those who see their doctors, still, as an occult cult capable of curing all sickness? And what pill do you take for the ache inside you — the ache that your medicine cannot diagnose and cannot treat ' ? ' An if vou dare, vou search out some one honest human being and vou tell him about the ache — the ache your professors of cardiology and rheumatology never told you anything about — and if he understands you, he looks at you and sad- 1 shakes head, and still more sadly smiles, You ' re be- ginning to become a doctor. You will have that ache inside you for the rest of your days. It will never go away. But it ill not always hurt vou so. And you v alk away, and trv to find a quiet corner you can crawl into, and the corner isolat- ed and quiet gives no solace. And you find there is no place to hide yourself away, and the ache is too deep, and you do not know how to nurse it, and you have not learned to live with it, and do not want to. And you seek our your old teach- er and friends, and there is nothing he can answer to your accusing look — Wh - am I hurting like this ' ? ' V ' hy didn t you tell me ' ? Why don ' t you sa ' something? And if he answers you — then it is out of a lifetime of frus- tration and defeat — What am I to say to you? A hair of the dog that bit you. Go back to your patients. There are too many sick people. I tried to teach you — now go learn.
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