GRAY'S ANATOMY

GRAY’S ANATOMY Last month I received a note of appreciation from Dr. Foster Hall regarding UPSTREAM IDAHO. Foster and I were both born at the Rigby Maternity Home in 1948. We were high school classmates with similar academic interests and became roommates at BYU before leaving on LDS missions after our first year of college. Had Foster not been an excellent student, making correct choices, I may not have pursued a career in medicine. He also encouraged me to date Mary Kay Hunter, who was the only other member of our high school class to go to BYU that year. Upon my return from a two-year mission to Canada, we were married. When I was a bishop at BYU-Idaho, Mary Kay was speaking to our ward and told them that she had waited for me while I was on my mission. Then she told the congregation, “I would never do that again.”  Foster notes that while he was looking at our high school yearbook, he found a picture of the “Future Medical Careers Club” filling nearly half of the auditorium. He was amused that I was not in the picture and was the only kid in our class to become a physician. Fortunately for me, belonging to a futures club was not a requirement for medical school. When I went to Provo to attend BYU, I did attend a few pre-med meetings but found the advisors mostly to be discouraging men who told us NOT to become physicians. My personal advisor was a seriously negative physiology professor, who was noted more for his absence of grace and civility than his teaching skills. This man told me that I was never going to be a physician. Good grief! That was the last time I asked him for advice and it was also the sentinel moment needed to ignite the fire under my smoldering plans to become a doctor. I applied to four medical schools. At the end of my junior year, a fat envelope arrived from Washington, D.C. Mary Kay opened it and started crying before she even read it to me -- she wanted to stay in Utah. The letter inside started with, "You are invited to join The George Washington University School of Medicine Class of 1975."  At the time I wondered if they realized that I didn't have a college degree, but was not about to turn down their invitation.    The first day in medical school will forever be etched into my mind. The Class of 1975 was the last class to complete their first two years in the "old" medical school. It consisted of a few historic, deteriorating buildings at 14th and H streets, in Washington, D.C. The lecture halls were the same ones my father and uncle sat in when they were in medical school in the 1930s. Building erosion was evident to even the most casual observers and underlined the need for a new medical school. Asbestos ceiling tiles regularly collapsed and fell on us during class. Large rats were often seen in the trash bins in the alleys. What great fun! The red light district had overtaken most of the other buildings in that area — certainly a contrast to the gleaming buildings and squeaky clean campuses of the intermountain west that I was used to. Gross Anatomy was the first class of the day and the morning included orientation to the cadaver lab, a large, open room, perched on the top floor of the school. There we met our cadavers, freshly delivered from the formaldehyde infusion and holding tanks. In our group of four students, two of us were interested in surgery and the others were happy to let us do most of the dissection. My lab instructor was George McCullers, who took me into a small office adjacent to the cadaver lab to observe a white-haired anatomist dissecting a baboon’s forearm, tracing the radial nerve. George said, “Roger, this is Dr. Goss. He is a visiting professor this semester.”  I had no idea who Dr. Goss was, but we exchanged pleasantries, and he, quietly and almost humbly, explained his dissection for about five minutes. As I watched, I appreciated that I was watching a man who loved what he was doing and truly enjoyed quietly sharing his profound knowledge with others. Afterward, George asked me if I had ever heard of Dr. Goss. I told him that I didn't recall ever hearing his name. He then told me to look at my newly purchased and not-yet-opened copy of Gray’s Anatomy in my briefcase. The name on the binder said, “GOSS.” Charles Mayo Goss had been the editor of Gray’s Anatomy since the year I was born. I had just been learning at the feet of the world's greatest anatomist, not knowing who he was. He was a gentleman and treated me like a respected colleague.   The first class of the afternoon was biochemistry. The man to my right had a Ph.D. in Microbiology. To his right was a classmate with a photographic memory who chose not to take notes. To his right was a classmate who thought he too had a photographic memory and took no notes — until after the first test. On my left, George McCullers sat down. It turned out that George, with a Masters Degree in Anatomy and my lab instructor in the morning, was my fellow freshman medical school student in the afternoon. And then there was me — a kid from Idaho with no college degree and no photographic memory, sitting in an old building in Washington, D.C. with around 200 highly qualified, over-achievers. I realized that I had taken a great leap of faith and was wondering what I was doing there -- wondering if that caustic BYU physiology professor had been right. I decided to get up early each morning, tape my ankles, and spend my days running as hard as I could. I did this for the next forty-eight years that have passed in what seems like the blink of an eye.        This spring, I sold my medical office and was faced with what to do with years of medical memorabilia that had accumulated on my shelves. The process was more painful than I had imagined. At the time of the move, I was away and could not be there as loving staff and family packed it all up into boxes. Unpacking the boxes, I picked up my 28th edition of Gray's Anatomy, and a flood of memories poured out. This very text was present for the actual beginning and the recent end of my medical career. The rich irony of this moment is that the book hasn't changed at all, while nearly everything around it is dramatically different from 1971.  As I placed it on the shelf in my library at home, I realized that a major portion of my life was now just rich history and will never be repeated. I would do it all over again.    Ever vigilant, Roger H. Tall, M.D.