Hooked on mnemonics

Memory is elusive (and of course, it “lights the corners of my mind”—or at least Barbra Streisand's mind). That's why there are so many tricks to remembering things, like acronyms, acrostics, rhyming keys, the image-name technique and the keyword method. All have their place, and different ones work better for different learners. I myself am a fan of mnemonics.

My history with mnemonics started in childhood with “Every Good Boy Deserves Fun,” which is a way to remember the notes on the staff of the G-clef (E, G, B, D, F). Then there was the ever popular “ROY G. BIV,” for the colors of the rainbow. Later came medical school, where many of the mnemonics were X-rated (and thus more memorable). Some from med school are still in play today, such as MUD PILES (for the causes of high-anion gap metabolic acidosis).

So where do mnemonics come from? The root of the word itself comes from the Greek goddess Mnemosyne, the personification of memory. She was a Titaness—the daughter of Uranus—and had godly romance with Zeus. Zeus slept with her for nine nights in a row and she consequently gave birth to the nine muses who preside over the arts and science: Calliope (epic poetry), Melpomene (tragedy), Euterpe (lyric poetry), Erato (love poetry), Terpsicore (choral songs and dance), Urania (astronomy), Thalia (comedy), Polhymnia (sacred poetry), and my favorite, Clio (history).

Mnemosyne was said to give humans the power of reason, and a name for every object, but above all she gave us the power to remember. While dead souls in Hades were encouraged to drink from the river Lethe to forget their past life, a drink from the river Mnemosyne had the opposite effect. When Bob Hope said “Thanks for the memories,” he was thanking Mnemosyne. At least I think it was Bob Hope; I can't recall.

Last week I had an experience with mnemonics that sent me down memory lane. I was on the wards, rounding with my team, when we came across a patient who had tumors throughout the skeleton. I asked my team which tumors most often metastasize to bone, and while the answers were correct, they were disorganized. So I pulled out the old chestnut “P.T. Barnum Loves Kids” (P: prostate, T: thyroid, B: breast, L: lung, K: kidney). It mentally brought me back to my fourth year of medical school.

Like any good medical student, I spent my days cramming facts into my already overfilled cranium, hoping for a chance of retention at test time and a glimmer of understanding. Bone insertion points and metabolic pathways fought for storage space with the lyrics to the Gilligan's Island theme song and my first grade teacher's name.

I remember looking at Harrison's Textbook of Medicine for the first time. Even back then, it was a weighty tome, many inches thick. How would I approach it? I decided on day one to make a mnemonic for each chapter. That's right, 252 mnemonics. And so I slaved away, using years of Scrabble, anagrams and bad puns to construct 252 mnemonics. At last, my Herculean feat was complete. But how could I remember this many mnemonics? The answer…another mnemonic!

I took the first letter of each mnemonic and constructed an über-mnemonic. It was a sentence 252 letters long, comprising 31 words. Yes, I was worshipping by the river Mnemosyne. But soon this was not enough for me. Thirty-one words? Why not make another mnemonic for the mnemonic?

And so I did. Weeks into the project, I had condensed those 31 words into another sentence, just five words long. Fueled by bologna sandwiches and stale coffee, I was almost there. For my final act, I took the first letters of those five simple words and made the “master mnemonic.” With this simple five-letter word, I could unlock the soul of Harrison's Textbook. Exhausted by my labor, I slept for two days.

I awoke that Monday morning and started my general medicine rotation. The first patient had meningitis. The attending physician glared at me.

“Tell me, Mr. Newman…What are the most common organisms that cause meningitis?”

I knew this; I had a mnemonic for it! But wait, what was it? I had to unlock the mental code, with that five-letter word that would give me the five words, which would give me the 31 words, which would give me the 252 letters, which would give me the whole of Harrison's.

But I had forgotten that five-letter word.

And so those weeks of study were for naught. Somewhere in my data banks is all of Harrison's, but I cannot access it. Perhaps it was not coffee I was drinking with my bologna sandwiches, but water from the river Lethe.