Fear and Innocence

So I just finished writing the first set of exams in my second semester. I am pretty sure I did well on Phisiology and Immunology. Molecular Biology is another story; I’ll be lucky if I passed. I have been asking myself why I have had such a difficult time studying for this class.

This block, we were studying the cell biology and genetics of cancer. Now having just had skin cancer removed, I am still a little paranoid (I already have a mental list of additional lesions that I want looked at and possibly taken out as soon as I’m back home for Christmas). While I studied for this exam, I had difficulty really digging into this subject. It makes me afraid to know more of what is happening to my cells. I have spent the last two weeks seeing mutated proteins and pathways gone haywire on a lecture slide, and imagined them happening in my skin cells. And listening to the stats (and knowing that 31 is pretty young to get skin cancer, even for a blond raised in Africa), it’s been hard not imagining myself the bearer of some horrible mutation that will eventually lead to full-blown metastatic disease.

We joke about Med Student Syndrome, where students imagine themselves to be suffering from whatever they are currently studying about. It’s an ironic reversal when you actually have what you’re studying about. To be perfectly honest, in the last three weeks, I have experienced moments of terror; first not knowing what it was, and now, even though I know I had Basal Cell (which is good), I still don’t know what I will have next.

Of course, the logical part of my brain keeps telling me that I’m borrowing trouble: they got it, you know what it is, what it looks like, and isn’t it neat that we know so much about cancer and that we can treat it so much better than we used to be able to. But the visceral part of me is loath to go there. And because I have always valued and trusted my intuition, I keep wondering if my fear is well-founded; that my body knows something I don’t and there is indeed a more dangerous lesion that I haven’t spotted yet (or that I’ll be one of the <.01% with metastatic basal cell). And so, while I studied, much of what I tried to learn didn’t stick. It didn’t help that my incision scar started to hurt last week. Pain isn’t a good sign, is it?

Many among you (and part of me) may well say, “You’re in medical school, it doesn’t matter if what you’re studying terrifies you, just suck it up and learn it! If you have a patient with this disease, you have to know what you’re doing, and can’t whine about how afraid you are of it.” And I agree with you.

I have always said that to learn a piece of information is to sacrifice innocence. For the most part, this loss of innocence is generally not a difficult transaction; the benefits of knowledge outweigh those of innocence. But I have found that even more than my experience in Gross Anatomy, this whole experience has forced me to confront my own mortality, and the uncertainty of life. When I was cutting into someone else who had died I could distance myself, and even though I was forced to think about my own death, it was easy to imagine it in a remote never-land; when I’m old and decrepit. In many respects, being forced to confront my own present frailty has been a huge affront to innocence; one that I’m still working through.

I have spent these past few weeks thinking about what would happen if I were to die now; things I regret, things I wish I had done, what I would like to have accomplished. There have been tears, and I’m sure there will be more. I have wondered whether it’s any use to be in medical school, racking up many thousand dollars in debt, when life is so unsure and I could be hit by a bus tomorrow. I have been confronted by my own loneliness and feelings of failure. Logical? Perhaps not, but it's where I've been for the past few weeks.

And I have been reminded again that the journey we take is often circular; it seems that we often learn something, only to be re-taught the same lesson later, at a deeper and more personal level. As a kid (in addition to many bad sunburns), I lived through the opening salvos of a civil war and learned very early that life is uncertain, and that our lives can change very quickly, and very badly. It would appear that God thinks it’s time for me to relearn this lesson.