Laminectomies and Anatomy Lab

I survived.

Can't say much more than that, but I survived, at least so far. We don't know our results yet, but rumor has it that "many of us will be disappointed." I'm afraid I may be in that group, but then again, for many of my classmates, any score below 90% may be considered extremely disappointed. For me, however, a business major who feels like not just a fish out of water but a fish beached on the blistering hot sand amidst a sea of biochem, biology, and other science majors, I'll be happy to just have passed the first exam.

This post is not about the exam, but instead about a few other thoughts I'd like to share tonight while here on this box of soap.

Today in our anatomy lab, we performed what is called a laminectomy. In medical terminology, the suffice "ectomy" means "to remove or to take out." So, today we removed the lamina from our cadavers, or in other words, we removed the lamina of the spinal vertebrae, revealing the tissues that the vertebrae are designed to protect, the most notable of these tissues being the spinal cord. Without describing in too much detail how the laminectomy is performed, let me just mention that we used a bone saw, a chisel, and a mallet to break the bones of the vertebrae to remove the vertebral lamina and expose the tissues of the spinal cord.

As we finally broke through all of the vertebrae covering the spinal cord, I watched as my lab partners pulled off the newly broken strip of bone and tissue. I had read about the spinal cord, seen many artistic renditions of the gray and white matter, studied the posterior and anterior trunks and nerves that brought nervous impulses to and from the spinal cord and brain, but even then, I waited nervously to see what it would all look like. We first came to the dura matter, the superficial tissue of the meninges, a brownish/pinkish tissue no wider than your pinky finger. We then made a long cut and pinned back the dura matter, to then reveal the remarkable meningal tissue deep to the dura matter, the arachnoid matter, so named for its transparent, whispy, and cobweb-like appearance. We then noticed that there seemed to be some type of liquid inside the arachnoid that would rise and fall when the tissue was slightly depressed. "That's cerebrospinal fluid!" one of my classmates remarked, followed by echoes of "wow" and "no way" as we realized that this was the very fluid that is removed when a lumbar tap is performed. We delicately cut and pulled away the arachnoid matter, then revealing one of the most simple, yet remarkable structures in the human body--the spinal cord. Covered by the deepest of the meningeal tissues, the pia matter, the spinal cord is no thicker in diameter than a pencil. It is lined with blood vessels and about every two inches has nerves protruding from both sides. I realize that this description is not only evidence of how little I know of anatomy, but that it is also an injustice of how beautiful is the spinal cord and its surrounding structures. To think that every heart beat, every muscular movement, and every skin sensation of a pin on the tip of your finger passes through this simple tube we know as the spinal cord is evidence to me of the incredible creation that is the human body. Surrounded by blood vessels, cerebrospinal fluid, and a protective covering that can only be penetrated using a drill and hammer, this spinal cord is one of the most vital tissues for life. So when you wake up tomorrow morning and crawl out of bed, stretching and yawning as you begin the day, "stand a little taller," stretch yourself, stretch your vertebrae and your spinal cord, knowing that your spirit is housed within what we know as the human body, one of God's most remarkable creations.

Is this my new life?

It is 7:47 pm on Sunday and I am wondering if this is how my new life will be. The rest of the world is enjoying their evening and I am feeling the adrenaline of my sympathetic nervous system pulsing through my veins, causing my pulse to increase, my blood pressure to rise, as I prepare to "fight-or-flight" for tomorrow.

Tomorrow is my first medical school exam.

Perhaps it is that I am nervous because I never took anatomy in college, or perhaps it is all the other brainiacs in my class that intimidate me, or perhaps it is the page-long email from the School of Medicine Dean's office that we received on Friday evening telling us that we are not allowed to bring watches, mp3 players, backpacks, paper, or pencils into the exam on Monday morning and that we should arrive early because the exam will begin promptly at 8 AM.

Hopefully once I get this first test out of the way I'll be able to relax a little bit and know how to prepare next time. The first-game/first-test jitters will hopefully not prevent me from performing well on the exam. That being said, this is medical school, and I think I may have just entered into the fraternity of anxiety, stress, and worry that seems to ail most doctors. After all, this stress and worry is largely due to the pressure to learn the material so that I can tell you what's wrong with your sick baby, why you can't seem to get pregnant, why your sibling/parent/friend has a chronic disease, and so forth... I guess with that in mind, maybe it's a good thing it will be so difficult and challenging? It will be worth it, right?

Although I am somewhat anxious for what lies ahead, I am equally thrilled. This first week of school has been very exciting and lots of fun. Now if I can just get this first exam out of the way.

The revolving door . . .

Do you remember your last day of elementary school? I sure do. I waited eagerly at the door for the final bell to ring, ironically anxious to leave elementary school and move on to junior high. As I ran from the halls of Rosslyn Heights Elementary, my heart raced with enthusiasm. I was thrilled for summer, and excited at the new world that was Hillside Junior High. Despite my enthusiasm, however, I believe that even as a pre-adolescent twelve year old, I still realized somehow that life would never be the same once I left. Gone were the days of recess, of saving my money for the two edible foods in the cafeteria-peanut butter squares and pizza, of trading my mom's to-die-for chocolate chip cookies for Eric Anderson's Swiss Rolls, and gone were the days of being the fastest runner in the school. I was excited to leave elementary, nervous to be at the bottom of the newly complicated junior high heirarchy of popularity, but simultaneously enthused to begin a new adventure.

Funny how so many of the experiences of life are merely iterations of the past. I somehow managed to make it through junior high, then felt similarly mixed emotions upon leaving Hillside Intermediate to enter Highland High School, became teary eyed when I pulled off my football helmet for the last time as a senior and gazed up at my friends, coaches, and family as I sang the school song for the last time, was thrilled to leave for Brazil as a missionary but sad to leave family and nervous at the adventures that awaited me and then two short years later was thrilled to leave Brazil as a missionary but sad to leave family in my new home and nervous at the adventures that awaited me back at my suddenly unfamiliar home in Salt Lake.

The opening and closing of chapters in life is not so much a progressive journey down a long hallway as it is a revolving door. We enter just at the right moment when the door is open. If we wait too long, the revolving door will pass us by and we'll have to wait for the next time it comes around, missing out on the adventures available only once we take that step across the plane of the door. Once inside, we join others that have also chosen to enter the door at the same moment. We learn with them, we learn from them. We cry, we celebrate, we experience what that rotation of the revolving door has to offer. We don't often realize, however, that time continues to pass, that the revolving door is still doing that, revolving, evolving, changing. Just when we are comfortable, the door opens once again and we nervously must leave our familiar experiences and step into the unknown. We are saddened to leave what is left behind, but thrilled for the new experiences ahead. And then the door opens again, and we get in at just the right moment to start the next rotation of life's revolving door.

The door is closing on this last chapter of my life. I am sad to leave what has been so familiar to me for the past 5 years of life. I will not miss Provo itself, University Parkway traffic on a Friday night, church meetings in a biology lab, or the creepy and weird chant of the BYU fans lifting arms up and down in robot-like rhythm to the theme of Star Wars. I will, however, miss the great times with my bro and sis, my friends at work, and the important lessons of life learned while in P-town.

The revolving door of life continues, and with the close of this past chapter of life, the door once again opens to a whole new world, and I don't mean A Whole New World of magic carpets and "new horizons to pursue" like in Disney's Alladin.

What will this new world be like? How will this new world change my perspectives, my goals, dreams, and insights? What lessons will I gain in this new chapter of life? What is this new world, this new chapter of life to which I am referring? Well...

Tomorrow I will start medical school. Enough said.

Introducing...Steve's Box of Soap!

In the early 19th century, the executioner's gallows were removed from the Northeast corner of London's famous Hyde Park. The public, however, continued to visit Hyde Park--no longer for its gallows, but instead to have a forum for free speech. In 1855, for example, shopkeepers gathered in the Northeast corner of the park to protest the newly passed law which forbade businesses to operate on Sunday. Other public rallies followed, and in 1872 the Northeast corner of Hyde Park was officially designated as a site for public meetings. Since 1872, political enthusiasts, religious missionaries, radical thinkers, drunks, leftists, rightists, and everyone in between is invited to stand on their own "Soap Box" to offer their opinion. The soap box enthusiasts have included revolutionary thinkers such as Karl Marx, George Bernard Shaw, George Orwel, and even V.I. Lenin. Each speaker is typically given three minutes to develop their theme, someone then shouts "Liar!" and then the fun begins. The soapbox speaker is then subject to the often-outlandish comments of his listeners until someone else spins off their own idea and takes control of the proverbial Box of Soap.

And herein is born Steve's Box of Soap. While many blogs address a very specific topic, this blog is without limit, just as the SoapBoxes of the Speaker's Corner in Hyde Park. Steve's Box of Soap will hopefully be funny, insightful, random, goofy, and interesting. Most importantly, Steve's Box of Soap will be insight into what I would be saying if I were standing on a Box of Soap in Hyde Park's Speakers Corner.