Sucks To Be Yorick

In high school, I went through a crazy Shakespeare phase. And for those who are familiar with my psycho obsessive personality, you’ll know that when I say crazy, I mean CRAZY. I had Shakespeare insult cards (my personal favorite: “First thing we do, let’s kill all the lawyers!” We doctor types think that’s funny) and a gorgeous copy of the Complete Works; I watched Shakespeare in Love on a basically continuous loop. I even wrote one of my Penn application essays on Shakespeare (which essentially went, “The most important moment in history was the birth of Shakespeare, because he invented my name!!! Also, I am clearly a complete tool. Please admit me.”).

But despite my persistent belief that Shakespeare could do no wrong, I never really got this scene.

Why does Hamlet feel so bad for Yorick? I mean, sure, the guy’s dead — and has decomposed at an impressively fast rate — but Hamlet’s the one with real problems. His father’s dead, his uncle’s a quasi-incestuous sleezebag, he’s got all these Freudian feelings, and his girlfriend is totally nuts. Plus, he has to be played by Jude Law. If anything, Yorick should be proclaiming, “Alas, poor Hamlet” from the great court of Denmark in the sky.

But since we’ve started learning the head and neck in anatomy, I’ve started working on a new theory that totally explains Hamlet’s sympathy. It goes like this: skulls suck. I know we need them to, scientifically speaking, protect our brains and crap like that, but honestly they’re just horrible, horrible structures. How horrible, you ask? Great question. To quote my anatomy textbook, “The neurocranium in adults is formed by a series of eight bones….The viscerocranium consists of 15 irregular bones.” If my math is right (and I was an English major, so it really might not be) that’s 23 bones. 23 bones! Call me crazy, but doesn’t it seem like the skull should just be one big bone? Yeah. It’s not. And don’t even get me started on their names. All I’ll say about that is — who the hell came up with vomer?

So, to rewrite a classic scene:

Hamlet: Alas, poor Yorick! I knew him, Horatio.

Horatio: Don’t feel too bad, Hambone, at least he got to die before this whole insane mess started. We should have been so lucky.

Hamlet: Well, yeah, the state of Denmark is hella rotten. But to be (or not to be) reduced to nothing more than 23 annoyingly named bones? I’d rather have funny feelings about my mother. Sucks to be Yorick.

Pros: Money, Security, Swayze

Check out that serratus anterior. Yum.

Med school is turning out to be the best, and most expensive, personal trainer ever. I’ve learned how to work my pectoralis majors (adduct and medially rotate my arms!) and my deltoids (um….OK, I should know this. Something about using a steering wheel?). Unfortunately, my expertise (and I use that word liberally) is currently limited to the anterior thorax, upper arms and back, so if I actually did apply all my fancy muscle knowledge to my exercise routine, I would be highly disproportionate. (Like this guy.)

But despite the fact that I can officially become the world’s nerdiest body builder, having to learn all of these muscles has a major downside: it requires a psycho crazy amount of memorization. I’ve always been a big fan of index cards (and in middle school I was notorious for my obsession with highlighting), but lately my tried-and-true studying techniques just aren’t cutting it anymore. So I’ve decided to take a new approach to memorizing every single freaking muscle in the human body. It’s called the Swayze method.

Here’s how it works: I watch Dirty Dancing, and every time Patrick Swayze is shirtless — in other words, 83% of the movie — I list all the muscles he’s using, their proximal and distal attachments, and the nerves that innervate them. Like when he lifts Baby into the air? That’s trapezius and pectoralis major. And when he crawls toward Baby in that bizarre lip-synching scene? That’s latissimus dorsi, loverboy. It also works with Swayze’s other movies — in that pottery scene in Ghost, he’s clearly working his triceps brachii (and, um, another muscle too).

Thanks to Johnny Castle, I’m one step closer to my MD. Now, if only someone could explain what “nobody puts Baby in a corner” actually means. Seriously. It makes no sense.

A Hoarse Is A Hoarse Of Course Of Course

Freedom poster. (Get it? 'Cuz it's in French.)

So apparently the Single Most Important Thing to know in the medical profession is the differential diagnosis for hoarseness. This is the only reasonable conclusion that can be drawn from the fact that I’ve been in med school for 10 days (227 hours, 35 minutes down, a helluva lot more than that to go!) and have officially learned 5 different ways a person can get hoarse. I’m not going to list them (you’re welcome; also, I don’t feel like typing out “recurrent laryngeal nerve” five times). But this whole hoarseness issue got me thinking. During Jimmy Stewart’s filibuster scene in Mr. Smith Goes to Washington, was he hoarse because he’d been talking for like a day, or because he had a lung tumor?

I’m gonna go with lung tumor, and I’ve got proof (it’s scientific!). First of all, as earnest as Jeff Smith is, there’s no way he didn’t smoke. It was 1939 for Pete’s sake; who wasn’t lighting up? On top of that, who knows how many Boy Scout bonfires this guy was exposed to? All those burning s’mores, no way there weren’t consequences.

The more important piece of evidence, though, is that Mr. Smith was clearly exhibiting neurological symptoms. Nobody gets that choked up over seeing the Capitol unless something is seriously wrong. And wandering away from his escorts when he first gets to Washington? That was just plain dumb, Jeff. The tough government operatives write off Jeff’s kooky behavior, dismissing him as an idealist. But I’m pretty sure he had paraneoplastic syndrome. This also explains his attraction to Jean Arthur. And his decision to live in Wyoming.

Differential diagnosis: a tumor of the superior lobe of the left lung, compressing the left recurrent laryngeal nerve, leading to patriotism-inspiring hoarseness and a distinct form of democracy-themed erratic behavior. It seems so obvious now, doesn’t it?

The Color Of Money

Sigh. Be Mine?

As the (apparently) hot AAMC lady spent way too much time telling us today, we med students are going to owe a shit ton of money when we get out of school. I’ve always found it grimly ironic that we pay 6 figures to be incredibly stressed out. But that’s life, and I’ve (almost) learned to accept it.

The main gist of our terrifying financial aid talk was that tuition is up, salaries are down, and we, Future Doctors of America, are going to be paying off our loans for freaking forever. Which means that I’m going to have to resort to one of the following options:

1. Robbing banks. It worked for Bonnie and Clyde (well…mostly) and for Butch Cassidy and the Sundance Kid (y’know, kinda); it can work for me.

2. Pool hustling. Fast Eddie Felson is my soul mate. Or at least, Paul Newman is

3. Make like Marion Cotillard and hook up with John Dillinger. Alternately, make like Susan Alexander and hook up with Charles Foster Kane.

4. Plastics.

Every Time a Bell Rings, an Angel Gets a Winged Scapula

Fly, Forrest, Fly!

My greatest fear when I started medical school last week was that the work would engulf me, and leave me no time to stay culturally informed. Well, maybe not my biggest fear — the phrase “oh god, oh god, I can’t believe I actually have to put my fingers in that” may also have crossed my mind several dozen times. But as a pop culture junkie, the idea of being so grossly absorbed in medicine for The Rest Of My Life with no room for the important things (y’know, who’s making what movies and which actresses have eating disorders) was a daunting thought. How could I realize my dream of becoming a Sanjay Gupta-A.O. Scott hybrid if I didn’t stay with it?

The answer: use medicine to gain a greater appreciation of pop culture. The line “Here’s looking at you kid” from Casablanca becomes so much more potent when you’ve learned that without cranial nerve II, Rick wouldn’t be able to see Ilsa at all. And knowing that all Jake has to do to forget Chinatown is ablate his hippocampus is, somehow, comforting.

This week, one of my all-time favorite movies was thrown into a sharp new light. My family watches It’s a Wonderful Life every Christmas, despite our overwhelming lack-of-celebrating-ness, and every year I cry. I don’t just get misty-eyed, I bawl unrestrainedly. My tears come to a particular peak when Zuzu, the most adorable little girl who was never in another movie ever again, tells George, “Teacher says, every time a bell rings an angel gets its wings!” She’s just so cute, and George is just so happy that he’s the richest guy in town, and it’s all just so beautiful! I lose it.

Now that I’ve learned (or at least, am supposed to have learned) everything there is to know about the thorax, I have a new reason to cry. What Zuzu really meant — she was a very precocious little girl, apparently, with a surprising amount of medical knowledge for a first grader — is that every time a bell rings, an angel gets a winged scapula. Their long thoracic nerves are paralyzed, and so their scapulae are free to go wherever the hell they want. Poor Clarence — he gave George his first edition copy of  Huck Finn, and all he got was this lousy musculoskeletal condition.

So stop ringing bells. You’re seriously maiming our angels.