Sunday, September 25, 2011

Scatterbrained and other thoughts

Hard to believe that there is only a week left of Gross Anatomy.  We have moved from the pelvis and abdomen down to the thigh and calf.  This week we'll learn the ankle and foot, review for a bit, and then take the final the day after General Conference.  Beyond that, we start Head and Neck and then hopefully I'll be back into more familiar territory with molecular biology and biochemistry.

It has almost been a year since I played flag football and tore my face open from lip to chin.  Almost as if in commemoration, a few classmates and I decided to try a game on Saturday and had a wonderful time.  I can tell you that my pectineus, adductor longus, semimembranosus, semitendinosus, biceps femoris, vastus medialis, gastrocnemius, as well as my rhomboideus minor AND major hurt really bad.

Being executive secretary with 9 am church means I'm there at 6:45 for a bishopric meeting and then after for either ward council or priesthood executive committee.  I decided to ride my bike so that C and S wouldn't have to be late and so that I could stay as late as needed.  After church, I sent them home so C could take a nap and decided to poke my head in the door to see if Bishop Filips wanted me to stick around for the interviews.  I was counting on being there Tuesdays for interviews just to have someone else in the building, but wasn't sure if I needed to be right outside his door on Sunday.  We asked a high councilor who said that according to his understanding I could leave because there were enough people around.  In the time it took for that conversation to come to a close, the weather went from mostly sunny to overcast and rainy.  I haven't yet heard a weatherman forecast for this area, but I would venture a guess that it goes something like this:  "Today we are going to experience all four seasons..."  So after a lovely bike ride home in the rain I walk in on S making pizza for lunch and decide that all is right in the world.

We started potty training C this week.  It is almost easier to keep her in diapers because she goes almost every five minutes.  She drinks so much and there is no block from in to out.  This will be a wonderful obstacle to have behind us.

As I've read this and a few other of my older posts I am struck by how scatterbrained it all sounds.  I am afraid my journal is having an identity crisis.  The point is exacerbated by an article I read recently about the possible mechanism of crucifixion and burial in the 1st Century AD.  There does not exist a description of the exact mode that crucifixions in the time of Jesus were carried out because the writers at the time could assume that everyone in their audience had seen one firsthand. To a large extent I take my life and my experiences for granted not knowing what may or may not be important in the moment.  Also, I do not have the wonderful talent of being able to take out the trash and have a riveting story to tell about the mundane experience so I try to think thoughts in a new way to offset the poorly formed narrative of my life.

This is a calcaneus bone from the foot with a nail projecting medially through it.  The point of the nail is curved into a hook because presumably it hit a knot in the olive tree it was nailed into.  For that reason the soldiers were unable to remove the nail to reuse it and the body was buried with the nail as shown.

Monday, September 19, 2011

Sunday, Sept 18

We took our second test on Monday and found out the scores the next day.  Class average was 72% and I got a 60%.  I wasn't feeling very stellar, but neither are about 40% of my classmates who scored below the 70% passing score.  I did well enough on the practical part (88%) that I still have a passing average in the class, but I never thought I'd even face the possibility of failing.  Retaking the course over the summer would not be a fun thing to deal with.  I'm still trying to figure out what happened and pull myself together.  We have one more test for the course and then we start the next intense course.

I like that there is only one difficult course at a time interspersed with weekly supplemental classes like Physician and Society where we talk about sociology, ethics, etc.  Another class is Interprofessional Education which emphasizes how to get along with nurses, pharmacists, veterinarians, various technicians.  There is also a course set up kind of like the TRC in which we have actors playing as patients with various symptoms and situations (talkative, depressed, suspicious, poor, unintelligible in English, etc).  The goal is to take a history and physical and then write a SOAP note that is broken down into the subjective history you gather from the patient and the objective findings from the physical and examination.

Physician and Society could be interesting if the ideas from the current teacher were more developed.  The first part of the course was very eye-opening when we were discussing chronemics (timing), proxemics (personal space), haptics (touch), oculesics (eye contact), adornment, and other unspoken aspects of nonverbal communication between various cultures during conversation.  This teacher has written the unwritten rules of culture...but I'm sure Chuck Norris helped.  Anyway, it helps explain behavior on elevators and other tight places as well as why German trains are always on time, but Italian trains are not.  He recommended that if you want the best treatment from a doctor possible, go dressed in a suit and when they ask about your work, say you are a lawyer specializing in medical malpractice. There is an unconscious bias to treat well-dressed professional equals better than the poor or uneducated.

Recently, we watched a documentary about the progression of eugenics (mercy killing) during Nazi Germany and have been focusing on ethics.  The ethical lessons are so underdeveloped that most of the class leaves.  At the end of last lecture there were ten of us left and half were playing Angry Birds.  The lectures are broadcast from the mother campus real-time so there isn't the same pressure to stay.  I also disagree with his premise that those who can provide medical care to a society are required to do so as though by our choice to study medicine, society somehow owns our occupation.  I prefer to think in terms of simple supply and demand economics which means that there is a price below which I will refuse to provide service.  Call me callous, but any pro bono work I do will be out of the goodness of my heart once I can afford it.

Friday, September 16, 2011

When you have an image to protect...

...and your music is sub par, it will be the coolest song ever with a Rube-Goldberg machine.  Nuff said.


Best music video ever.

Sunday, September 11, 2011

Sauropod Surgery

We have our test on the abdomen and thorax tomorrow.  That means we are covering the heart, lungs, diaphragm, stomach, liver, pancreas, and both the small and large intestines.  We have different teachers than we did for the back and arm.  In fact, each section has its own instructor; in this case, we have an integrative biologist teaching the thorax and a surgeon teaching the abdomen.

Each teacher stresses different things.  During the mostly muscular section of the back and arm, the emphasis was trauma and the deficits you would expect depending on the nerve or artery that was severed.  For the abdomen, the surgeon stresses orientation and positional relationships as well as problems that may arise from development (hernias, vitelline duct not closing, malrotation, etc).  I'm not quite sure what the integrative biologist stresses, but I do remember him showing us pictures of places he has gone to do archeological work and he once stressed that the recurrent laryngeal nerve starts in the brainstem with the vagus nerve, courses through the neck, loops under the aorta on the left or subclavian artery on the right, and returns to the neck to innervate the vocal cords.  The reason he thought this was so cool was because giraffes do the same thing and evolutionary relatives such as the diplodocid sauropod must have had nerves 92 feet long.  Those are big cells.  Anyway, I'm not sure how his 25 questions of the test are going to go.  Hopefully, he just sticks to human medicine, although it would be pretty sweet to be able to tell people that I am certified to perform vocal surgery on dinosaurs. 


In the lab, we have a Scottish instructor who helps with the dissections, radiology, and identification of structures.  During a review he asked a question and I gave him a bad answer.  With a half-smirk on his face he told me, "Bloody ---, you give me an answer like that and you better do the honorable thing and fall on your sword like people used to do."  His tongue lashings are rather severe, but he tirades in such a way that most people just laugh it off.

Anyway, I got home from studying late last night and my phone had run out of batteries.  Consequently, S told me upon arrival that the bishopric wanted to meet with me.  The bishop left to Afghanistan with his brothers on a business venture and may or may not be back by Christmas.  Some restructuring was possible so I breathed a sigh of relief when she said it was the bishopric and not the stake president.  Turns out when we showed up for the meeting that it was in fact with the high councilor.  He asked me to be the ward executive secretary.  I told him I was willing and he said, "Now I'm a dentist so I know that you will have time for this calling even while you are in medical school."

Sunday, September 4, 2011

Apto and Logos

In Elder's Quorum today we had a lesson about Joseph Smith and his call to be a prophet.  During the lesson, the teacher asked, "Have you ever read a different translation of the Bible that is perhaps easier to read?"  and then proceeded to explain the horrors associated with a Biblical translation bereft of prophetic guidance.  The class was in full agreement and in the spirit of unity, I declined to share my thoughts on that occasion, but I have included a few examples as a rebuttal to his position.


First of all and most obviously, the Bible translation that is currently endorsed by the Church we believe was inspired but was prepared without prophetic guidance.  Is it at all possible, I wanted to ask him, that others with the same enlightened spirit could offer in some cases a better translation?  I have included two examples that have long confused me.


μη μου απτου (Touch me not)


John 20:11-17 KJV 

11 But Mary stood without at the sepulchre weeping: and as she wept, she stooped down, and looked into the sepulchre,
 12And seeth two angels in white sitting, the one at the head, and the other at the feet, where the body of Jesus had lain.
 13And they say unto her, Woman, why weepest thou? She saith unto them, Because they have taken away my LORD, and I know not where they have laid him.
 14And when she had thus said, she turned herself back, and saw Jesus standing, and knew not that it was Jesus.
 15Jesus saith unto her, Woman, why weepest thou? whom seekest thou? She, supposing him to be the gardener, saith unto him, Sir, if thou have borne him hence, tell me where thou hast laid him, and I will take him away.
 16Jesus saith unto her, Mary. She turned herself, and saith unto him, Rabboni; which is to say, Master.
 17 Jesus saith unto her, Touch me not; for I am not yet ascended to my Father: but go to my brethren, and say unto them, I ascend unto my Father, and your Father; and to my God, and your God.


Now, before we start talking about the metaphysics of a resurrected being which invariably sparks late night discussions among missionaries, let's take a closer look at the Greek word for 'touch.'  The lexicons give a few definitions of the Greek word which is translated here as 'touch': touch, hold, take hold of.  The JST of this verse changes the word touch for hold.  Believing the simplest explanation to be best, it is more likely that Mary, realizing who the "gardener" was, embraced Him.  When it was time to part, I imagine Christ gently telling her, "Stop holding me.  It's time to let go.  I haven't even been to see the Father yet...etc."


According to Dana and Mantey, authors of the A Manual Grammar of the Greek New Testament,
the phrase is written in the present imperative and that a prohibition in the present imperative demands that action then in progress be stopped.  The difference is slight, but important as in "Don't eat," which has a different meaning than "Stop eating."



17 λε   λεγει αυτη ο ιϲ μη μου απτου ου πω γαρ αναβεβη κα προϲ τον πατε ρα · πορευου δε προϲ 
τουϲ αδελφουϲ   και ειπε αυτοιϲ · ϊδου αναβαινω προϲ το πατερα μου και πα τερα ϋμων · και θν 
μου · και θν ϋμων · 



Logos


I believe some things like names and titles should remain untranslated.  The opening canticle of John is a perfect reason why.  


      1:1α
γ

  1. εν αρχη ην ο λογοϲ και ο λογοϲ ην  προϲ τον θν και

       In the beginning was the Word, and the Word was with God, and the Word was God.

2
2. θϲ ην ο λογοϲ ου τοϲ ην εν αρχη

     He was in the beginning with God.     

3
3. προϲ τον θν πα τα δι αυτου εγενε το και χωριϲ αυτου εγενετο ουδεν ˙

     All things came into being through him, and without him came into being not one thing that is in being.

4
4. ὁ γεγονεν · εν αυτω ζωη εϲτιν · και η ζωη ην το φωϲ των ανθρω

     In him is life, and the life was the light of men.     

5
5. πων · και το φωϲ εν τη ϲκοτια φαι νει και η ϲκοτι α αυτο ου κατε λαβεν ·

     And the light shines in darkness, and the darkness comprehended it not.

During seminary and other lessons on John 1, I was unsatisfied with the answers of the teachers and students about what the heck John is talking about.  Why does he say the 'Word' capitalized and say things about the 'Word' that we ascribe to Jesus?  Why couldn't he say "In the beginning was Jesus, and Jesus was with God, and Jesus was God."?

Various answers I heard were, "It refers to Christ as the author of the Gospel," or, "The 'Word' means scripture was with God and, okay it's not a perfect analogy," or some other behemoth falsity.  Turns out in Greek, 'Word is translated from λογοs or logos.  It literally means 'word.'  Any word as it turns out, but then why 
capitalize it?

Not until you go back to around the time that John was written (circa 90 AD) can you understand the context  
surrounding logos.  There was a Hellenistic Jewish philosopher named Philo who diead around 50 AD.  He 
borrowed the title logos from the Greeks and applied his understanding to it.  His writings are rather dense
and require a working knowledge of Platonic "idea" principles, but simply, Logos is the bridge or intermediary
between matter and Plato's perfect idea.  Philo wrote that Logos is "the first-born of God...the Logos is the 
living God which is the bond of everything, holding all things together and binding all the parts, and prevents them from being dissolved and separated."

So when the authors of John introduce  logos, they are using a popular concept and claiming that the 'Logos' 
everyone is talking about is Christ.  John says, "Hey, Logos and Jesus are the same. Listen to what Jesus says."

Unfortunately, the title Logos got translated to English as Word and Tyndale couldn't have forseen 
that when he sacrificed the title for poetic cadence, a generation of incurious teachers would hand down
poorly drafted ideas about what John 1 actually means. I would have left it as "In the beginning was Logos
and Logos was with God and Logos was God."

Another Week

On Wednesday we found out the score to the anatomy test we took the Friday before.  I got about an average score with an 79 on the written and an 84 on the practical.  The scores were prefaced by one of our instructors with "shame on you for not spending more time in the lab and shame on us for not making that clear."  We found out later that the practical test we took was significantly more difficult than the test our classmates in Pomona took.  Since class rank is relatively important for residency applications, most students in Lebanon advocated evening the playing field.

I don't think I have explained before the structure of WesternU. In 1979 the College of Osteopathic Medicine opened.  As the school expanded to include dentistry, podiatry, pharmacy, and veterinary sciences the administration changed the name of the school to indicate its a university.  Now, an extension has opened up.  Technically, we are the same school and most of the lectures are broadcast real time to us.  This means that we are not only compared to the students here, but also to the mother campus making a large class of over 300 students.  Synchronizing events, bureaucracy, access to teachers, and class officers has been a little rocky.  I thought when I came here the school would be more divorced from the mother campus and that is the eventual goal.  However, problems with accreditation from the AOA are a possibility and the school is planning to advocate in January for independent accreditation for the our campus on the condition that the same lectures are available at the same time.  When a brand new school opens, there is a four-year probation until the first class graduates and the minimum standard on the licensing exams has been met.  Since we are not technically a new school, we were granted accreditation status on the condition that the lectures and curriculum were broadcast to both campuses.

We began learning this week about the structures in the thorax and abdomen: lungs, heart, stomach, intestines,  liver, etc, their embryologic development, the nerves that innervate them, and their blood supply.  Our next test is two weeks after our last one, so it's coming up next Monday.  Shelli and Chiara are thriving in their new home.  Chiara has all the friends she can handle, but not enough hours in the day to play all that she wants too.  Shelli has also made some close friends among the wives of other med students.

With the risk of appearing snobby, I present the following as mistakes that should never be made.

Unswavering is not a word - I think the speaker meant unwavering as in 'unwavering loyalty.'

Superfluous does not mean obsolete - "I am from the pre-digital age and with all the new technology, my profession has become superfluous." Superfluous means more than enough as in 'two cherries on top', or an unnecessary addition.

Supposedly does not mean supposably - Supposedly means 'allegedly, or purportedly the case.'  Supposably means 'capable of being supposed' as in 'believable.'

There is no word 'irregardless.'

Click here for more.