If I only had a brain

The process of packing, sorting, organizing, and/or discarding my possessions for the upcoming move to the West Coast is causing many relics of past lives to float to the surface. For example, this afternoon I came across two bars of "If I Only Had a Brain" from The Wizard of Oz arranged for theater pit orchestra in my hand.

Once upon a time I worked as a music copyist for the Fifth Avenue Theatre in Seattle when the big musicals would come to town. The numbers were often edited for the requirements of local choreography, etc. and needed minor (or major) re-arranging. In this case the song was cut short, requiring two new final measures that exactly matched the existing arrangement. It was the end of the day, everyone wanted to go home, and the number was being rehearsed in the morning, so I volunteered to do it. (The arranging goes quickly but players' parts have to be prepared for the entire orchestra, which is the time-consuming part, even if it's only two bars.)

Anyway, my two measures saved the day (or at least saved my boss some time that evening) and it turned out to be be my big break in theatrical arranging. I got to do more and more work on subsequent shows, which became a big part of my arranging work in those days when I was composing and arranging professionally.

It was really fun work, too. The shows' original scores were done by the old Broadway pros and I had to seamlessly match the new material with the classic old arrangements. It's a strange gig because -- even more than film scoring -- the better you do your job, the more imperceptible your work should be. However, I would sit up in the balcony during a rehearsal or performance and when, during a dance number, the romantic ballad would appear as a tango, I had the satisfaction of knowing that the change was my work but hoping that to the rest of the audience it all sounded like the original score.

R.O.C.K. in the U.S.A.

As my cohort of fellow medical students heads off to start intern year we're understandably a bit nervous about the prospect of the responsibilities we're about to face. In particular, quite a few of us worked in other countries during the last six months where we had a chance to see how doctors are trained elsewhere. And let me tell you, it was pretty humbling. In the U.S. we're required to take (and beat the curve in) three or four years of premedical basic science courses before we even start, after which the first half of med school itself consists largely of another two years in the classroom. It's not until the last two years of med school that we really get out and work with patients directly. But even then, the curriculum has changed in the last couple of decades (in large part due to a combination of legal pressures and specialization) so that we're extremely limited in the procedural training that we actually receive. I personally don't know any American medical students who feel that they've gotten the practical, hands-on training needed for what they'll be expected to do as interns.

In contrast, a common model in many other countries is for med school to start directly after secondary education, so that students are trained to do procedural work with patients much earlier. The result is that, although our foreign counterparts may not have our command of biochemical minutiae at this point, they are way ahead of us in terms of their practical abilities on the hospital wards. Although it all evens out down the line (we hope), more than a few of my U.S. companions sure wish we'd gotten more training in procedures during the past few years, even if it came at the expense of some basic science in the classroom. This is echoed by the old-school clinical professors who will often remind us that when they were medical students they already knew how to do more in the hospital than most interns do today.

However, although I may wish I had more practical training going into residency, it occurs to me that the U.S. is pretty much the only place where I could do what I'm doing at my relatively advanced, non-traditional age. (I'm the oldest student in two or three consecutive classes at my school, and an outlier on the age chart for any med school in the country.) It's common in other parts of the world for even a few years taken away from medical studies at a young age to disqualify a person from becoming a doctor (or at least become even more of an obstacle than it is here). So for those of us in the somewhat older, medicine-as-a-second-career club: go USA!

Pomping the circumstance

Finally managed to fulfill my bloggy tourist responsibilities by getting a few pictures up from the recent Mexico adventure. Tomorrow is graduation so Lady M and I are getting ready for an influx of house guests and other visitors, as well as a round of social events. It still hasn't really sunk in that medical school is finally over. Lemme tell ya, it seemed like it would never end....

But here we are. Several days of frantic formal fun, and then it's time to move to San Francisco.

Images from Mexico (3): Details

Floral tiles, Xochimilco.




Wall of skulls, Templo Mayor, Mexico City.




Sundial, Oaxaca.




Corner window on the campus of the National Autonomous University of Mexico.

Images from Mexico (2): Looking up, looking down

Metropolitan Cathedral, Mexico City.




Interior observation deck of the Torre Latinoamericana, Mexico City.




Domes of the Palacio de Bellas Artes, Mexico City.




Reversing spiral staircase, Torre Latinoamericana.

Images from Mexico (1): Views

Bougainvillea petals drip onto the cobblestones in Xochimilco, Mexico City.




The fortress of San Juan de Ulúa and the modern port of Veracruz.




Tepepan neighborhood, Mexico City.




Bronze Tenochtitlan (a model at the Templo Mayor site, Mexico City).




Xochimilco street scene.

First editions

What to do with my time off? Well, this afternoon I stopped by the John Martin Rare Book Room. The librarian very graciously pulled a first edition of De humani corporis fabrica off the shelf (and let me browse through it!), as well as pointing out the the exact spot in a first edition of Exercitatio Anatomica de Motu Cordis et Sanguinis in Animalibus where William Harvey first introduces the concept of circulation of the blood (at the beginning of Chapter Eight). It was all quite a treat for a bibliophile like me.

Done!

I can hardly even believe that I'm typing these words, but I finished medical school today! There's going to be some misbehaving tonight....

One... more... day...

Tomorrow is my very last day of medical school. What am I gonna do with myself next week?

Spell check

You know that guy, the one who takes his finger and scrawls "Wash me" on a dusty car? He lives in Mexico, too....



"Láveme" is Spanish for "wash me." But what makes this one really special is that someone took the trouble to correct the spelling. "B" and "v" are pronounced the same in most dialects of Spanish, and substituting one for the other is not unusual. (During my month in the hospital doctors frequently had to spell out drug names so that Bactroban wouldn't come out "Vactrovan.")

That was close

Yesterday after finishing for the day I was walking under some trees behind the Med Labs building. There's a scenic little ravine back there with a grassy spot where employees gather for smoke breaks. We've had some storms lately and a lot of branches are down.

As I'm walking towards the road I hear a thud on the pavement. I turn around and there's a branch as long as I am tall lying on the pavement where I had been walking just seconds before. A woman standing nearby smoking said, without changing her expression, "that woulda hurt."

Only one week of medical school left. Perhaps this was an apt metaphor -- a narrow escape? I think I'm going to go buy a hard hat.