Monday, November 17, 2008
Tales of the Perineum
Pictured here is one of many different views of the Pelvic Floor and Perineum. This is the region of the body that has, well, all of those bits that you need to finagle around during your history and examination without *actually* talking about them.
At my medical school 'Abdomen, Pelvis, and Perineum' (APP) is the last large anatomical section covered before the comprehensive final exam. The faculty, wisely, threw us into Perineum first, as though to get out of the way.
You see, this section turns every driven, focused, sometimes married medical student into a Twelve-year old-- if only for a few minutes during a supplemental study group session.
My moment came this past Thursday when our Supplemental Instruction, an elective review group that meets twice a week to review lecture and lab concepts started reviewing the features of external genitalia. For the vast majority of the time, we sift through the slides, label diagrams, and look at Netter diagrams that are just contrived enough, without sacrificing accuracy, that one wouldn't feel uncomfortable.
Avoid eye contact, crack a little one liner, and keep labeling-- Rinse repeat.
Our group leader, Christine, thought we should go through and check our answers as a group. Usually this is a portion of the class where a few of the students, typically bright, type-A's tend to dominate the conversation and turn each question-answer session into a competition. I joined in at the beginning of the year, tasting the same prospect they must have to set themselves apart from a group; but I've since chilled out and filled the niche of "that guy who follows up what people say with some witty retort". I figure, let's save the frustration and stress of such competition for when we have to impress someone.
Christina pointed at a structure using her handy-dandy overhead and we mumbled out an answer (or sometimes a few different answers). We began on the external female genitalia: mons pubis, labia majora, etc.
Finally her pointer landed smack dab on the glans clitoris.
Well, in the rush to answer first my good, and married, friend Steve (one of the competitive types, but with a good sense of humor) blurted out, "External urinary meatus....uh..err." He strained, quickly realizing the gravity of his error.
I couldn't resist. Before Steve could correct himself I loudly responded, "So Steve, how's your marriage?"
The group erupted in laughter for a good moment, and a few people chimed in with various un-professional-but-hilarious comments they seemed to have bottled up. It was as though we performed some fasciotomy on the compartment syndrome-like tension.
After getting that out of our system we continued with the review series and went on learning.