At the museum under our noses, by Seth Morrison

History of Medicine museum, Faculty of Health Sciences, Ben-Gurion University 

It is quite remarkable what a medical student can learn simply by walking through the corridors of the BGU-MSIH medical school campus. There, a wealth of medical historical knowledge has been built into the very walls of its interior spaces. Thus, it is really an effortless undertaking for any medical student with a curiosity to understand the origins of their profession to simply walk and read through these exhibits. A total of an hour or two spent perusing them is sufficient to attain the beginnings of a well-rounded medical historical education from ancient times to the modern era. It was with this intention that I purposefully took to these corridors one day to see what I could find, and what follows here is an account of my findings.

The ancient Egyptians practiced a form of medicine in keeping with their mythology, incorporating various rituals surrounding their deities into their treatments. There are many different unique remedies that were used on patients, including hippopotamus fat and human excrement. The Nile dwellers also acquired more knowledge of bodily organs than other contemporary civilizations due to their routine procedure of embalming the deceased.

Medicine in biblical times drew on the religious traditions in the Bible and Talmud. The Hebraic practice of medicine was fascinated with life and death, a result of the veneration of mankind imbued by its creation in the image of God. The basis of Hebraic treatment was mainly social and personal hygiene: 213 out of the 613 mitzvot (precepts of God) are related to health in some fashion. Some of the surviving rabbinic texts, like the Mishnah, reveal a stark similarity of issues to the ethics of modern medicine in the polis: the rabbi criticized physicians for over-commercialization of their services and failure to attend to the poor, and drew a hard line by saying that refusal to attend to the poor is tantamount to homicide.

The basis of Greco-Roman medicine was Galen’s Four Humors. A “humor” is not a joke or jest, but the term applied to a bodily fluid. On their account, an imbalance of these humors was the etiology behind every disease, and they determined each person’s temperament: either melancholic, sanguine, phlegmatic, or choleric. Additionally, Hippocrates was the leader of a rationalist school of medical thought in Rome, and the Hippocratic corpus descends to us from this period. This corpus, we know, provides the ethical foundations for our modern practice of medicine in the West. And have you ever wondered where the medical symbol of a serpent wrapped around a staff derives from? It comes from the myth of Asclepius, the Greek god of medicine, who apparently carried such a staff.

Medicine in the Islamic world was also heavily influenced by Galen and the Roman rationalist school. The best hospitals in the world during the Middle Ages were said to be in Cairo, Baghdad, and Damascus. Many brilliant thinkers emerged from the Islamic world. Rhazes (d. 925) wrote the first accurate clinical description of measles and smallpox. Avicenna first suggested the contagious nature of tuberculosis. Maimonides, a prominent Jewish philosopher and physician, was a physician in the court of Saladin in Cairo in the late 12^th century and his fame extended into every great civilization of the time.

In medieval medicine, the term “physicus” began being applied to the academic doctors who philosophized about medicine more than they spent time treating people. Galen’s theory of humorism remained the dominant one, although there were many elements of folk medicine brought into the mix during this period. Observation of the characteristics of urine was the primary diagnostic test, and bloodletting was used as a treatment for a variety of ailments. Many odd elixirs, balms, tinctures, tonics, pills, and potions were given to patients to take, one of the most common being theriac, which had a long list of ingredients including viper flesh. Medieval doctors were not known for their effectiveness in healing. In fact, they were often derided for their impotence in jokes like this medieval poem:

Said time to the fool, be a physician,

and kill people for their riches.

You will have an advantage over the angels of death,

for they kill mankind for free.

This history may seem dry to some, but meaning always follows from reflection. It is given here merely to consider that there are many things to discover about the medicine of the past, and understanding where we came from is not a trivial pursuit. In reading these exhibits and inspecting their historical artifacts, I was reminded of the Hunterian anatomical gallery at the University of Glasgow and seeing its cadaverous collection of centuries-old anatomical specimens. It was there that I first became interested in the early roots of modern medicine.

In the end, it is unlikely that any hospital department head or patient of mine will ever be dissatisfied with me as a physician if I don’t know something about Vesalius or Boerhaave, Galen or Willis, Harvey or Hunter. Nevertheless, even though these things are inessential, I would think myself to be missing something vital if I was completely oblivious to the fact that, as Newton admitted, “if I have seen further, it is by standing on the shoulders of giants.”   - blogger of the month, Seth Morrison

for more information on the MSIH, visit our website at http://www.cumc.columbia.edu/dept/bgcu-md

On Hitting One's Stride, by blogger of the month Seth Morrison

The shuk in Beer-sheva

Once upon a midnight dreary,

while I pondered why I moved to a foreign country,

a strange sensation struck my psyche.

Was it elation, bliss, or gladness?

Lamentation, grief, or sadness?

None of these it was,

though for them many an instance gave just cause;

Instead the passion rubbed the middle,

defied assurance, like a riddle.

My heart had gathered all peaks and vales under its tent,

at long last found contentment.

This describes my recent progression through a set of phases people often experience after moving to an unfamiliar and less comfortable place than wherever it was they came from. Although the individual durations of each vary, it is said that one progresses through four phases in total:

1) the honeymoon phase,

2) the resistance phase,

3) the understanding phase,

4) the assimilation phase.

The honeymoon  period occurs when you first begin living in your new environs. The differences in culture and surroundings are still novel and intriguing. Every day is sweetened by new experiences and relationships.

When the honeymoon period wears off, the resistance phase sets in. This is when the question “What on earth am I doing here” is a perpetual elephant in the room. Small, relatively trivial trials and tribulations of daily life compound to appear as a massive, unsolvable problem. Second-guessing the decision to uproot and move increases in daily frequency, just as reversing that decision is decreasing in feasibility. My resistance phase hit its final climax last week, when our class of 2016 was taking final exams and simultaneously a four-day rainstorm hit Beer Sheva and all of Israel. I usually enjoy rain after having lived in Washington state, but Beer Sheva has a peculiar phenomenon some students have been calling “mudstorms.” This is what happens when rainfall and the fine Negev desert sand blown up by the wind mix in the air to create a clay-like mud vapor that tinges the horizon brown and coats any object that stands in its path, as though the desert wind god had taken up abstract expressionist painting. Consequently, the mental trauma of test-taking and dreary weather blended to produce a potent concoction of gloom that made me ask that question above a few times more than was comfortable.

This week, as I wrote about in my January 14^thpiece, the final exams were a thing of memory, a fleck of dust in my rearview (provided I passed them all, some scores still pending). It was during this week that I had my midnight insight, realizing that I had passed on into the understanding phase, and thus had gained some contentment to moderate the initial highs and subsequent lows of the preceding months. It was a week of reconnections with friends, such as an evening dinner and conversation stretching late into the night. It was a week of re-enculturation, such as spending a morning shopping for produce with the locals in the shuk (market). And, this week the skies cleared and temperatures rose all week long, as if God had revealed the bright Israeli shemesh (sun) to mark a promising new beginning for our class.

Blue sky in Beer-sheva

The assimilation phase has not yet set in and mustn’t be rushed. It’s both reasonable and prudent to give it ample time and space to develop on its own schedule, for that final phase is measured by a rate of furlongs per fortnight, not inches per instant. For now, my stride has been hit, and I have some work to do.   - blogger of the month, Seth Morrison

2nd year cardiology! by 2011 blogger of the month Nicole Magpayo

Second-year medical student Nicole Magpayo (seen second from right) couldn't resist sending us this post, to give prospective students a glimpse of second year.

She writes "As we get back into our normal daily routine of classes, 2nd year MSIH students continue with medical Hebrew classes. This week we were taught Cardiology physical exams and performed them on each other!"

Jaffa, by January blogger of the month Seth Morrison

There are few feelings quite as nice in the life of a student as the feeling of completing a round of semester-end final exams. When these are finally over, as they are now for our class of 2016, it is like a colossal weight that is lifted off the shoulders. This new-found freedom does not set in instantaneously after stepping out of the examination room, however. The pain lingers for about a day afterwards, like the residual aches a trekker feels in his thighs upon setting down his burden to rest by the campfire after traversing a high mountain pass. Then, after that day has passed, ever so gently the new freedom sinks into the soul as softly as a butterfly alighting on an outstretched palm. The world seems fresh and new, full of color and potential.

Fresh air is breathed by lungs that have known little else but stagnant, indoor, dusty Beer-Sheva air for the previous several weeks of reviewing. Once again the senses are reawakened, and the singing of birds and smells of the earth are noticed and appreciated. Of course, this spirited jubilation is always short-lived in the life of a medical student, for the rounds of intense study, exams, and interspersed periods of liberty are cyclical in nature.

It is in these interspersing periods of relative liberty that I most enjoy setting off on some new small undertaking. This, I think, helps to re-sharpen dulled corners of the mind and to find again fragments of knowledge that you forgot you knew. The undertaking could come in many shapes, sizes, and durations. It need not be doing some noble deed or philosophizing until a brilliant epiphany into the nature of existence is attained. It could be something as simple as walking next to a river, attending a symphony performance, visiting a museum, reconnecting with a friend, or writing a letter to your grandparents. Nearly anything that lies without one’s regular sphere of activities invites contemplation for those with a curious intellect.

So it was with this in mind that, after the completion of one semester and seeing the looming advent of the coming one just around the corner, I set off to spend a weekend in the seaside town of Jaffa on the southern skirts of Tel Aviv. Jaffa is renowned for its oranges (which I did not get the chance to try and which are currently out of season anyway), but it certainly had much more to offer than fruit. The town, possibly the oldest port in the world, is beautiful. Indeed the name, Jaffa/Yafo, comes from the Hebrew and Arabic words for beautiful (יפו in Hebrew). It is perched like a fortress on the side of a jutting hill facing the sea like an amphitheater, and has a density of art galleries that rivals any historic old city. Spending my weekend there achieved the desired effect many times over: it allowed a plethora of new and returning insights to sink into my brain. I watched fishermen bringing in their catch in the afternoon twilight. I saw an African-Israeli family celebrating a wedding in the town’s lovely hilltop gardens.  In the evenings, I heard the Islamic call to prayer belting from minarets, trailing through the chilly winter air, and then mixing with church bells chiming from nearby steeples. In short, the town’s idyllic charm and rhythmic, undulating ebb and flow of life set the mood for a relaxing and inspiring weekend, which was just the lift I needed to be reinvigorated before beginning a new chapter in Part One of my MSIH tale.  - Seth Morrison, first-year blogger of the month