“Live as if you were to die tomorrow. Learn as if you were to live forever.” ~ Mahatma Gandhi
College life was fun. Not only because of the pleasure we had with our extra-curricular activities, but also because we loved what we were doing. Admissions into medical colleges were and still are quite difficult. Only those students with high marks are considered for admission, and not everyone is chosen. At that period of time very few seats were reserved for women, and the competition was fierce. Thankfully, that isn’t the case anymore, and the establishing of an all-women’s medical college launched opportunities where in the past there were none. The majority of the students were happy to have been given a chance to become doctors and provide future healthcare to the people, especially to the female population of the conservative villages in the country.
Reading the history of female doctors worldwide, I did notice that in the past, women had to either disguise themselves as men to be “allowed” to study medicine, or they were consistently ridiculed for even thinking that they could be “good enough” to compete in a man’s world. One had to be strong and thick-skinned to survive. And survive they did, paving the way for the modern female physicians. It was seen quite early on those women did excel in this field, and today, all over the world the ratio of women to men medical students is steadily increasing. There is a sort of passion intertwined with kindness along with inherent medical intelligence that drives us. I definitely suppose it’s more about the patient than the paycheck (though a healthy paycheck does sweeten things). Or so I would like to believe.
When one is interested and loves what they are doing, studying doesn’t seem like work, and in the first couple of years in college, we happily used to spend hours poring over anatomy specimens and studying bones in painstaking detail. It wasn’t unusual that we even used to fall asleep with a human skull or a femur near us. You could have without any doubt found a small bone if you had put your hand in one of our pockets. That wasn’t too bad. Undoubtedly, I think that is normal for any medical students all over the world. The disgusting parts were usually when we used to eat meat in the cafeteria, and some bright spark would come up and ask how our gluteus maximus, or deltoid tasted that day….. It took me quite a while to start eating meat once again, and even then, I prefer chicken if at all.
As it is, the food served was variable in variety and quality. Sometimes we would go back for seconds and other days….
I do need to mention here that one day we were served meatballs that were so hard they bounced. My friend Laila was playing with her food, and was trying to bounce the meatballs on the table, when one of them slipped towards the entrance of the cafeteria as fast as a projectile. Coincidently, I walked in just at the right moment, fielded the meatball and handed it back to Laila with a flourish and a bow. My friends still giggle about it because at the time it was considered quite hilarious.
Once, during the summer holidays, I was able to borrow a human skull from the college and took it home to study. You see, the base of the skull is the most complicated bone in the human body. That is because it has so many openings, and we had to learn every nerve, artery, or vein that passed through a specific foramen. I really needed to study the bone intensely, as our first professional final exams were just a month away. And I definitely wanted to be proficient and have the names of the structures just flow off the tip of my tongue when I was called for my viva voce. It’s interesting to know that the commonest mistake I heard a student make while discussing the skull was that they thought the food passed through the foramen magnum… This is one of the most prominent openings on the base of the skull through which the spinal cord passes when it exits the cranial cavity. (Hey dude, did you actually study?)
Well, here I was sitting in my room at home and concentrating on studying the said skull. While reading and trying to co-relate the structures with the descriptions in the book, I had used an eraser as a fulcrum and had fitted the tip if my pencil in the front gap of the skull’s maxilla where a tooth was missing. As I continued to read, I absentmindedly moved the pencil up and down, and the skull looked as if it was nodding rhythmically. It must have looked hilarious, but I didn’t give it another thought, after all I was used to being knee deep in human remains. So here I was innocently perusing my enormous Gray’s Anatomy tome and was in my own world till dusk, when I unexpectedly heard a high-pitched scream from the corridor that startled me. It was my brother, and he had this absolutely terrified look on his face. He started to shout at me that I should be careful because the skull was moving! Of course, it was! I was the one moving it! After he took a deep and calming breath, he explained that he had walked into my room to let me know that dinner was on the table, and since the only light in the room was the island of light created by my table lamp, he was startled when he saw the skull move in the dusky gloom. Rest assured; I still tease him about it to this day.
As the days went by, and we became more proficient with our dissection skills, I started to get the impression that dissecting a human body was like working on an archeological dig site. One couldn’t just pounce on the body and extract the parts and organs that we needed to study. The nerves, veins, arteries, and muscles are bound together by fascia and fat, that are very flexible when one is alive, but stiff and paper-like when seen in a mummified body. Our most commonly used instruments for dissection were forceps and scalpels. The accepted methodology was to demarcate areas (like a dig site, isn’t it?), and to scrape the skin and fascia slowly and gently off the muscles, as well as venous, arterial, or nervous systems to identify their origins and where they were heading. If one thought about it, it was quite beautiful, like some intricate work of art. Just to see what the Creator made in the human body was so interesting and actually awe inspiring. Every little bit has its uses, and there is beauty in every part isolated. However, just a little slip or cut would be enough to spoil the whole specimen.
I remember watching a science fiction movie called Fantastic Voyage where a submarine was shrunk to microscopic size and after they were injected into the blood stream, the doctors travelled in the submarine to perform surgery on an inaccessible tumor in the brain of an important scientist. I was fascinated. The movie showed how the submarine and the scientists travelled throughout the whole body, especially the lungs, liver, heart, and the kidneys. I thought at the time that the props and mechanics were amazing. I’m not sure how I would feel if I saw the film now, but suffice to say, it addressed the working of the human body in a delightfully scientific way and it had thrilled my adolescent heart.
Obviously, we were quite clumsy as first year students, but our experienced demonstrators were able to make beautiful specimens for us to study. It goes without saying that these specimens were extremely important to educate us in the working and structures of the human body since the correlation of the systems in a real human body with the garishly colored Plaster of Paris models that we know from middle school was quite difficult.
It so happened that in our enthusiasm to excel, we started to focus on the “specimen” part of the studies rather than the “human” part once we got used to handling them. The general attitude was that if we would think that these were once upon a time, human beings, who lived and loved just like us, it would have created fanciful, even scary thoughts and a barrier to proper learning. It was no surprise at all that the specimens that were supposed to be stored in the anatomy museum, would sometimes make their way to one of the students’ rooms where group studies would take place in the dark nights like budding cults with the same creepiness and membership criteria.
Inasmuch, there were times when the specimens available to us were limited, so to compensate, a large group would crowd around a dissected body and eagerly discuss nerve pathways, organs, and muscle movements. It would be a bonus if we could get a demonstrator to help us identify the bits and pieces excavated. Sometimes, one was pushed against the body, and no one thought twice about it. That is apart from having the smell of formaldehyde coming out of every pore and every bit of clothing we owned including our underwear. As the days passed, we continued to dissect the bodies, sometimes even without gloves so that the finer structures could be felt with our more sensitive fingertips. The downside was that the skin of our hands became hard and tough. That was predominantly due to the preservative and mummification properties of the formaldehyde the morticians used in the bodies. It was an uphill task to get them to soften even with the most expensive soaps and lotions. Acne was considered normal in the first-year students, and we would know when someone just came back from a short holiday, because their faces would be glowing, smooth and pink. Our general wellbeing and sense of smell became better only when we went home for short breaks during the college holidays. It was good to feel “normal” again even for a short while.
Nevertheless, no matter what the attitude, I believe there must still be some connection with the spirit and the body especially in such unusual circumstances as ending up as an anonymous entity and being cut to a million pieces in a dissection hall of a medical college. And I have proof! I know some people might call me fanciful or strange, but I am sure that the encounter that I had one dark night showed me once again, that even though we are being taught structures and human mechanics by the bodies in the morgue, we still need to think of their humanity and thank them for being the reason that we could be taught well.
The story I am about to tell you happened one extremely busy day when we were crowding around a dissected body while an anatomy demonstrator was lecturing us about the nerve pathways in the arms leading to the thorax. Sometime during the lecture, I was suddenly pushed forward by a student who had climbed onto a stool behind me and was leaning over my shoulders to get a better view. What was more, my elbows were not very gently pushed against the torso of the poor hapless body. Obviously, I didn’t think twice of what happened, and continued to stay in that position as it gave me a better view of what the teacher was pointing out and trying to explain to us.
That night, around one AM, I was suddenly woken up by the sounds of a furious electrical storm that lead to a city-wide power outage. The sound of the wind blowing through the trees was just as frightening as a B-Grade horror movie. It was extremely dark with not even a sliver of light seen anywhere. It was oppressing, hot and quite disorienting. I felt as if I was in a dark box with no way to claw myself out. When I had suddenly woken up from my deep sleep, I felt a sharp and continuous pressure on my chest. It wasn’t painful, it just felt as if something heavy was pressing down on me. As if I was being leaned upon by someone heavy and strong. I was terrified, but even if I tried, I couldn’t utter a sound or move. I tried to look helplessly towards my sleeping roommates, but I couldn’t see anything in the absolute darkness, and I also knew that they would not be able to help me in any case. There was an intense feeling of claustrophobia, and I was sweating profusely and yet my hands and feet were ice cold. Just when I thought that I wouldn’t be able to stand it anymore, I heard a hollow voice ask me how it felt to be leaned upon. I was terrified and immediately recited a protection prayer. Then I vehemently promised the unseen voice that I would up the ante for respect of the dissected bodies in the morgue as well as those alive or dead, that I would be encountering herewith in my professional life. It was only then that I felt the pressure diminish, as if I were released from an ominous hold, and I immediately fell into a deep dreamless slumber.
This incidence disturbed me for days. I tried telling my friends, but I only encountered ridicule and skepticism. Or I was told not to scare them with my ghost stories. But I know what I felt and saw. Without doubt it was quite disconcerting. But to this day, I have kept that promise to the entity of that dark night to the best of my ability. And I actually did feel lighter and happier because of the pledge that I made, as a terrified medical student. It has created an understanding in me to underline empathy and kindness that every patient coming to a doctor for treatment, has the right to receive. I believe those two principles are the foundations of good clinical practices. Even if we prescribe the best treatment in the world, a kind word or look, a reassuring squeeze of a shoulder and a gentle demeanor is the icing on the cake towards excellent medical care.