Exam Week Ends: A 50-Day Winter Break Begins, and This Semester Was Fruitful

Today, our exam week for this semester finally came to an end. After sitting the last professional exam this morning, I shouldered my bag and took the high-speed rail back to Beijing. Ahead lies a winter break of fifty days. I ate lunch at home, then slept straight through the afternoon—catching up on the sleep I had missed during exam week, when my sleep quality was poor.

It has been nearly thirty years since I last took exams at school; my impression of school exams was stuck in memories of more than two decades ago. But in fact today’s exams are far less demanding than they used to be, and one need not expend nearly so much effort to earn top grades. Students nowadays are remarkably relaxed; even in exam week they remain absorbed in games and short videos, and many do little studying, because getting a diploma at university has become too easy.

A semester passes so quickly. Every day I am busy, drawn forward by ever more new and interesting knowledge, producing many new sparks of thought; there is far more I want to study deeply than time allows. My teachers and classmates are kind to me; teachers of non-major courses have tacitly allowed me to arrange their class time as I wish, and several teachers exchange a few warm words with me after each class.

From the second month on, I became the class’s “door-keeping uncle,” arriving after six each morning to unlock the classroom and leaving last at night to lock it up—a true homebody. To avoid drawing more attention to myself, not long after military training ended I basically confined my movement to the playground, the dorm, and the classroom; I did not even go to the university library, and spent most of my time in the classroom with my head buried in study.

Although I previously studied Chinese medicine, I had long wanted to open the door to Western medicine as well, and this semester that wish finally came true. I enjoyed and mastered the foundational courses—anatomy, histology and embryology, physiology, medical biology, and genetics—very thoroughly. By either our school’s standards or those of top medical schools, I should have reached an excellent level in these subjects.

Right before the exams, I gave more than twenty classmates with weak foundations an intensive review of this semester’s professional content. Setting the textbooks aside and needing no handouts, I lectured from memory, explaining the semester’s material clearly and accessibly, with only one or two minor errors. Many things they had not understood all term, I helped them build a systematic grasp of in an hour or two, easing their exam pressure.

Before studying clinical medicine, I had read online accounts by clinical-medical students of how extraordinarily hard the major is, and I felt more than a little apprehensive. After this semester, I find that the difficulty of clinical medicine is far less exaggerated than people make it out to be; at age 46, I can still handle it with ease.

I also let go of my fear of declining memory. After two months of adaptation, I found my memory had returned to its youthful level: while studying I can still remember things at a glance, and much sticks completely after a single pass. This may be because my memorization habits differ from the norm; I organize first, then memorize. Before learning anything, I organize it and connect it to knowledge or experience I already have, so I remember easily and quickly. I am also skilled at systematic, analytical memorization, which lets me remember quickly and in volume.

For example, studying anatomy, I cleverly used the origin and insertion of the esophagus to link many human structures together and memorize them as a whole. The esophagus begins at the sixth cervical vertebra (humans have seven cervical vertebrae) and ends at the eleventh thoracic vertebra (humans have twelve thoracic vertebrae); its origin is exactly the second-to-last cervical vertebra, and its end exactly the second-to-last thoracic vertebra. By analyzing and remembering the “second-to-last” feature, I locked in the esophagus’s origin and insertion at once—no review needed, and I will never forget it.

The esophagus’s upper end is the pharynx, and its lower end is the gastric pylorus; both connect seamlessly. Moving upward from the lower esophagus is the esophageal hiatus of the diaphragm (through which the esophagus and vagus nerve pass), and moving downward is the caval opening of the diaphragm (through which the inferior vena cava passes); these landmarks are each separated by one vertebral body. Once I remember the esophagus’s origin and insertion, I naturally also remember that the lower larynx is at C6, the pylorus begins at T11, the esophageal hiatus is at T10, and the caval opening is at T12.

The adrenal glands also lie level with T12; the kidneys, just below the adrenals, are one vertebral body lower, at L1, and L1 is also where the adult spinal cord terminates. Linking these together, I remember the approximate positions of a whole chain of organs and tissues firmly. I used this same analytical, associative method to memorize the skeletal, vascular, and nervous systems—the complexity of which makes many medical students’ heads spin—and memorizing them cost me no effort at all.

Sometimes I use catchy mnemonics to memorize quickly. When reviewing knowledge with my classmates, I taught them to remember the five nerves of the brachial plexus using the action of tickling an armpit. I put it in a playful phrase: “Scratch-tickle the center of the armpit, and goose bumps rise all over.” The syllable ci (scratch) echoes chi of the ulnar nerve; nao (tickle) resembles rao of the radial nerve; armpit (ye) connects to the axillary nerve; center (zhengzhong) to the median nerve; goose bumps (jipi) to the musculocutaneous nerve (jipi). The five main nerves of the brachial plexus—ulnar, radial, axillary, median, and musculocutaneous—no longer need rote memorization.

I used this trick to teach another classmate to quickly memorize the complex branching of the abdominal aorta, leaving him stunned—they had never studied this way. I taught him a homophone mnemonic for the inferior mesenteric artery’s branches: the sigmoid, rectal, and left colic arteries. I told him to imagine a high-maintenance (“zuo”) girlfriend and describe her as “yi” “zhi” “zuo” (always making a scene), using those three syllables to remember the three arteries. “Yi” connects to the sigmoid colon; “zhi” to the rectal artery; “zuo” to the left colic artery.

Then I used analysis to memorize the superior mesenteric artery’s branches: the right colic, middle colic, ileocolic, jejunal and ileal, and inferior pancreaticoduodenal arteries. Since the left colic artery is already under the inferior mesenteric artery, the related middle and right colic arteries must belong to the superior mesenteric artery. The mesenteric arteries mainly supply the intestine; besides the rectum and colon, the gut includes the ileum, jejunum, and duodenum, so by analysis the superior mesenteric artery’s branches must include these too. Analyzed this way, memorization speeds up greatly.

Continuing with analysis, I memorized the branches of the celiac trunk. The unpaired abdominal organs besides the gut include the stomach, liver, spleen, and gallbladder; since the inferior and superior mesenteric arteries already cover the gut, the celiac trunk must supply the stomach, liver, spleen, and gallbladder. Memorized this way, the celiac trunk’s branches can almost be guessed by name, then refined with moderate recitation and drawing, so the unpaired arteries of the abdominal aorta can be memorized within minutes.

My method avoids memorizing in scattered fragments; fragmented memorization is arduous and painful. Studying my way, most things need be memorized only once and are kept for life, with no need to follow any “forgetting curve” of repeated review. I suspect the forgetting-curve theory was invented purely to make people dull. Memorizing by that rote scheme would mechanize the human brain.

I am especially fond of a famous Churchill speech from World War II: “We shall fight on the beaches, we shall fight on the landing grounds, we shall fight in the fields and in the streets, we shall fight in the hills; we shall never surrender.” People good at memorizing use every method: mathematical, linguistic, humorous, by analogy, by analysis and diagrams. Only when no method works do we resort to rote recitation—and in truth very little truly requires it. Many tell me anatomy is hard, but I think that is a fallacy produced by learning the wrong way.

Of course, I have always held that memorization is only the tip of learning—a minor craft—whereas understanding is the root, the key. Once you understand thoroughly, these little tricks are unnecessary and things still stick firmly. So repeated study is worthwhile, because it deepens understanding. Often we think we understood after one pass, but on rereading we find new insights. Thorough understanding not only fixes memory but sparks breakthrough thinking and innovation—that is the best state of learning.

When I read, I practice “slow reading”; I read very slowly and carefully. How careful? This semester I even caught several errors in our textbook. As I read, I think about whether the knowledge follows a pattern. Once a pattern is found, memorization is fast—and such memory does not decline with age. I suppose that is why many scholars remain sharp-eyed, clear-thinking, and well-memoried into old age.

Also, whenever an idea strikes, I leave notes in the book. This semester I went through more than twenty pencils just making notes. I prefer pencils because my notes are mostly instantaneous thoughts, and instantaneous thoughts are often wrong; on the second and third reading I may need to erase and revise at any time. I never take mechanical notes—such notes are worthless, mere bookwormish copying, and far from efficient study. That is why I dislike using colored pens for notes and underlining that cannot be erased; when inspiration comes and I need to revise, I would end up smearing ugly black blobs across the page.

I organize many valuable thoughts into text on my computer, to study further when I have large blocks of time. This both strengthens memory and preserves sparks of thought. So although I am much older than my classmates, my memory is the best among them, and I study the most deeply.

I am very satisfied with my decision, at this age, to retake the college entrance exam and return to campus. Many admire me and want to follow suit, but this is not something ordinary people can imitate; it requires resolve, self-control, and learning ability—and, above all, having already settled finances in the first half of life, with no worries at home. Peers without these conditions should not overthink it; they are better off living well in the present.

Western medicine demands not only systematic study but also many experiments in the laboratory. This semester we spent a quarter of our school time doing experiments; next semester may be even more, and this cannot be managed by self-study. Without going to a medical school, you have no chance even to observe a cadaver. In medical school, observing a body together in a group is not as intimidating. Elsewhere, studying a human corpse alone is not only illegal but beyond my nerve.

Through this semester, I have worked out a whole set of study methods suited to this major, so next semester should be far more efficient. I look forward to more gains after the winter break.