Was that a "click"?

A funny thing happened while I was studying yesterday. I finally felt like all these random, individual information bits I was learning in the neuro/psych block were all starting to come together... things finally 'clicked' into place.

You see, starting out the neuro/psych block feels like having to navigate a rainforest without a map. They might as well have written the entire set of notes in Latin. Every time you try to read something, you get about two sentences in before you don't know what something is. So you look it up... and... well... let me illustrate:

"Hmm, what is the 'caudate'? Oh I'll just look that up. It says here,

'part of the basal ganglia.'

Uh... okay.... better look that one up too. Basal ganglia... blazing danglia... here it is....

'large nuclei deep within the cerebral hemispheres.'

Good thing I know what cerebral means. Now... nuclei?? what's that? ok looking that up...

'a group of cell bodies and dendriates of neurons, such as the red nuclei, a part of the rubrospinal tract.'

Okay. Got it. Except... I still have no idea what the caudate is. and what is the rubrospinal tract?! Do I need to know that??"

Or it's also fun when you think you've learned something... for example, that a certain group of nerve cells ends in the thalamus of the brain... but then later on you read that they end instead in the ventral posterior lateral nucleus (VPL). Damned if you didn't already know that the VPL is a part of the thalamus.

Perhaps now you can see how excited I was to feel as though things were finally coming together.

Interestingly enough, a similar thing is happening with the entire program (not just the neuro/psych block).

It's coming to the end of two years of medical school, which means that by the end of this year we will have had units and lectures on every major body system.

At the start, it's all new, and that can be quite a challenge. Medical terms, lab tests, diseases, all of which you've never heard before. Starting out with things like cardiorespiratory is fortunately pretty straightforward, and you study those units hard, then you feel like you finally know something little about medicine.

But by the end of the two years, you start seeing things over and over. You start seeing how they relate. You start understanding how things fit together. You start doing the physical exam skills not just in a tutorial session, but also in a family practitioner's office, then in a clinical hospital setting, and learning the basis for those exams - for example shining a light into patients' eyes, tapping their knees, and asking them to say 'aah' - helps to learn the pathology and physiology that we need to know for courses outside of the clinical skills course.

One example of a disease we've seen many times now is hemochromatosis -a disesase in which the body can't get rid of iron, and so it builds up in various body tissues. It affects many different parts of the body, so we learned about its effect on the bloodstream in the blood unit, then talked about its effect on the musculoskeletal system in that block, and how it damages the liver in the gastrointestinal unit.

It's a relief to feel as though things are finally making sense, and while some students might give me flak for giving the faculty some credit, it does finally seem as though there was some method to this madness and that we might actually have learned something.

Then again, from what I have heard, that feeling of knowing anything disappears completely next year on the wards...