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This month... Drinking

David G. Thoele

I was on the cusp of my first year in medical school, and time was running out. Classes started in two weeks. I needed a place to live--ideally someplace cheap, not too far from school.

There was an opening at Phi Chi medical fraternity, a large brick house of faded elegance located less than a block from my classes at the University of Minnesota. At $75 a month for a tiny room in the co-ed fraternity, it fit my budget. When I learned about the "beer machine," an old Coke machine that dispensed beer at 15 cents a bottle (a bargain in 1979), it felt like my kind of place. I signed the lease.

But throughout the entire discussion with my prospective frat brothers and sisters about the charms and quirks of Phi Chi, no one mentioned The Arm.

The first week of medical school was overwhelming. By Saturday we were exhausted--but not too exhausted to throw a party.

The party began slowly, but gradually people began to trickle in, and soon the dark living room was packed with med students, nursing students and several of my high-school and college friends who lived in town.

Loud music, dancing. It felt like a celebration. We had indeed survived our first week of med school. Only 199 more weeks to go!

Medical school seems as tough as its reputation, I thought. But maybe the occasional party will help me get through this.

At midnight, things had reached fever-pitch, fueled by beer, a week of pent-up energy and hormones.

Suddenly one of the second-year students let out a blood-curdling scream:

"Bring out The Arm! And cut the music!"

A hush settled over the sweat-drenched crowd of young future doctors and nurses. Soon someone emerged from a closet, carrying a cylindrical glass container. It was filled with formaldehyde. And a full-length human arm.

Dozens of people swarmed around it. A few left the room.

I found it repulsive, macabre, but I was also fascinated--unable to step away, or even avert my gaze.

The comments were predictable:

"Gross!"

"That is disgusting."

"I'm going to lose my lunch."

"Is it real?"

The Arm appeared to be a complete specimen, shoulder to fingertips, muscular, probably masculine. Its fingers curled inward, the nails a bit darkened but intact; there were hairs present on the forearm. In some spots the skin was peeling. It looked ancient, like the product of some medieval arm-removal torture procedure.

Lorenzo, a second-year student, gave us a short if incomplete history: "The Phi Chi Arm was removed from the anatomy lab a long time ago, maybe in the 1940s or 1950s."

I was incredulous.

"You mean they stole it?"

"It's more like it's on permanent loan," he said in a gleeful, half-crazed voice. He seemed to delight in shocking us first years, who lived in a medical fraternity but were still so new to the medical community. Maybe this is our initiation ceremony, I thought numbly.

"Whose arm is it?"

"Who knows? But it only comes out at special times--like this. And only second years get to decide when that is. First years like you: hands off The Arm!"

I felt like screaming, "This is the weirdest thing I've ever seen! Why are you all acting so upbeat and jokey? This is a real arm from a real human being. You're a bunch of body snatchers! If this is what I have to do to become a doctor, I want OUT!"

But I said nothing. Maybe I was afraid I wouldn't be accepted into the medical community, which now seemed like some kind of cult.

I looked around the room. My classmates were ghostly pale, wide-eyed and shell-shocked. None of us had ever seen anything like this.

All the second-year students were grinning from ear to ear.  

Lorenzo spoke for the group: "Welcome to medical school."

The Arm was returned to the closet. Soon the music resumed, and in a little while people were dancing again as if nothing much had happened.

But something had changed in me. Like The Arm and the second-year students, I had become detached. From my emotions.

I would face many such situations in the course of my career--times when I would strive to stay emotionally present in the face of human suffering. Sometimes I managed to remain connected to my feelings. But sometimes, to survive, I felt I had to detach from what was going on around me. Like I did that night.

I didn't know it at the time, but I now realize that this was the night when I indeed entered the cult of medicine.

After my encounter with The Arm, there was no going back.


About the author:

David G. Thoele is a pediatric cardiologist and director of Narrative Medicine at Advocate Children's Hospital, in the Chicago area. When his daughter got sick, in the mid-1990s, he experienced the medical system from a parent's point of view, which led him to reexamine how he practices medicine and helped him to develop deeper compassion for his patients. "I lead interactive writing workshops with physicians, nurses and parents, and I use writing and relaxation exercises to understand the role of the caregiver when my patients face illness and sometimes death." His creative essays are featured in Hektoen International and Physicians Practice, and he has published articles in Circulation and other journals.


Story editor:

Diane Guernsey

Comments   

# Dick David 2014-06-09 13:15
The story captures that induction we all went through elegantly. Why did they start our dissection in gross anatomy lab with the deep epaxial muscles of the back? How do you expect a hundred 20-somethings to keep it together in a room with dozens of dead people. We had never seen death. They had to teach us to intellectualize to survive. Unfortunately many physicians never make it out of that protective psychological sheath again and their connections with patients are the worse for it.
Nice writing, Dave.
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# Bruce Campbell 2014-06-08 19:03
David, Thanks for an essay that rings true. Creepy, but true!
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# Scott Newport 2014-06-08 08:26
Hey David, loved your writing style. I am not really sure but it seems that, “The Arm,” may have more meaning than I can really absorb right now. Later today I will re-read your wonderful story about how we see things from a different perspective.
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# Giancarlo Oviedo 2014-06-07 11:46
As a undergraduate pre-med student, it helps to know there are still few who truly care about the being of the patient without losing touch of feelings.

Thank you for sharing.
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# martina 2014-06-07 10:40
Wonderful story. I like the way you told it. For me, the anatomy lab had the same shocking effect. And I like that you are using interactive writing workshops to help yourself and others understand suffering. You said "understand the role of the caregiver" but I think it is wider--- it is actually helping each of us, in our various roles, which we often mix and match, to understand suffering. I learned something from your story, about helping others to write what is mysterious and hard to understand. Finding coherence is hard, and important.
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# C. Collins 2014-06-06 23:56
Very,very good article. Felt like I was there living the moment with them.
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# David Power 2014-06-06 22:59
Thank you David. As a current faculty member at U of Minnesota, I think I walk by the house you are referring to most days of the week. I have my own memories of medical school (in the early 80's) and subsequent residency with various unhealthy rites of passage whose main purpose, was, it seemed, to really test my mettle.

I believe that medical education now - while not perfect - is more humane and that graduates will not have had to endure some of the 'mettle-testing ' challenges of our pasts - hopefully for their, and our and society's betterment. Right? David Power
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