Pressure makes diamonds

Thirty-nine years ago, I made a career choice.At the time I was a faculty member at Columbia, fully engaged in neurophysiological studies, utilizing intracellular microelectrodes to analyze cortical and thalamic neurons.Then one day a call came from the Albert Einstein College of Medicine, inquiring as to my interest in becoming Chairman of the Department of Anatomy.Why me?I soon learned that it was the expectation of the Search Committee that I would build a strong neuroscience group based in Anatomy.Presumably, I could leave the heavy lifting in gross anatomy to others.Recalling my own experience as a freshman medical student at Harvard in 1949, I did the unexpected.First, I spent my first year as Chairman of Anatomy interviewing all the first-year students to learn about their general interests and specifically their impressions about gross anatomy.The result of this was a validation of my own sentiments about anatomy and its importance as the gateway to the proper study of medicine.As Chairman, then, and as Dean now for over 20 years at Einstein, I continue to hold the view that medical education stripped of the historical and experiential study of the human cadaver would fail in its essential purpose of defining the process that transforms students into physicians.It may not come as a surprise to learn that many faculty think otherwise.In attempts to find time for an expanding curriculum, some maintain that too many hours are devoted to lectures, demonstrations, and laboratory dissections in gross anatomy.Indeed our curriculum must be configured to provide more time for new subjects such as genomic medicine, molecular and cellular integration, and epidemiology and for teaching about cultural diversity and professionalism.There is anxiety that students may be so pressed to study gross anatomy that they neglect other subjects.My response to hardpressed students is: Pressure makes diamonds!After all, we admit students who have demonstrated uncommon intellectual maturity and capacity for cognitive growth.Thus, it behooves us to make our entire curriculum as stimulating as possible, even in this Age of Limits.In the fifty years since I began lectur-ing Columbia medical students about the brain, I have been privileged to bare witness to major revolutions in medical science, therapeutics, and interventions.But what I'm particularly grateful for is the thought that the surgeon who replaced both my aortic and mitral valves last year may have consid-