Saturday, March 6, 2010
30000 idiots……. (learning to cure –Part 1)
FLASHBACK (in 24 bit colour....I’m not that old for a black and white/Eastman color flashback)
1995, February….anatomy dissection hall, Medical college Trivandrum.
Scene – half asleep, gangly, geeky, nerdy guy (The character in this flashback may look, talk and behave nutty like me , but is not me....similarly the other characters may resemble real life nut-cases, but that obviously is just co-incidental ;) .The first person narration is purely for my own ease) looks through his thick spectacle lenses, with a sense of ‘shock and awe’ at the specimen of a dissected human upper limb placed in front of him (His mind is pretty blank as usual but at least now he realizes why this stuff is called ‘gross’ anatomy).A slightly more gross, but live, human form is staring at him through thick-lensed, thick-framed spectacles, across the table – no awe ,just shock….mixed with equal measures of disgust and contempt – my anatomy examiner.
“Tell me the surface anatomy of the ulnar nerve” Madame X threw her question at me with contempt (ps: the names have ABSOLUTELY nothing to do with the glamour quotient of the characters in questions….it is purely for sake of being unidentifiable).
“Uh…the ulnar nerve…duh….it’s surface is …er…smooth..??” I am sure Madame x does not have a high opinion of rhetorical ,dumb questions as answers to her straight questions…but c’mon I wouldn’t have answered that way if I was sure of the answer would I? Besides from the specimen I had in front of me the ulnar nerve did look kinda smooth.
Madame X’s anatomy ,physiology and biochemistry all got quite ruffled it seemed.The lady was turning various interesting shades of purple and blue.
Madame X upped her ante.
“Tell me about the elbow joint”
This was easy
“The elbow joint…..it kind of folds at the elbow…”I even demonstrated this magical phenomenon for her sake.
Madame X wasn’t impressed, unless it was routine for her eyes to pop out of their sockets when she is impressed.
Madame X was at loss for words (Expletives actually) “ Have you ever attended your dissection classes??????”
Now that was taking it too far.I mean the dissection classes were THE place to discuss movies, cricket, girls, non-existent love lives, ....I mean we even discussed Shakespearean literature....”To pee or not to pee” was a constant dilemma haunting our tortured souls.
Anyway the point was I did attend dissection classes .......very regularly.
“And what pray did you do in these dissection classes?sleep?”
I would’ve liked to explain how the previously mentioned activities kept us wide awake during dissection hours, but Madame X obviously was really not into that empathy thing.
Next she went right into the heart of the issue (forgive my rotten puns) and pulled out a formalin preserved section of a human heart from the steel tray in front of her.
“Tell me about chambers of the heart”
I didn’t have the heart to do this (there I go again), but adventurous that I was I quickly pointed with my quivering index finger to the 4 shrunken cavities -this,that,this this.....chambers of the heart” So there.
Now madame X obviously was interested in hearing a wee-bit more detailed explanation- like the names of the chambers for a start, but she wasn’t going to pry it out of me that easy.Brevity was always one of my innate strengths...especially when answering in Viva exams!
There was a grave expression on her face now “Hmmm ok...I’ll give you a last chance” Her hands reached out to a set of polished human bone lying on one corner of the table. She meticulously selected five of the bones and handed it across. With the kind of mood she wouldn’t have been surprised if she just threw them across the hall and said “Fetch”
“OK...identify each of these correctly and I’ll give you a pass grade”
I looked with an even graver expression than hers on the remains of some poor soul who was probably watching me from up there and laughing away to glory.
So now 5 distinct, interesting looking bones, stood between me and failure.
I picked up each specimen gingerly like those guys would do in CSI Miami (Only difference was here the murder was not yet over...though you could never tell when madame X would tip over and do a little dissection on me)
“This is the..er....hmm.....femur”
Slightly amused expression on Madame X’s face.
“This here is ah...a humerus.....?!” Smile on Madame X’s face ....maybe that was humorous to her.(That's the last bad pun, I promise)
“This is definitely a tibia” Smile + surprise?
“This one is a Fibula” Smile 2x + surprise 3x
Now I picked up the last long bone from the pile, gave it a good look...and realised that I was at the end of my luck...
I kept silent for a minute. By now Madame X was beaming and writing something on the sheet of paper in front of her. Seeing that I was maintaining my silence she pushed the sheet in front of me. A big zero stared back at me.....it was all over....I was crushed.
Madame X was still smiling though and as if to rub salt into my wounded anatomy she tapped on the elaborately drawn zero with here pen again, this time drawing a line right through the middle of the zero. OK...so now she feels that even a zero is too good for me!!!
Now she looked curiously at me ...and again tapped the centre of the zero.
What the heck....???????
I passed the exam; though it took a while for me to understand that the honourable Madame-X was actually trying to help me by drawing what she thought was the radius of a circle. Don’t you get it?...line through the zero is a diameter and half of that is the radius and well the bone in my hand also happened to be a radius etc. Etc. After the exam I thanked Madame X profusely for her leniency. She replied that she had earlier had a look at my theory marks (Which were not all that bad, I might mention) and so assumed that I was just having a bad day at the office and so didn’t want to flunk me......besides I got my bones right...right?!
Post-script to post-script
The truth is that theory exams are easy meat for anyone who cares to sit and mug up the whole curriculum...but to apply the same practically you need to understand what’s going on why and how exactly. I never did make an extra effort for that during non- lecture classes like dissection sessions (It was understood that lecture classes, like night, were created by god for rest and sleep) and honestly neither did most of the tutors around inspire me even remotely to make an effort. It was basically mug and vomit. The more eloquently you vomit, the better you score. Interesting having a thorough mugged up knowledge often helps you through viva sessions also because many of the viva examiners are really no better than a theory exam. Evaluation of students is also an art in itself I suppose...an art which unfortunately very few medical teachers care to master. There are around 450 Medical colleges in India, churning out about 30000 doctors and scattering them all over the country and abroad. This still falls far short of an ideal doctor to population ratio …..that however is a different issue altogether.
What set me thinking of penning this bit was the movie ‘3 idiots’. I am sure a majority of those who had seen the movie would identify at least partly with ‘learn by rote’ system satirised in the movie. I can obviously speak with authority only for my own medical education (actually my undergraduate medical education..... because I was blessed with some fantastic teachers during my specialisation period) and I must say when I was doing my under-graduate medicine, the only route to take for ‘success’ was the ‘rote route’.
Medical education is apparently undergoing changes. There ARE a lot of faculty around who are really interested in changing things …..and things ARE changing…at least they’re beginning to….but back then things were quite different...