Flashback [solo] The beginning of Medical School

[Xavier Belt]

15th of spring, 510 AV Xavier crammed into the room with twenty other brand new medical students into the small classroom. The room was stuffy and crammed the chalk boards that covered the walls looked as if they hadn’t been used in ages. A professor with the remains of a scraggly white beard sat in front of the class looking down at his book not giving the least bit of attention to the now expectant group of students. Xavier felt slightly disgusted that here at the university, supposedly the pinnacle of learning in the known world, people could buy their way into medical school, or more accurately their parents bought them into medical school. Xavier spotted at least two students who, if university rumor had any credence had failed entrance exams more than once. In some other subject this may not be an issue, but medical school dealt directly with people’s lives, it also intrigued him, how easy money made things for them. Xavier lost his train of thought when the professor cleared his throat loudly to quiet the class. The hum gradually lowered until the professor, now standing, had the attention of the class. The professor seemed to gather himself before launching into his obviously rehearsed introduction speech. “Welcome, welcome to Basic Medicine I hope everyone is in the right room? “ A few chuckles floated around the room before he continued in a fairly monotone voice. “This class will not be easy, it will be gross. You will touch and cut dead human bodies in an effort to learn how to put them back together. If you are up to the task at the end of this semester of class you all will branch out into more specific disciplines of medicine.” He paused here; slowly looking around the room, Xavier could feel him judging as his eyes passed over him and was amazed at the urge to cower that came over him as the professors eyes passed him. After the professor had finished his stare he turned to the board while grabbing the chalk, talking and writing at the same time. “Before we get started we need to cover the basics, Medicine as far as we are concerned is the ability to diagnose, treat and prevent disease and physical harm in a worldly manner. We make the distinction because there are some who are blessed with the power of healing. These people are not Doctors; they merely possess the power, not the knowledge to heal. Those who possess neither power nor knowledge we call quacks, there are many.” “Now that we have that out of the way let us get started!” The professor said looking back at the students who were scrambling to get out note books and stumbling over each other to get chairs. “We can start with some basic directional terms. In medicine we do not use normal directional terms such as up, down, left or right because they are subjective. Instead we describe portions of the body in relation to each other. For example the nose is inferior to the forehead, anyone willing to take a stab at it…?” A prim looking male student in the front, dressed in a high fashion jacket with a gaudy scarf simultaneously called out his answer while throwing his hand into the air. “The nose is posterior to the forehead because it is below, posterior means below.” He spat out, managing to sound both annoyed and perplexed at the same time. Xavier decided on the spot he would avoid him, he gave off the rich and privileged vibe. Unfortunately he was correct, no doubt that would add to his already inflated ego. The professor continued to draw arrows all around a crudely drawn human body. Distal and proximal represented being farther from or closer to the origin of something, like an arm or leg. Medial and lateral represented being closer and farther from the midline of the body, drawn directly through the belly button. This continued on for hours and Xavier was beginning to lose his mind when the professor finally called a halt for lunch, the room had grown significantly stuffier since class had started, even with the ocean breeze temperatures were unusually high. Looking down at his notes Xavier started to feel like he was in over his head, page after page of script and this was just the first class period! “How did anyone get pass the first course?” he thought as he walked out to get some lunch before next class period.

[Xavier Belt]

Xavier managed to get a decent lunch of bread and cheese and a quick nap in before the evening session was set to commence. Xavier walked into the room and immediately noticed the diminished class milling about, it looked as if nearly a quarter of the class had abandoned already after the first lesson. If the pace of this class kept up though then no doubt more would follow their classmates. However Xavier was remiss to find out that “rich know it all” was still among the remaining students. Xavier grabbed a seat near the back and a short time later the professor swept in, a rush of flowing robes and papers. He stopped just inside the door a small grin on his face before motioning everyone up and to follow him back out into the hall way. The class stood and shuffled awkwardly out the door as the professor led on into university proper. Passing the students entrance to the infirmary they instead entered a small door set to the side farther down the hall which led into a large stone room with stone slabs about body size set on the sides. “I had hoped to start this later in your education but dissection is completely dictated by availability of bodies.” He said. Now that the students had spread out some he could see the body of what seemed to be a sailor had been stripped naked and hung by the ankles, his throat was slit while the remaining blood dripped down into a large bucket. The professor continued on with a little more glee than was necessary “Sailors pulled this guy in this morning, no one could identify him so we get the body! And by the looks of things he is pretty drained and ready to go, can I get some help here taking him down?” Xavier watched from the back as they took down, the clips on his heels left marks on the ankles and he was extremely pale. Once the sailor was set on an examining table Xavier was able to get a good look at him. He was built stocky and powerful, the typical sailor. His shoulders and the muscles around his neck were bulging, more than likely from years of hauling ropes and cargo. He had a large scar that ran from the middle of this thigh down to the top of his knee, dark molted skin showed where an inexperienced surgeon had attempted to stitch together the wound, made obvious by the many smaller dot looking scars that ran the length of the previous wound. A metal scraping sound caught everyone’s attention, looking over the Professor was unrolling a bundle of metal tools, knifes of all shapes and lengths. With a grin on his face, “Who is ready to get started?” he said softly before grabbing a particularly nasty looking knife and turning towards the body. He started on the breast bone by sliding the knife in right above it and doing a mixture of sawing and hacking to get a fairly straight cut down the middle of the chest. Then, putting his fingers inside the newly opened chest cavity he stepped to the side, bracing himself with his feet and gave a hard tug. With a series of sickening cracks and pops the ribs gave way and the chest was pulled open, he went and did the same to the other side. The deceased sailor’s left lung was black and shriveled while his right had grown to compensate leaving his chest looking lopsided from the inside. “Ok everyone look in here, we will start with the most important organs and work our way through the list of importance. This here is the heart.” The professor said pointing to the large red ball looking thing in the middle of his chest. Students rolled their eyes before the professor launched into a description of the various functions of the heart, things that had been covered before and need not be reexamined. The professor continued on his tirade before grabbing a smaller, scalpel looking knife and used it to open up the large artery leading from the heart to the lungs. A trickle of water came out of the lungs spilling out into the chest cavity. “Judging by the water in the lungs I think we can safely say cause of death is asphyxiation via edema in the lungs. Everyone remembers what edema means right? Edema is the gathering of fluid in an area, in this case seawater in the lungs. “ Next the professor moved on to the blackened lung. The mass of dead tissue had obviously been there for some time and it was surprising it had not become infected. By the looks of things this person had lost a battle with a respiratory disease early in life and his healthy lung had grown in size to compensate for it. The professor had each student practice cycling through being up close to the body to study the various issues and before long the body was cut to shreds. The professor dismissed class, no doubt tomorrow in the classroom would be much more difficult than today’s dissection had been.

[Xavier Belt]

Muscles and tendons, the driving force behind movement in human biology and a major source of injures from weapon wounds to sprains, proper rehab of muscles was critical in getting someone back to normal. Xavier sat studying his models that he’d drawn on paper during the last class feeling somewhat overwhelmed. Muscles were an extremely complicated subject and knowing their function and proper workings compared to possible issues was a huge task. Over the hours of study Xavier had managed to boil down all this information into a couple basic points. First, that a muscles structure is directly related to its function, if you can figure out the “end goal” of the muscle then it is possible to find the problem with it. Although this can be said for any part of the body, muscles held to the point most closely. Looking through his notes Xavier came upon the best example. Large muscles such as the muscles in the legs held heavy loads and develop wide and thick while the accessory muscles around them, for balance are rather small and long. Second, muscle injuries need to be properly treated in order to get back to normal function. Tears and open wounds to muscles without proper stitching can result in abnormal healing which in turn impairs the muscle function in the future. Although the professor did not go into further detail here Xavier thought that it may be possible for the body to heal itself given enough time a rest. But this was merely a theory. Xavier rubbed his eyes again, trying to get sleep to leave him alone yet despite his best efforts. All of this studying and these dissections he was learning so much about the human body, yet still he did not get to use any of the knowledge. The reply was the same every time, they did not allow basic students to work anything other than observation shifts in the infirmary and nothing remotely interesting happened there. Xavier pushed the thoughts aside and tried to get back to the notes at hand. Tendons, one of the most important structures in the body that connected muscles to bone, these structures created no actual pulling force of their own. Tendons transferred the pulling force of a muscle across a joint to create motion. The best example of this was the thigh muscle pulling on the kneecap, which would extend the leg straight from a bent position. Xavier noted an interesting tidbit he had scrawled into his notes here, tendons did not heal on their own and, if they separated from the bone they joined there was no known way of reattaching them. Tendon ruptures, common in animals would lead to an early put down and in humans would result in a life-long disability.