Med School 1

Noise in an auditorium has an odd effect. All the new students shuffling their pens and binders, while chattering with their new acquaintances, are sure noisy. Yet, until one tries to speak to the person in the next seat and cannot even hear oneself, one does not realize that the sound levels are as high as a jet plane taking off. That's why the professor is fidgeting with the old style microphone that hangs around his neck. His voice stops the beehive like activity, even though the speakers are faint and crackling.

Dave stares down from his high seat at the end of a stadium like lecture hall. There are over a hundred students in the hall. Some have creative fashion haircuts. Some girls have still wet and matted hair. Some guys sport elegant 20's style hats. A dozen girls have a fun hair colors like a dash of red or completely green. Some already were white or blue medical coats. Others still showed up in baggy pants and oversized, untied basketball sneakers. The latecomers were sitting on the stairs leading down into the pit. The pit contained the professor in a dapper suit, a traditional leather bag on the desk, and his name on the chalkboard, professor Greenberg.

"Ladies and Gentlemen, welcome to medical school. Medicine has an ancient and proud tradition. It is the only established profession that does pure good as sworn by an oath. A chemist can work on rocket science after a four year bachelor degree. You will learn medicine, which is vastly more complicated. You will study hard for over a decade before you get to cut for the first time."

"Now, please take a look at the student to your left and right. Introduce yourselves. Only one of you will be here by the end of the semester. The first year drop out right at our institute is around 70%. Some of you will fail our tests miserably. Some of you will give up utterly crushed. We do not make doctors for average hospitals here. We nourish heads of surgeries for the most prestigious hospitals. We inspire the doctors that make medical breakthroughs."

Dave looked under the table at his leather shoes. A leather boot was knocking against the side of his shoes. The leather boot was stiff with the toes standing up. Flames were stitched on the shaft of the boot with purple leather. The male student next to him looked at him intently. He wore a white shirt with thick fabric along the edge of the fabrics, where the buttons were. The thick fabric made the white shirt stand stiff. The two top buttons were opened. The student smiled and leaned over to Dave.

"That's Professor Dick. All the other professors hate him, yet they treat him nice. He washes out most of the students. The other professors appreciate to be spared wasting their time on dim wits. You survive him and you get to experience some of the most brilliant people on this planet. My name is Armando."

"Hey, Armando, we can talk after class. Right now, I want to pay attention to the lecture. My name is Dave."

Armando seized up Dave. Dave was wearing blue jeans with an oval washed out section on the thighs. Thin lines of washed out jeans looked like faded creases. Above the right knee was a small roughed up square, where the designer went to town with a knife to scrape the fabric. At the left bottom was a heart and 'K' stitched almost invisibly into the fabric, because the thread was exactly as blue as the jeans. The bottom of the black shirt fell over the top of the jeans. The black shirt had an oversized Marilyn Monroe printed over ten entire torso front reaching under his armpits. The photo print was painted over with bright colors. Her black pupils were filled with the outline drawing of one fetus each, proposing her pupils to be wombs. The Edge of her smiling lips had a cross of two tiny long bones. From the distance they only looked like an X. The black shadow in her blond hair was an illusion. It was actually, the outline of a sultry Goth girl with long flowing hair reclining on Marilyn Monroe's forehead.

Dave leaned forward onto the narrow surface in front of him. The entire row was sitting on fixed wood chairs. In front of them was a white plastic surface as a writing surface. The writing surface was attached to the top of the chair row in front of them. The row in front of them was lower, so that they could look down onto the heads of the person in front of them.

In front of Dave was a girl with dark dirty blond hair. The hair was twisted into a neat noodle with two white chop sticks sticking way out in both directions. Japanese Kanji characters were engraved on the end of one chop stick. The line drawing of a peacock finished the phrase. The other chop stick had waves, their white crest, and a koi fish engraved. The girls flip flops were hanging of the balls of her feet with a large gap at the heel. She clapped the heel of the flip flop against her naked heal in mindless abandon. The binder in front of her was pink with a large Hello Kitty face. The summer dress was cheery yellow with straps on her shoulder. The guys could see the top of her breasts a bit.

Armando slowly, soundlessly tear a quarter sized paper piece of a bar flyer. He rolled the paper into a tiny ball and snipped it into her hair. The paper pellet had two shiny strands of hair running over it. Yet, a few other loose strands held the paper a bit above the actual hair. The paper was hovering. The girl did not react. Dave whispered to Armando "No."

Armando proceeded to make the next paper pellet. The paper pellet landed right between the girl's flip flops. Dave quickly grabbed Armando's hand and held it. The girl did not react. "You can't do this." Armando smiled in success until the professor interrupted him: "The next person that utters a sound will have to leave this session immediately. I don't care if you just found out the meaning of life or your class mate stepped on your foot."

Armando snipped the next paper pellet into the girl's hair. He fully looked at Dave to capture his reaction. Dave looked away. The girl roused. She reached for her hair. As her finger touched the first paper pellet, she started digging and pulling. She snipped it on the floor and went looking for more. Her hair was sensuous and recently washed. Dave could almost smell the fruity scent of her shampoo. She had a piercing at the top of her left ear. Her summer dress ended in the middle of her thigh. The skin and muscle texture looked young and in average shape.

This time, Armando rolled the paper pellet in his mouth before he flung it down at the girl. He went for her décolleté. The wet paper hit her chest high and stuck to the skin. The girl turned around. Her fierce eyes were right in front of Dave's who was still leaning forward. Armando placed his finger on his lips to warn the girl from speaking to avoid the ire of the professor. When her facial expression changed, his finger in front of his lips slyly pointed at Dave. The girl shook her hand at Dave. Dave waved 'no' with both hands. The girl turned back to the front. Dave hit Armando into the side of his thigh with a closed fist. Armando's face brightened up only more.

The whole class stood up and started walking toward the front and out the doors next to the chalkboard. The next step was the surgical initiation. The professor believed that students needed a taste of actual surgery to be motivated through the drudgery of learning the basics. On their first day, they were to assist life surgeries with a menial task like injecting a drug into the IV, sucking blood out of the surgery site, or handing the surgeon a scalpel. The surgery rooms were behind the lecture hall. The students formed five lines for each of the surgery rooms. There was a lot of waiting for students to neatly wash the hands all the way up to the forearm and dressing with hairnets, gloves, and surgical gowns. Then, as one student exited one door, the next student could step in. There was usually only space for five students at a time to observe among the many people of the surgical team.

Dave stood next to Armando: "You are an absolute ass."

"You have a problem with hesitation. In medicine, not the students that study the most win. It is the students that can step over boundaries. That girl in front of us will be unable to step over the boundary of cutting a corpse. She will fail anatomy. You will fail, because you are too modest. You will kill the woman with vaginal bleeding, because you don't dare asking her the right gynecological questions. Perhaps, you won't ask her a single one. Medicine is not normal. Cutting and sawing into bodies requires you to give up your hesitations. You still have a chance to get over it before they kick you out."

Dave and Armando stood quietly in the line of blue students covered in puffy coverings head to toe. The pre-room was large, functional with a wooden bench to get dressed and rows of oversized hand sinks. The sinks had foot pedals to operate the water to avoid the clean hands touching anything. Every five minutes, the door opened with a glimpse of machines, large surgical lights and the surgeon. Rancid air wafted into the room from burned flesh. Blood vessels were soldered to stop the bleeding. Everyone looked ahead and was quiet.

When Dave stepped into the room, he scanned the surgical staff to pick out the student, surgeon, anesthetist, nurses among the anonymous smurf-like looking people. The appendicitis surgery would be open soon. He recognized the bothered girl from the class earlier standing near a nurse. He pushed himself past the other students to stand next to her and apologize. As he pulled up next to her, he reached with his right hand for her shoulder to get her attention. His elbow knocked against a shiny stainless steel try. The meticulous instruments rattled loud. A ten blade fell to the floor with the ringing sound of a coin jumping around before it finally settled, only louder. Armando quickly stepped on top of the ten blade with his shoes. The surgeon paused. The nurse next to the surgeon quickly exhaled. "Who dropped a scalpel in my OR?" The nurse next to the girl from class quickly twisted her body around. Her body relaxed a bit, because she had something to do. She peered on the floor and reported: "There is no scalpel on the floor." Another nurse joined her search and confirmed. The surgeon grumbled without a word and continued poking in the abdomen of the patient.

Armando whispered in Dave's ear: "You owe me. I get to double dip and do your surgery task as well. They won't recognize us with the face masks and eye shields."

The girl cut him off by whispering to us: "You guys are in so much trouble!"

Armando cut her off: "Actually, you are in deep trouble." "Phew" "Just look down at your feet. Those are pretty Hello Kitty flip flops. But what are they doing in this spanking clean OR, where sharp instruments can drop. You were lucky that the nurse was so focused on the scalpel that she did not notice. Once she calms down, she may remember."

Her face looked haunted. She reached for my arm: "Oh my god, I will get kicked out on my first day. Let me get passed you, so that I can get sterile shoe covers."

Armando firmly grabbed her biceps to stop her: "My dear, running will only draw more attention to it. It is a common beginner mistake to forget protection. Your peers are here to cover for you. I saw you going in like that. So, I grabbed an extra pair. I will drop them on the floor. You will put them up. While you are down there, you will pick up the ten blade under my boot and sneak it out."

She squatted down in front of Armando. She pulled the bunched up shoe coverings apart and stepped into them. Then, she pushed Armando's boot away to grab the ten blade. She put it into the pocket of her surgical gown. The next minute, the space opposite the surgeon opened. She stepped to the unconscious body. The nurse gave her a sponge with rusty red fluid to sterilize the skin around the sutures. The appendix surgery was near the end and the cut already closed. She painted thick lines of rusty red on the lower right abdomen.

They meet again the next day in the library. The girl introduced herself as Sandy. The professor introduced the reason for the odd class location. Yesterday, they had tasted the joy of surgery. Today, they would taste the ardor of long hours of work. They all had access to anatomy books. Their task was to learn all the 206 bones of the adult human body in one long session. The day could either end by passing an oral quiz on the bones or being expelled for falling asleep. The maximum allotted time was 72 hours -- 3 days.

To make things more interesting, everyone had to grab a study partner. The study partner was actually an adversary. If a study partner fell asleep and the awake partner could write 'loser' on his/her forehead, the sleeping partner would be eliminated. The awake partner would be rewarded by having to answer one question less on the quiz. A new study partner would be assigned. There were ten questions on the quiz. A particularly alert, yet dumb student could succeed by simply staying awake long enough. The same is the case in real world situations. During long shifts, surgeries, and disaster emergencies, the last doctor standing still saves patients, while the brilliant yet exhausted doctor does not.

Armando was paired with Sandy. Dave was paired with a small Chinese girl with large glasses. The morning in the library was packed with a lot of noise and movement. By early afternoon the snack vending machine in the library had run out. Students were re-using their soda cans to drink water from the bathroom tap. All four were sitting on the floor. The coarse floor had become familiar like a home by now. In the morning, it seemed like a dirty floor. Now, it felt like an inviting living room. Looking up at the window brought a reassuring familiarity. Everyone knew the major bones like femur and humerus. Some even name all the wrist bones: scaphoid, lunate, triquetral, pisiform, trapezium, trapezoid, capitate, and hamate. Pisiform was the most easy to remember, because of its crude reference to 'piss,' and the prominent location as the bump on the pink side of the wrist. They had learned them in pre-med classes. Yet, the small and unusual ones gave even the top students a challenge to remember.

Dave noticed glitter on the Chinese girl's cheek. When a second tear ran down her cheek, he recognized the glitter for crying. He talked softly to her and offered his last pretzel in the aluminum pack to help her blood sugar stabilize. "Eight hours. I only know 103 bones. Last hour, I learned five new bones and forgot three." Dave put his hand on her shoulder. She shrugged sharply and grabbed her bags. She whisked out. Dave followed her. Near the door, the professor stopped him: "Congratulations son, you are down one question. Now, pair with Sandy and Armando. They sit over there."

Night passed surprisingly quickly. Most brains were too exhausted to track time. The blue, red, purple sunrise inspired the first student to try the test. The student passed. It was the thirteenth student to leave. The other ones had easer silently walked out in shame. Or, they had received loud cheers of the sleep deprived raucous students for the red word on their forehead "Loser." They had fallen asleep. The first student to dare write on the forehead of the other had broken a taboo. Everyone was now eyeing their partner carefully to fall asleep and provide an easy way out.

When Sandy dropped the book on her belly, Dave expected Armando to immediately scrawl 'loser' on her forehead or face. Yet, Armando leaned forward on his knees to get closer to Sandy on the floor. He carefully placed his index finger on Sandy's heal. Her flip flops were somewhere else in our circle. Then, his finger glid along the sole of her foot to her toes. On the second pass, Sandy snorted and flung her eyes wide open.

"Sleeping beauty, you almost wasted your parents savings by flunking med school. I got just the thing for you." Armando pulled an orange prescription container out of his pocket. "600 mg of modafinil proven to keep combat pilots alert and accurate for over 40 hours." Armando turned prescription container over while waving it back and force, so that the pills clicked against the lid. "What is it going to be? Years of school for nothing or doing whatever it takes?"

Sandy lurched forward to grab the modafinil out of Armando's hand. He pulled it away quickly and she fell on his legs. Armando laughed: "There is a string attached. There are always strings attached. You let Dave and I practice breast exams on you, so that we pass the women gynecology part. In exchange, the modafinil will help you pass the bone test. Sandy punched Armando's chest and walked away to the bathroom. Armando sang: "Time is on my side, yes it is. Now you were saying that you want to be free, but you'll come runnin' back"

For then next hour, Armando intermittently belted into "time is on my side" and evilly added "yes it is." The room took little notice of his antics. All the people with ticks had started showing them. The tall guy with the basketball shoes was bending his torso all the way forward to his thighs and back into the backrest of his chair. A yoga girl had taken all kinds of odd positions. Once she was balancing on her with her legs stretched to the sides. Her hands were holding onto the anatomy book. Some people had purple sacks under their eyes. Some people had really disheveled hair as the spray wore out and they scratched their head. A survivalist girl had tried eating the plant decoration of the library. It was a South American plant that gave her hallucinations. A nurse took her away.

Unerringly, Sandy's abrupt head dropping and jerking back up ended in her head staying down. Armando picked up his soda can of purple. He moved it over Sandy's crotch and let a drizzle of water from the bathroom down. Any remnant of sticky colored soda had long been washed out by the frequent refills. Dave punched him hard. Armando lost his balance and dropped the can into Sandy's crotch. The can quickly spurted out the water onto the brown dress. Sandy woke up and punched the can away.

"Sweetie, this time it was really Dave. However, you have not reason to be upset. We saved your ass. It is modafinil time. It is time to feel like a top gun pilot, wide away through forty hours of combat. See even Dave will take one. He has an open tap on IOU's with me. He already owes me one favor for the scalpel drop. Sandy, it is time that you join the gang."

Dave quickly grabbed a modafinil. Even he knew that he was simply a string man to induce Sandy into the boob grabbing, he knew that he was a slow learning in need of an edge. Sandy poked her stinky finger into the air at Armando and took a hit of modafinil as well. From then, Sandy got only more edgy. Every other time that she flipped a page in the anatomy book, she'd hiss peanut balls, trashy rat, and so on at Armando. Armando enjoyed getting back at her by talking about spiders walking in her hair or her getting dangerous wrinkles from dehydration. Sandy would each time jump up and run around the library. The side effects of edginess and anxiety were setting in.

Around noon, a group of noisy kindergartner kids ran into the library. They were on an excursion trip. Their teachers quickly herded them out. Armando had noticed the two Pakistani girls had not looked up at the kids screaming "I will be a doctor, too." They were both sitting in armchairs with a little magazine table in between them. Armando slowly closed in from behind one. Armando said, "For every evil under the sun there is a remedy and your mine." Neither of them motioned. He carefully got his red pen out and wrote "loser" on their foreheads. After they still did not rouse, he undid the top two buttons on the shirt of one girl, so that the inside edges of her boobs could be seen. Then he walked over to the professor to get the two questions down credit for his deed.