Previous Challenge Entry (Level 3 - Advanced)
Topic: Think (09/02/10)
TITLE: Hitchhiking from the Classroom
By Emily Gibson
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Dr. Rossi believed in active student participation in class, in the cadaver lab, on oral tests. He told us from the first day on: “You will learn to THINK in this class like you’ve never thought before! Your patients’ lives depend on this. You will be prepared for my class each and every day, just as you must be prepared for whatever your patients will need from you.”
He was correct.
There were 110 of us in the lecture hall that first day, looking nervously at each other and at the empty podium down in front. We had been assigned three chapters in the anatomy textbook before Dr. Rossi’s first lecture and were expected to know the names of the bones and major blood vessels.
Dr. Rossi’s assignment for himself was to memorize our names and faces from a photo directory provided to him two days previously.
He began his lecture in the barely darkened room, running quickly through a carousel of slides of graphic photos and drawings of body parts. Within five minutes, he stopped and in his thick European accent, pointed at a student in the second row said: “Mr. Davis, can you tell me the name of this blood vessel on this slide?”
The student sat up startled, and sat silent, gathering his wits. Dr. Rossi looked pointedly at his wrist watch and started saying, “Drip. Drip. Drip…” The student started to sweat.
“Drip, drip, drip—your patient is losing blood, Mr. Davis.”
The student, in a moment of enlightenment asked, “the inferior vena cava?” and Dr. Rossi said, “Very good, Mr. Davis!” and made a notation on the tablet on the podium in front of him.
The rest of our hearts immediately were in our throats, something that Dr. Rossi would later tell us was an anatomic impossibility, no matter how much it felt like it. There would be no dozing off, daydreaming or not preparing for this class.
My turn came the following week as he called out my name, his steely eyes fixed on only me. I got off fairly easy with a question from Dr. Rossi about the attachments for the extensor pollicis longus. I had memorized all the arm muscles the night before so was prepared.
“Yes, very good. Now tell me, if I were to fall off this podium right now, land on my outstretched arm and rupture my extensor pollicis longus, what would I not be able to do with my arm?”
I had no idea. I looked at him somewhat aghast. I thought I had done the necessary preparation to be ready for his questioning. My memorizing names and locations of muscles and tendons had only taken me so far. I had not really thought about the functionality of what I was learning and how it might be relevant to my future patients.
“Think now! This is not so very hard that you can’t THINK it out!” Dr. Rossi demanded from the podium.
So I guessed. “Uh, you can’t grip?”
“Exactly wrong! You have not prepared yourself well enough. Go back to your book, and with each muscle you memorize, you must feel it on yourself or your study partner and think about how it works. Your patient will thank you for that someday.”
I survived that anatomy class, survived six oral exams over the cadaver with Dr. Rossi, and although I didn’t get an A in his class, I was very relieved to get a B+. As a student, I had never been asked before to apply what I was learning to make it relevant to my future work. Dr. Rossi was right. I had learned to not just memorize, but to think.
And when I saw my first extensor pollicis longus rupture seven years later in my practice, I was absolutely confident of the diagnosis because my patient could not lift up his thumb when asked to act like he was hitchhiking.
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