Posted by Roger Mallett Posted on 11 February 2024

The Complexity Science of Medicine Requires Freedom

In 1971 I was a first-year medical student, and I was struggling. We were studying Gross Anatomy and I just couldn’t seem to understand anything. At the time, a “regional approach” to anatomy was all the rage. We started dissecting the “posterior triangle of the neck” on our cadavers. Let me quote from a recent anatomy text:

The posterior neck triangle is a clinically relevant anatomic region that contains many important vascular and neural structures. The clinical aspect of the anatomy contained in the posterior neck triangle is useful for a wide variety of medical specialties, including anesthesiology, otolaryngology, physical medicine and rehabilitation, and others. Anatomic variations, as well as variations in nomenclature, exist among arteries and nerves in this region. This article will serve to mitigate ambiguity by providing alternative nomenclature when applicable…

Bounding a large anatomic region, the posterior neck triangle further divides into two smaller triangles by the inferior omohyoid muscle. These subdivisions include the occipital and subclavian triangles. The occipital triangle is bounded by the inferior belly of the omohyoid muscle, the trapezius muscle, and the sternocleidomastoid muscle. The subclavian triangle, sometimes referred to as the supraclavicular triangle, is bounded by the inferior belly of the omohyoid muscle, the clavicle, and the sternocleidomastoid muscle.


I became hopelessly lost! I kept on asking from whence these muscles, nerves, blood vessels, and fascia originated and where they inserted! It just didn’t make any sense. WHAT did these things do? WHY were these structures there? With each passing day I became more and more confused. I realized I needed to somehow do something different in order to pass this course! Then I discovered Gray’s Anatomy and reached the turning point I needed.

The forerunner of Gray’s Anatomy was first published in London in 1858. Unlike the regional approach we were studying, it is organized as a systems approach to the subject. Things immediately clicked for me. Anatomy became one of my strongest subjects and remained so throughout my career. It formed the basis for my thesis for entry into the American Society of Ophthalmic Plastic and Reconstructive Surgery as well as numerous publications and presentations. It all happened because of a difference in perspective.

Read More – The Complexity Science of Medicine Requires Freedom

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