Lecture 1

The word anatomy comes from the Greek word temnein, which means “to cut.” I know this because it was the very first Anki flashcard I ever made, on my very first day of medical school. I made it because Dr. Laitman told me to, in Lecture 2 (Skeleton), slide 25: Start learning these “generic” terms. Make your own little dictionary. Most terms are from Latin or Greek, with occasional terms from old English and Arabic. Enjoy!

I made a total of 2339 Anki cards for Anatomy. But by the time I reached 500, I felt a sense of unease. In my haste to learn the new material, I was neglecting the things I had previously studied. (The thymus? What was that again? And that thing Dr. Reidenberg said about the medial and lateral pectoral nerves… eh?) The cards were building up—I could picture myself drowning in them, as if the grey text boxes I clicked through each day had escaped my laptop screen and transformed into white three by fives with sharp corners digging into my skin. A few of my friends felt the same way. “Man, I already forgot everything we learned before the midterm. I feel bad.” “How the hell are we expected to know all of this?” I wrote an email to my peer mentors (second and fourth year medical students) about my dilemma: should I attempt to retain all the knowledge I’ve gained or just give up? They responded a month later, after Anatomy ended. Their answers were, more or less, give up. Focus on the useful things. Anatomy, they said, is not a useful thing.

That was an answer I heard over and over. The stuff you learn in Anatomy—or many first year classes, for that matter—is useless. Focus on what’s clinically relevant, the “high yield” material. Don’t waste your time on the little details. In Gray’s Anatomy for Students, there are green boxes scattered throughout the textbook with clinically relevant information for the structures described. But our course syllabi told us to skip those sections unless we had extra time. I hardly had time for the required material, let alone the bonus stuff. Yet it seemed as if the boxes were the important things, and I was wasting my efforts on useless details. Who cares about the left recurrent laryngeal nerve? Why did I stay up until 2AM memorizing the branches in the abdominal aorta? For nine weeks, I struggled with these opposing ideas: the desire to master everything thrown at me (if only so I could look my TA in the eye during a table conference without shitting myself), and my frustration that the stuff I learned was “useless.”

In his very first lecture, Dr. Laitman told us that we, as medical students, answer to a “higher authority.” We shouldn’t study simply for the sake of test scores or pleasing our professors or getting into elite medical societies. We should aim for something greater. But I never figured out what that something was. I’ve gone through my notes again and again, but I don’t remember what he said that day. So I met with him to talk about it.

“Anatomy—and all of medical school—is like a feast.” You have to go and sample things, because who knows what you’ll like? Try a little bit of this, a little bit of that. Dr. Laitman told me about colleagues of his who were inspired to spend their careers in a particular field because of their discoveries in the anatomy lab. Sir William Osler said, “Medical students should divide their time between books and wandering.” If you only focus on the things you need to pass the boards, you’ll miss out on the joy of learning. “And it is such a privilege,” said Dr. Laitman, to spend your days sitting around and learning new things. If medical school is a feast, how lucky are we to be invited? There are so many people who desperately wish they could have the opportunity to see and learn the things we take for granted. And here I was, complaining that the appetizers weren’t quite to my taste.

“Some of the things you see in the anatomy lab you may never see again in your life.” I guiltily thought of the left recurrent laryngeal, which Akbar had triumphantly tied with a string one afternoon. I had barely given it a second glance. I felt a tiny twinge of sadness at the thought that I’d never see it again. If I’d known this during our lab sessions, perhaps I wouldn’t have been so eager to hurry out the door and wash the smell of formaldehyde off my skin. What untold mysteries had I hastily opted out of for the sake of an extra half hour at home? I mentally chuckled every time Dr. Laitman introduced a new dissection during lab. “Today, we will be saying ‘hello’ to the spleen…” (I pictured myself taking out the spleen and giving it a pat.) “We’ve got a full day today! We will be saying ‘goodbye’ to the abdomen and moving on to the pelvis and perineum…” It never hit me how right he was. They really were hellos and goodbyes, like new friends that have come and gone. He told us to let ourselves wander during lab, dissect a finger, trace the course of a nerve. I suspect that many of us left the Anatomy lab with too few stains on our smocks, our scalpel blades too sharp.

I told Dr. Laitman all that had bothered me about Anatomy—the need to know everything, the pass-fail structure of the course that allows people to barely scrape by, the older medical students (and residents and attendings) who told us that Anatomy doesn’t matter. (Unsurprisingly, he disagreed with that last statement.) He answered by quoting Sir William Osler again. “Do that which is at hand superbly.” When you’re in Anatomy, your job is to study Anatomy. Don’t worry about the table conferences or the boards. Don’t worry about what’s clinically relevant. Ten years from now, you will be a physician and you will spend the rest of your life worrying about what’s clinically relevant. You won’t get to just study Anatomy anymore. “Focus on what is in front of you and on the beauty of that moment.” I wondered which moments of Anatomy I found beautiful. There was the day I read about the pyramidalis muscle, absent in 20% of the population, whose sole purpose is to tense the linea alba (read: help you flex your abs). There was my favorite nerve, the perforating cutaneous nerve, which innervates the medial gluteal folds. I’m embarrassed to admit that what I loved most about Anatomy were the little things I found hilarious. (A tiny nerve for the middle part of your butt fold? Who makes this stuff up?) I suppose there was a certain beauty in those moments, paging through Gray’s at 2AM and chuckling to myself, as if I were sharing an inside joke with God.

I asked Dr. Laitman if it was okay for me to share the things he said. “Sure,” he laughed. “I don’t think I’ve said anything interesting.” I reassured him that his words were more than interesting; they were important, perhaps even profound, and I haven’t stopped thinking about them since. I wish I’d heard them when I’d first started medical school. And I had—he said all this before, during the very first lecture of Anatomy. But I never studied the first lecture. It was only an introduction to the course; there was no “real” material covered. It wasn’t on the exam. I looked through the slides today, for the first time since August 18, and the lessons were there, Sir William Osler and all.

Dr. Laitman told me that he lies awake the night before giving us a lecture because he is worried that he won’t inspire us. Knowing that, I wish I had tried harder. I wish I had learned more. I comforted myself after a bad day with “P = MD” (the only thing you need to graduate from medical school is a pass), but I still beat myself up for not knowing everything, not exploring enough. I didn’t see a way out of my dilemma until I realized that neither a P nor 100/100 will do. They aren’t even the right metrics. I want more out of my four years than an MD; I want to graduate knowing that I have made the most of it, on my own terms. I entered medical school with this mindset, but all it took was one table conference to make me lose perspective. Luckily, talking to my professors was enough to bring things back into focus.

I asked Dr. Laitman if he had any parting words for our class. “Don’t be afraid. I have taught thousands of medical students over the years. Some of them come to me the week before the exam, and they are all so afraid. There are things in life to fear: death, illness, the loss of a loved one. But a test? That’s nothing to be afraid of.” He wants us to stop worrying and enjoy our time here, to make ourselves less busy and “just go to the movies.” He hopes that we will never, ever doubt that we belong. Don’t think for one moment that your admittance was a mistake. “That was before you came to medical school. That’s a past life. But this—this is a new world.”