Philadelphia, Pennsylvania (Summer 2016)
We are gathered here today to mourn the loss of yet another beloved colleague and friend, the Branches of the Internal Iliac Artery. Like those who have gone before him, he was taken from us far too soon, during yet another brutal morning rounds. This marks the fourth time this week that the Student has failed to remember basic anatomy. We should’ve seen this coming. After all, the Attending had a pelvic surgery scheduled for this morning. But, like the passing of the SIRS Criteria last rotation and the loss of our dear friend the Henderson-Hasselbalch Equation during the board exam, this death hits hard not because it could have been prevented. On the contrary, this loss hurts because the Student had just reviewed this information. It was only yesterday that He had glanced at a Google image search of “vascular anatomy pelvis,” but when the Attending turned his frightening gaze upon the Student, the only words He could muster were “Ummm… the pudendal? the femoral? There’s one more, right?”
But we cannot lay the blame for this senseless tragedy on the Student. It is not His fault. Not even the all-powerful Attending is responsible for the loss of our friend. Sadly, my fellow factoids, this is a cruelty inherent to our own fleeting nature…
The other day, I was strolling along the paths of the Hippocampus with my friend, Ms. Rate Limiting Step of Glycolysis. The two of us were musing on the tribulations of the Student’s day, wondering which of us was next to be called away from our campus to stand before the Halls of Recall in service to Him. Rate Limiting Step of Glycolysis told me she felt herself fading, her usefulness vanishing before her eyes. “That can’t be true,” I responded. “He just took Step 1 a month ago!”
But she turned to me and said “MARMU, you are a simple and nonsensical mnemonic. You’ll live a long and (Student willing) useful life. Some of us have had to struggle for years just to stay clinically relevant. One of these days, our beloved Student will choose to specialize. Maybe He’ll be a gynecologist. Maybe a pediatrician. Whatever He chooses, I pray I do not live to see the bloodshed that day.”
It was a sobering conversation for me. Despite the Student being merely in his third year, I began to ponder how much He has already forgotten in the past few months. Hundreds if not thousands of our friends are vanishing into the Depths of Forgetfulness, leaving us behind: a motley crew of factoids, lab values, and commonly associated symptoms. If not for multiple choice exams and mandatory learning modules, would any of us still be here?
And so, we mourn not only for our beloved Branches of the Internal Iliac Artery. No, instead we mourn for all of us. We mourn for the fickle nature of memory. We mourn that the Student might completely forget the Law of LaPlace or First Line Antibiotics for Community Acquired Pneumonia but forever remember That One Awkward Time A Waitress Said “Enjoy Your Meal”and I Responded “Thanks, You Too!” Today, we mourn for what should be a healthy young mind reduced to quick recall and even quicker forgetfulness. Today, we are all the branches of the internal iliac artery.
Dedicated to the iliolumbar, lateral sacral, superior gluteal, obturator, inferior gluteal, umbilical, uterine, vaginal/inferior vesical, middle rectal, and internal pudendal arteries.
May they live on forever in the Halls of Wikipedia.
Samer Muallem is a medical student, stand-up comedian, and humor writer. He graduated from Brown University with a B.A. in Literary Arts and is currently attending the Sidney Kimmel Medical College of Thomas Jefferson University in Philadelphia.