Sustaining the Heart

Demarcating Railroad

Between the brain and heart, no other collection of tissues has inspired as much depth in human thought and curiosity. A couple of months ago we dissected the heart: that vital and tireless organ, the vessel sustaining our bodies with life’s elixir. Just as centuries of thought before me likely pursued, I also thought of the heart’s emotional and cultural depth. What did it mean that I manipulated the heart and traced its own sustaining vasculature?

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I really miss Milwaukee. I really miss its culture and personality–especially its young art scene and creative crowd. I love being back in school, learning, and studying, but even good bread becomes stale. The monotony becomes monotonous: wake up wishing you had an extra hour of sleep, go to class, eat lunch, study, go to lab, eat dinner, study, take a short break, study, sleep later than you wanted, repeat. Whenever my friends and family ask me how school is going, I regret that my initial thoughts and response cannot develop beyond, “Good. I study a lot”–oh, and maybe some complaints. All medical students love to complain.

In anatomy, there is the general idea that environment and space are dictated, that placement and infrastructure follow function and activity. My function, as a student, is to study, so my “form” is largely bounded to within the limits of campus, my apartment, and the rare off-campus study-spots. If studying was all there is to being a medical student, my structure and function would be adept and confluent–but I think there is more to being a medical student. Currently, my “form” is not following my function.

I really want to learn more about the city I’m in. I can’t really put a finger on its pulse, identify the automaticity of its beat, or characterize its qualities. I wish I had, or at least I wish I could feel like I have, time to explore and learn the various neighborhoods and communities. I want to know more about this city and its citizens so that I can more wholly and authentically care and serve. Since four months ago, my life has become school, and, since then, I feel like I’ve become somewhat selfish with my time and relationships. I feel slightly off beat, almost as if rhythmic discontinuity of the heart were a precursor to its atrophy.

The disintegration of my dreams and the constriction of my creativity were some of my greatest fears upon entering school. It’s unfortunately common throughout medical education for students to lose those traits. A large part of that might be because, as first year medical students, all we really are tasked with is passing our exams. School, the one obstacle separating us from our dreams and career, essentially becomes a selfish venture, and we subtly rationalize that selfishness as necessary for this season in our lives: “I need to pass my exams. If I don’t pass, I won’t even have the opportunity to care for people in my 3rd and 4th years,” or, “You’ve made it this far, so it’s fine if you just take these next two years to focus only on school.”

Another reason might be because medicine, like fast food and as some might say, is a service industry. Some people don’t think doctors require a developed or even extant sense of altruism or selflessness; a doctor simply needs to be able to perform his or her job competently. Some people, on the other hand, think a doctor needs an intuition of altruism and selflessness; a doctor ought to appreciate the privilege of the profession and its innate services to all men and women. I fall in the latter camp, and I think it is overly reductionist to think a doctor only needs to perform a job competently–but perhaps I am too much of an idealist. Medicine, after all and as some might say, is like fast food: a service industry.

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Although it is a rare experience and unique to the medical student’s experience, holding the heart in my hands in lab did not give me any profound or poetic thoughts. I thought I would have been able to contribute to the libraries upon libraries of poems, songs, and essays on what the heart meant to poets, singers, and rhetoricians–but, for me and at this point, the heart is just tissue derived from embryonic mesoderm that folded upon itself and differentiated into a pump within a sac. Has medical school diminished me into this sort of minimalist? Has it already started to depreciate my dreams? I hope not and I don’t think so. There is emotional and cultural depth to the heart, but right now, regrettably, I don’t have much time to consider it. I’m scribbling my soul away into legal pads and loose leaf paper, and it’s easy to forget that I, too, have a heart that needs to be sustained.

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