From the past: This week in shit to listen to while we memorize the cranial fossas

Dated 10/20/2013

http://youtu.be/EQIVWhKhwPA

I hope all of you are taking advantage of a short respite this week of insanity - after our ferocious powderpuff win (Facebook pictures for proof), the races I ran, and an (almost) free weekend (at least no test on Monday!), we are shuffled yet again into our next challenge - the NBME mini-board exams. I can assume that none of us have ever taken this exam before, and that we all have some anxiety for it.

The engagement of examination and studying is non-stop, and the number of unknowns is in itself unknown. Some of us don't even have a preceptor assigned yet. 

But in the end, we must keep calm and carry on. This is the essence of character captured in the second movement of Symphony 5 by Beethoven. All of you have probably heard the defining motif of the first movement, as Fate herself knocks on the front door! The second movement is far less ominously foreboding. The first few phrases in the major key give a sense of stoicism, as if one is marching forward with steadfast composure in the face of the most challenging of circumstances. 

I remember this coming onto the radio in Boston (WGBH 99.5) back in the summer of 2011. At this time, it was my first try at applying for medical school, with only a few interviews and no offers. I knew I should have waited, as I had a weird and jerky start to the first half of undergraduate career, but I decided to bite the bullet and give it a try. 

This was a time of great uncertainty for me, as medical school rejections compounded with job application rejections. On top of that, I was studying, yet again, for the MCATs. One can no doubt imagine the depressive and pitiful state that I was in. On some days, getting up in the morning was the most difficult thing to do. And I remember very vividly, in the middle of June, with my iTunes alarm set at 7 AM to play WGBH, I was awakened by Laura Carlo's announcement of Beethoven's 5th. The first movement was certainly a good wake up call, but I stayed in bed, not moving for the duration. It wasn't until the second movement that forced my volition to get up and say to myself, "I got shit to do." 

Fate, if you believe in it for philosophical or religious reasons, has already completed her duty as our pathfinder. Fate knocks on the door, we open it, and invite her in for a hot beverage and Minnesotan hotdish. And the idea conveyed in the second movement is the idea that regardless of what path Fate has assigned to us, it is up to us to make the best of it; to let ourselves divulge into pouting, saying that "Fate is unfair", or something to that liking, does not help our condition in any means. Sometimes, events transpire even when we have no control over them. If one believes in the just nature of Fate, one must grit their teeth, smile, accept the fact that any outcome is the best of all possible outcomes, and tackle her challenges head on, like Val did during the powderpuff game.

But that branch of philosophical discourse is not what I am thinking of. What I think of when I am miserable in the library is how Fate has brought us together. You will make it through this, just like you did with the MCATs, the SATs, the middle school chess competition (I'm a nerd, I know); an added factor is that you will be amongst all of us (FOR THE NEXT FOUR YEARS WOW THAT'S SO MANY WEEKS OF CLASSICAL MUSIC I BETTER START WRITING AHEAD OF TIME). 

And that is an encouraging thought... that we are with each other, not the spam email I send to you every week... but still, I hope you enjoy them!

See you all on the dark side.

This week in summer vacation

It is about one year ago that I had visited Munich for the second consecutive summer. For some reason, the Bavarian city contains an allure that is hard to resist... or because there was a business conference that required my presence.

But truly, Munich in my opinion is a city in which one can settle. It has the ambience of Boston - considered a city due to its wealth in culture, education and pleasures, yet much less hectic than Manhattan. Its history and culture is rich as well, with the Pinakothek's, Kirchen, und Residenz. Even more attractive is its location at the heart of Bavaria; a few minutes on der Deutsche Bahn will place you on the Bavarian countryside, with magnificent views of the foothills of the Alps.

http://youtu.be/BMf314Ougus

The glass armonica was invented by Benjamin Franklin, and one was on display in the Deutsches Museum in Munich (taken by me.. yes, another Halperin moment). Franklin in the 1760s first worked with a private glass blower in London to create a mechanized "glass harp" (or, from Greek history, referred to as hydrodaktulopsychicharmonica, or "harmonica to produce music for the soul by fingers dipped in water"). It was in London, while traveling with his father Leopold Mozart, that W.A. Mozart was first heard the instrument. It wasn't until the last year of his life that W.A. Mozart composed for the instrument in Vienna. 

Around the same time, a philosopher by the name of Immanuel Kant was at the peak of his engagement with the intellectual spheres of Europe. His often-quoted essay on "What is Enlightenment" (1784) details the overall sentiment of the European Enlightenment, the rebirth of knowledge, rationality, and logic within the budding scholarly and scientific initiative in modern Europe at the time. To spare you reading Gothic German font, enlightenment is the progress of the human being to use his or her reasoning unfettered by religious censorship or authoritarian duress. "Habe Mut, dich deines eigenen Verstandes zu bedienen!"; "Sapere aude!"; Have the audacity to utilize your own reasoning!; Dare to know!

Having finished our first year in medical school, we ought to be amazed at our mental capacity. The brain and mind's plasticity under high levels of stress, torrents of information, and all the meanwhile preserving whatever is left of our ability to socialize, is truly something of a miracle. In the past year, we have gone through clinical anatomy, histology, the entire physical exam, physiology, biochemistry, biostatistics, neuroscience, and behavioral science/basic psychiatry, and we are ready for more to come! I doubt that anyone had known the amount of material that was to be thrown at us prior to starting medical school.

And this is the spirit of Enlightenment (note the capitalization). We dare to know, to learn about everything there is to know about the normal human, and in the near future, the human under duress of illness. Due to this sentiment of epistemology, this theory of acquiring as much knowledge about medicine as possible, and along with the shear breath of this type of knowledge, we are set apart from the rest of the world who rely on us to one day need doctoring. 

But herein lies an internal conflict - if we are so set apart from the rest of society in such a unique and necessary set of knowledge, how can we possibly collaborate with others of society, who know so much less, and perhaps due to their ignorance, may not have any of what we tell them?

Like it or not, each and every one of us, only taking into our account of knowledge that we possess, are outsiders, an existential entity that transcends the normal currents of society in thought, knowledge and skill. And this is dangerous: with our knowledge, we have the potential to do great justice, but just as likely to do great evil. In the clinical setting, in a person's weakest and most vulnerable state, we will have the capacity to give beneficial or malevolent advice for the organic vessel that contains their mind. All human action is guided by motives, upfront and ulterior, and this is dangerous. 

Outside of the clinic, our knowledge is very minimally required or even needed. We may even be considered outcasts of society, one which contains a majority of people who do not know what sort of environment we work in or care for the knowledge that we possess. We are set apart in our knowledge and the element in which we transcend all others. How, then, are we to integrate ourselves into society, as we are human, too?!

We participate in the humanities. At our recent Convocation Of Thanks, I had witnessed just the tip of the iceberg of what makes us truly exemplary human beings. Knowledge is one side of humanity, with rationality being the other. It is our ability to express emotion, through art and culture in whatever way, that makes us not only highly knowledgeable individuals, but also highly rational human beings. And it is through our rationality, a part of which exists as our expression of our human, that jettisons us back into society as its members. It is rationality that levels us and other in society, such that what is truly at stake in society are our dignities, vulnerable, exposed, and equal across all human beings. There is no derealization of our rationality (irrational thought, as expressed in the epistolary novel La Nausee by Sartre) along with no disillusion about the amount of knowledge we possess, will possess, or will never possess as far as medicine is concerned.

So, it is our practice of the humanities, such as music, art, writing, etc. that connects us back into society. This is why I love and practice music, write, and converse (even though most people hate it when I do). The exercise of our rationality keeps us human, and the expansion and utilization of our knowledge allows us to transcend and help our fellow humans in the appropriate setting. Because of our rationality, our human dignity is as exposed as all other in society. And in anticipation of our second year of medical school, I can only give you the advice of sapere aude, but listen to classical music and read my blog.