August 10, 2009

what the hell is water? (first day of medical school)

question: what about yourself, your life, do you assume to be true, that could be entirely and completely WRONG?

the answer is complicated (mostly because I don't know yet), but the question is a result of today being my first day of medical school. After the requisite intros to the school and the curriculum, we were introduced to our first course with a quote from a speech by David Foster Wallace, where he talks about how two new fish are swimming along in the ocean when a big fish swims by and says "morning boys, how's the water?" after he swims away, the new fish turn to each other and say "what the hell is water?"

our professor today (and David Foster Wallace originally) said this to demonstrate the importance of knowing the environment (and assumptions) we make based on the experiences we have had; and what we don't question because of it. the class is designed to make us question specifically this - what we think to be true - about ourselves, about medicine, about our patients - that just might not be.

It has made me think about the aspects of myself of which I am not yet aware. I looked up DFW's whole commencement speech at Kenyon because I was so curious how he elaborated. The theme of his speech is why learning how to think (i.e. what a liberal arts education teaches you) actually is really important. In the speech, he says, "...learning how to think really means learning how to exercise some control over how and what you think. It means being conscious and aware enough to choose what you pay attention to and to choose how you construct meaning from experience." I try to extract meaning from most experiences, but I am trying to think about the types of meaning I try to extract - truths about the people in the experience, truths about the places and relationships present, and maybe even bigger truths about the world, but perhaps too rarely to I try to extract meaning for truths about me. More on this later, because I want to think more (and tomorrow, in class, learn more) about how one does this.

In the meantime: Do you think you examine this in your own experiences? What are the tools or guidance you use to help you do this?

The instructor also introduced science as a philosophy based on "unrestrained curiosity" - unrestrained by assumptions of what is or is not true. Because in science, you can - and are encouraged to - test everything. He called it an open-minded skeptism of everything; taking it all in as something that might be true, but has not proved to be - YET. I dig it. I think this is perhaps why science is my favorite religious philosophy (if it could fit into that category...can it?)

On another note, my big sib (and guide through medical school) told me today that he has realized that he has to be a specialist. When I asked him why - he said that he's just not smart enough, doesn't have the mind capacity to understand as many systems as thoroughly as you have to in order to be an effective internist (same thing as a PCP). Later, I talked with a guy who is taking a year off between his 3rd and 4th year to work in a pathology lab. This means that he's getting paid to dissect bodies and tissue to figure out what went wrong. I asked him why he would ever want to do that for a whole year (or what I really said was: oh. that's cool. do you want to be a pathologist?), to which he responded that in his experience, the pathologists knew the most - and because he wants to be an internist, he has to know as much as he can. I love that primary care physicians are regarded with such a high degree of respect here. I guess I knew that would happen coming here, but I think I pictured it more like all these people who still acknowledged specialists were smarter, but knew that internists were more important. But now I am wondering why I ever believed specialized knowledge made you smarter. The more I think about it, it's just a different kind of thinking: do you want to have to hear the story and put the pieces together, knowing you'll never - or rarely - have them all under control, or do you want to be called upon to perform a set of skills that you have, for all intensive purposes, mastered? I'm going to keep asking myself that question - but I lean towards the former right now.

"It seems important to find ways of reminding ourselves that most "familiarity" is meditated and delusive."
-David Foster Wallace

"Try to learn to let what is unfair teach you."
-David Foster Wallace (Infinite Jest: A Novel)

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