"That's the submandibular gland, right there. No thanks necessary"

Right now in anatomy lab we are dissecting the neck. This area of the body is really complicated; there are a lot of intricate structures, arteries, veins, nerves, tiny muscles, etc. Thus, you have to be really careful when you dissect to avoid destroying things you need to locate. In fact, Dr. Cutty has mentioned multiple times that this is an area where caution is extremely important. So much so that we don't even use scalpels in this area, just these blunt probes that look a lot like metal chopsticks. This way one avoids inadvertently slicing that delicate, yet exceedingly important nerve or arterial branch.

Occasionally we have visiting physicians in the lab. Some people from the Emergency Department have shown us how to place chest tubes and do tracheostomies. We have had pathologists in to talk about different diseases our donors had before they died or to describe abnormal anatomy we find in the bodies. Radiologists come in to teach how to read X-rays and CT scans and MRIs. These doctors are great. They come into the lab to talk about the clinical things they do day in and day out. They clearly are the experts in what they do and what they are demonstrating in lab.

Then there is another kind of visiting physician. These are the doctors that want to "give back" to the school by helping us unsophisticated med students with anatomy. I'm not sure if these people are invited to help or if they are proactively volunteering their time to spend a day in the anatomy lab. We've had surgeons, gynecologists, oncologists and others "help" us out with our dissections. Today we had this guy who was an ear nose and throat (ENT) specialist. I have a few issues with these folks, paricularly with the guy we had lending us a rather destructive hand today.

I'm sure these people are excellent physicians. If I had an ear nose or throat disease, I'd probably be extremely lucky to have this gentleman taking care of me. The problem lies in the fact that the last time this guy was in an anatomy lab was at least 10 years ago. Thus, his dissecting skills are most likely not as sharp as they once were. Furthermore, in training to become a physician, one is not trained to be an anatomy lab instructor. You see, we have lab instructors already, with PhD's, in anatomy!

When he first came to the table he seemed nice enough. In fact, he actually said "Don't mind me, I'm just watching what you're doing." At the time, I was looking for a really fragile nerve in the neck and was checking a reference book to get an idea where to find it. The guy looked at me and said that I was looking in totally the wrong area and that I should be digging much deeper in the neck to find it. He then promptly grabed a scissors and jammed it deep into the cadaver's neck and ripped at the tissue in search of this one nerve. As I stared in shocked, mute horror, he tore open what was obviously a large and now shredded neck vein.

"Oh," he said, "that's your internal jugular vein." Then he smiled weakly, dropped the scissors on the table and walked away. All that Doublestuff, Minerva and I could do was stare at each other with that "did that just fucking happen?!" look on our faces. As I looked back down at the cadaver, right in the area I was originally dissecting, there, now also shredded, was the nerve I wanted to find in the first place.

At this point I'm pretty pissed, but what can you do? The guy is an MD, and he is there to help us. Besides, there are two sides to the neck and we can always work on the opposite side of the massacre to find the rest of the anatomy we need to identify. The remainder of the lab time was very productive and we were making great progress...until about 20 min before lab ended. The good doctor returned to our table.

At that point we were trying to find some of the very fine muscles between the Adam's apple and the chin. One of those muscles wraps around the submandibular gland. The mandible is just the anatomical name of your lower jaw bone and there is a salivary gland that lies just under and on the inside of it called the submandibular gland. As Dr. Shredder walked up to the table I was saying out loud to Doublestuff that all we need to do was locate the submandibular gland and we should be able to find...

"The submandibular gland? It's right here!" Dr. Shredder yells as he plunges his fat finger deep under the cadaver's jaw and wrenches all the muscles free from the bone. He then points to a round structure and proclaims "That's the submandibular gland, right there! No thanks necessary." and struts off to the next table. I look back at the tattered remains of our poor donor's jaw musculature and notice that what the good doctor was calling a gland was actually the jaw bone itself, freshly exposed by his ham-fisted dissection technique. Whereas before I was merely pissed, after that I was motherfucking livid.

I'm sure these physicians mean well in their efforts to help the students in the lab. Honestly, some are good at the dissections. And yes, I am a weeeeee bit of a control freak. I think the core of my issue is that doing a good job on the bodies serves no interest of theirs. If Dr. Shredder messes up the dissection today, does he care? Are there any repercussions in his life? No. Tomorrow at this time he's back in his ENT clinic writing his 30th Flonase prescription of the morning and still pulling down $250K a year. My lab partners and I? We on the other hand are not so lucky. We get the fun of wandering the anatomy labs looking for another group willing to let us look at an intact digastric muscle so we can identify it on an exam.

"He went well, it's done now"

Da Mullet, 2004-2006
He was a really good dog.

"The knowledge that I can fracture my penis when it's erect gives me erectile dysfunction"

Awwwwww. The University of Spoiled Children didn't win.

Travesty.

Here's the crazy, Fody-cent predicted it last week. This is a pic from a NYC bar tonight at a certain point in the game. Maybe there was 19 seconds left? Can you discriminate the Texas fans from the USC fans?





The quote is from a seminar that a urologist gave us today about male sexual dysfunction. Apparently you can fracture your penis, but only during sex and while it is erect. Is it any wonder that erectile dysfunction is the #1 sexual problem among males of any age group?

"Looks like Fody-cent is going to go get rid of a little seminal fluid himself"

So, long time no write. Yeah, I know, it's been a while. Not sure if you knew this or not, but Med School can get just a little busy at times. Alright let me see...where did I leave off...Sept 16??! September fucking 16th? Why the hell are you still checking this page? I guess Pavlov was right, behavior does persist longer if reinforced only occasionally. Well, I thank you for your persistence and I hope the entries will be more regular from now on.

So what's been going on in the life of a (now) 37-year-old 1st year med student? OK, in my favorite format:

1. The histology course came and went, and good riddance. That class made the line at the DMV on the last day of the month seem exciting. Staring endlessly at pink and blue and yellow dots, waiting for them to assemble miraculously into a fully realized and understandable structure is best left to the acid freaks in the Haight.

2. We have a course called MCFM. It's this monolith of a molecular and cellular biology course that is designed more to maim than actually kill. I think there are 8 units in total to this thing, of which we have completed 4. Genetics, Immunology, Cancer Biology and Energy Homeostasis - that's glycolysis and Krebs to you sci-nerds. That's right, for the 4th time this life I got to memorize glycolysis and that fun-loving bastard, the Krebs cycle. We're now starting a unit studying carbohydrate metabolism. Seriously, that's even more boring than it sounds. But we do cover lactose intolerance; any lecture that explores the intricacies of explosive watery diarrhea is aces in my book.

3. Introduction to Clinical Medicine (ICM) or, loosely translated, how to tell when your patients are lying to you. Apparently, the clue to knowing if your patient is lying to you is if their lips are moving. This is a class where we learn to interview patients by talking to actors and other assorted people they pay to be interviewed by us. Also, once or twice a week they let me loose in the hospital to wander around completely confused as the real doctors do their business. Due to my age, on more than one occasion I have been mistaken for an attending physician. About the third time it happened, I just went with it, wrote myself a prescription for Oxycontin and took a long nap in the bedding storage room. Good times.

4. Clinical and Developmental Anatomy (CDA) started the day after Halloween. I went this year as the dearly departed Hunter S. Thompson. This choice of costume, coupled with the average birth date of my peers here, resulted in my sounding like this the entire night:


"Hunter S. Thompson...the writer..you know, 'Fear and Loathing in Las Vegas', 'The Rum Diary' and 'The Great Shark Hunt'?...no, no, no, not a shark hunter, Hunter S. Thompson...the Rolling Stone writer?...Gonzo journalism?...nothing?...what?...yes yes, Johnny Depp in that one movie with Benicio DelToro...you fucking imbecile"

Anyway, our first day working in the cadaver lab was the day after Halloween. Many of my less wise classmates visited the restroom several times in that 3 hour period. My lab group and I (Me, Minerva and DoubleStuff) were assigned a "donor", as they are called, who was an 84-year-old woman. She is 4'10" and everything on her is in miniature. I often realize that, were I in any other vocational pursuit, they would lock me up in a rubber room and slip raw meat under the door for the next 50 years for doing what I now do for 3 hours a day 4 days a week. And I love it. I love anatomy lab so much it is frightening. It's my favorite class of all time.

My instructor for the lab is Dr. Cutty. Well, that's not his real name, but it sounds very close to that. Anyway, he's this late middle aged HIGH-larious, half perverted guy. We were in the review portion of the class before our first lab exam and he was doing a demonstration of the male reproductive organs. He dissected one of the organs and some fluid started seeping out of it and he casually mentioned that it was probably seminal fluid that is naturally found in that organ. One of the guys in the lab, Fody-cent saw it and said in a nausea-laden voice that he needed to go to the men's room. Without a pause or even looking up from the table, Dr. Cutty said "Looks like Fody-cent is going to go get rid of a little seminal fluid himself". Ah yes, crass medical gallows humor at it's best.

So that's about it. I also get down to "The City" occasionally. Every so often I go to the NYC Public Library to study. You may remember it as the building in Ghostbusters where the lion statues come to life.
I also hang out with med school buddies there. Here is me keeping it real with my west-side pride on the right coast. That's Fody-cent with the Budwiser. Great taste in beer that kid. Well, until next time, Mahalo.

Oops, I almost forgot to mention the cute little caffiene monkey I loaded onto my back along the way. I had been clean for about 8 months prior to starting school. No BS, I kicked a 6-pack a day Diet Coke habit last winter and since August, have relapsed to the Diet Coke addiction, and added occasional coffee for good measure. This morning I drank 24 ounces of Mt Dew in about 38 seconds. Now I'm strung so tight when I scratch my pubes they sound like guitar strings plucked at the top by the tuning knobs.

"I want one in each hand and then I'm going to blow"

Happy New Year to all. A good resolution would be to be more attentive to my blog. We'll see. I'm going to give it a shot. I'm sure the three of you that still check here occasionally are beside yourselves with glee.