YL5 Week 12: Head and Neck, Eyes and Nose (eyes and nose)

 YL5 Week 12: Head and Neck, Eyes and Nose (eyes and nose)

To commemorate the completion of the 3rd month of medical school, the month long anatomy heavy course of "muskuloskeletal and integumentary system" brought its big brother "Head and Neck". Additionally, my MBA class and group did our final presentations and submitted our final papers for the whole course– it was an emotional goodbye that felt more fulfilling than we had thought we'd get out of it when the course started. 

There has never been more repetition I had to drill in myself than what I went through this week along the tune of head and shoulders knees and toes compared to what I had in the entire MSK module. It started with the skull, then the muscles of the face and scalp for the first module. Then we moved on to the muscles of the eye as well as a short break from memorization with eye physiology. To end the week we went back again with more memorization with the neck muscles as well as touch a bit upon the larynx, thyroid and parathyroid glands (again with a dash of physiology).

What was new here in terms of learning was the inclusion of daily (or bi-daily) "labs" of which we MUST use our anatomy references (be it the textbook Netter's/Moore or the AnatomyTV subscription we have) to identify structures from dissections. Additionally, we had our first Small Group Discussion (SGD) on the eye, where we had a preceptor monitor a discussion of a case presented to us. What returned from the past was the Team-Based Learning (TBL) section for the neck where I reunited with my MSK dissection group after taking the Individual Readiness Assessment Test (IRAT) to take the same 20 point exam again as a unified one group submission. Then we worked on an application of the concepts of the neck. 

By far, I think the organization of Head and Neck invigorated me into trying to be more organized myself. I had to look at my take things day-by-day approach and at least modify it to having a structured schedule (again at least by the day). It also helped me to look at the whole module as an integrated whole. In a sense we started with the structure (the skull) but also noted how the structure is suited for function (the foramen ovale allows passage of cranial nerve V3, the cribiform plate near the nose for cranial nerve I for smelling, and the extraocular eye muscles innervated by cranial nerves III, IV, V1 and VI). These came up later in their respective modules so I couldn't help but spend this saturday reviewing them in context.  

Additionally, the exam structure only has one final exam (the other assessments are the above labs, SGDs and TBLs) so a holistic yet rigorous approach was needed. I also felt like I was being introduced more into the teaching style of ASMPH. The preceptor had noted that SGDs were a weekly thing when YL7 (3rd year med) came around. With that I came to appreciate the other allied subjects more, especially research (particularly because we had to submit something by the end of this week as a group). 

To be a dynamic physician for ASMPH appears to be to also use a wide variety of allied skill sets to teach (be it MBA or ethics or research or leadership) wherein the Med student, by doing ASMPH's MD/MBA program becomes the MD/MBA doctor. It was emphasized before by our ethics head that we become what we do. Not only is it Aristotelian but it is also profoundly Catholic. 

A little Popery

My "break" this weekend also consisted of reading articles by Pope St. John Paul II when he was still a philosopher and Cardinal Karol Wojtyla where he talks about the human person's "self-determination". For Wojtyla, self-determination of the human being is manifested by his using his will in the human act; he determines himself who he is, what he is by the act. And this is supported by finding in the self that not only does he possess himself but he is also possessed by himself. Analogously, not only does he govern himself but is also governed by himself. This reflexivity of subject-object reflects the intimacy of the person when he acts– he finds himself both the author and the character of his action– and in doing so becomes who he is. 

But not only is the person simply just one who uses his will. He also finds that his will is manifested in self-determination by the simple expression "I want". We can distinguish this from other synonyms by comparing it with "I feel like". "I feel like studying" is fundamentally different from "I want to study" (the former being the usual cloud of guilt many medical students face). In choosing (and doing) what "I want", we find in the human being a free will– freedom. What Wojtyla is acutely aware of here is the typical and usual deference of seeing freedom as merely being "independent". But he stresses that freedom is not merely founded in its independence 'murica style. Freedom for him is also characterized by man's dependence. And man is dependent on two things. 

The first is nature– when man acts he is also acting in nature– thus changing nature and also changing himself in the process. Without nature to distinguish from himself, freedom is not realized. Secondly, and more profoundly, freedom depends on truth. Here's where the famous first line of Aristotle's Metaphysics goes– "All men by nature desire to know". In using our freedom to act, we are nevertheless subservient to truth. Wojtyla goes beyond (but does not separate himself from) the Thomistic conception of man and truth in terms of deprivation (man acts perfectly good with perfect knowledge) by finding in man that he himself also is possessed by truth and is governed by truth (and also possesses and governs truth). This freedom Wojtyla philosophizes is profoundly personalistic. Man bears witness to truth by his actions. It is here that we find free will to be not a right but a tool– a unique privilege granted to man– used for truth that is inherently personalistic. It is this context where we find that famous saying of his:

"Freedom consists not in doing what we like, but in having the right to do what we ought"– Pope John Paul II

One may ask, in a weekly blog talking about ASMPH's first year of medical school, what does this talk of the philosophy of a philosopher-pope have to do with being a medical student? Well, as I've realized, ASMPH too is profoundly personalistic in the sense of its education structure being oriented around interdisciplinary and allied studies into things like business courses, leadership seminars, and research training. It is perhaps of no surprise to anyone that the Catholic part seems to be watered down (at worst) or invisible (at best) but one need only to look at its core tenets wherein it follows the Vatican II council's emphasis on Christian Anthropology– that “This likeness reveals that man, who is the only creature on earth which God willed for himself, cannot fully find himself except through a sincere gift of himself.” 

Sure, it would be great to restore a Biblical worldview (especially one that is grounded in reason as with Catholicism's affirmation of the non-contradiction between Faith and Reason/Science), but what needs to be emphasized first and foremost of all amidst and against all this confusion of identity (in the economical, political and societal sphere) is to recover the uniqueness of the human person, who experiences himself as that unique individual whose actions shape and is shaped by himself. Only then can the Gospel illuminate itself in us, the body of Christ. For we as Christians come to know truth radically not in a concept or lofty ethical idea (as Pope Benedict XVI puts it) but in the person of Jesus Christ.

"For this purpose I was born and for this purpose I have come into the world—to bear witness to the truth. Everyone who is of the truth listens to my voice" (John 8:37b)