Tag Archives: New Stuff

Back at It

It’s been quite a while since I last posted anything. I will admit that there were multiple times I seriously considered sitting down and writing again, I just never got around to doing it. So what have I been doing lately?

First of all, I finished the Neuroscience Module. I wouldn’t exactly say I passed it, even though I did technically pass. My final grade did not equal a pass based on the way the course was introduced to us in March, but because fully 1/3 of the class was in the same situation as I was, they (our overlords) moved that passing percentage a little lower. Why was that class so incredibly terrible? I guess it’s always been bad, it’s just been 10 weeks long for the last two decades. Because my class is going through a new curriculum, the course was supposed to be shortened and streamlined to 7 weeks. My belief is that the course directors just did the shortening and forgot about the streamlining, giving us 10 weeks of hard material in 7 weeks. And so we all just about died during those two months, barely passing.

I certainly liked the subject matter. I remain fascinated with the workings of our brain and the ways that defects can manifest in people’s ability to understand and interpret the world. Despite my terrible performance in the class, I won’t rule Neurology out just quite yet. To get a sense of some of the cool stuff we learned about in Neuro, I’d recommend “The Man Who Mistook His Wife for a Hat” by Oliver Sacks.

So we finished Neurology two weeks ago, and moved into a course called Behavioral Medicine (or something). I attended a few hours of lecture the first day, and then pretty much didn’t go to class for the next two weeks (except for a few required activities, which I mention below). Much of it was basic psychology, which I was familiar with from courses in undergrad, and the rest was easy to learn from the syllabus and online recordings. So those two weeks were more like a vacation than school, even if I did have to cram a little the night before the test (had to learn a bunch of medications), only to show up and take a test so easy I could have passed it without studying. Compared to the previous neuro stuff we were doing, this psych stuff was like taking a nap.

We did have very helpful sessions where we practiced interviewing standardized patients and working through some possible diagnoses. One session stands out because I had to do the history and questions, and I suddenly was not worried about the process of history taking. Instead, I had a list of possibilities in my head, and I had a plan on how I would get a full story and cover my bases on what I thought it could be. That must be how actual doctors feel all the time. It was encouraging, I have to admit.

Now I am writing this post called “Back at It”, but there are really only three weeks of “it” left. After I complete a short course in hematology/oncology, I will be free for the summer. I’ve mentioned before that it is my last summer ever, so I plan to enjoy it as much as I can. I also am less than a year away from taking Step 1, so I ordered a review book from amazon. It’s called “Crush Step 1” (which is my plan), and it’s really heavy for being such an average sized book.

I also hope to write more frequently here, because it’s very relaxing.

Let’s Talk About Drugs

Maybe the timing is coincidental. Maybe studying pharmacology so much lately is making me more attuned to notice stories and posts regarding drugs and disease. Or maybe there has legitimately been a lot of really terrible Facebook posts, links, and comments lately (at least on my Facebook page). When someone on Facebook posts a story and claims “this is why I will never get my kids vaccinated!” I sometimes die a little inside. I would love to dissect their claim, present some objective evidence, and state my own claim in a reasonable manner, but we all know how that goes. Instead, I have turned to my blog, where I will be presenting some of the more common statements I’ve seen and the reasons why they are ridiculous. We’ll start with….

1. Doctors overprescribe drugs. They need to stop throwing pills at problems. They put my friend on too many drugs and he developed all of these side effects. Etc.

As seen in:

Image

Yeah…I’m pretty good at MS Paint

:

First things first: it is very possible to be taking too many drugs. We had an entire lecture on this last week. It’s fine to be on a handful of drugs, but if you have a patient routinely take 10+ pills per day you are going to run into problems with side effects, compliance, and drug interactions. So why is it that patients accumulate so many medications? Why do doctors consistently prescribe drugs for patient complaints?

Probably because that’s what they are trained to do. And because it works. I am not attending medical school to learn how NOT to prescribe drugs. I’m learning how to harness the incredible therapeutic potential available to me and every modern physician. There are so many drugs that work so well at fixing common problems I would be remiss as a physician if I didn’t prescribe.

Example: If a 48 year old man comes into my practice for a check up, and I notice he has high blood pressure, I have two options. I can tell him he needs to eat healthier, exercise, and drink less alcohol. Over time, this would make him healthier and lower his blood pressure. Of course, very few patients will actually do this. He is most likely to walk back into my clinic a year later and tell me that he was busy at work, tried walking but hurt his foot, and otherwise didn’t get any healthier. And he was exposed to an extra year of uncontrolled high blood pressure, increasing his risk for serious problems later on in life.

I could also give him a prescription for Lisinopril. He could take a pill every morning, his blood pressure will go down, whether or not he improves his lifestyle, and I improved his chances of living a longer, healthier, happier life.

The trap of this example is when a patient comes in with an upset stomach, so I give a script for that. They take it and their stomach is better but they feel dizzy and sick, so I give another script for that. That’s usually when people start experiencing really bad symptoms from taking too many drugs. Do people think that the doctors were intentionally trying to hurt people with these medications? There’s nothing nefarious here. The intention was always to treat.

2. If I vaccinate my kids they will get autism. It’s unnatural. I don’t want to expose them to those terrible things. It’ll do them more harm than good.

As seen in:

This has come up a few times lately, especially after we watched Jenna Mccarthy on the Rockin New Years Eve a few weeks ago. I’d like to start by saying that if you are taking healthcare advice from a Playboy model, please re-evaluate your life and see an actual physician immediately. Vaccinations do not cause autism. I’ve looked at the evidence for it, and its pretty slim. For the rest of this article, however, I’ll assume it could (I’m feeling generous). People who don’t vaccinate their children are susceptible to two fallacies. First, that by avoiding vaccination they are somehow protecting their kids from exposure to the pathogens that cause disease. Second, that vaccination is primarily intended to protect their child specifically.

Ever heard of a kid with polio? Rotavirus? Smallpox? Probably not in recent memory. How about whooping cough? Few Americans (or none, in some of those cases) ever develop these diseases. The reason isn’t that the disease doesn’t exist anymore, but instead that vaccination has prevented the pathogen from causing disease. Viruses and bacteria are everywhere. Always watching. Always waiting. Just kidding, but there are way more of them than us, and our immune system clears them very efficiently ever day. If you don’t vaccinate a child against a disease, that doesn’t guarantee that they will never see that pathogen. It just handicaps their immune system if they should ever come across it.

Second, vaccinations aren’t exclusively intended for your child specifically. The key here is a concept called herd immunity. If you prefer to think of the human race as something different than a herd, call it population immunity. When the herd is vaccinated (say 95%) against a disease, only 5 out of 100 members will be susceptible to developing a disease. Should one of them acquire the disease, their chance of spreading it is low, because only 4 of the remaining 99 members can acquire it. If the herd is unvaccinated against that disease, however, one member acquiring it will cause a rapid spread through the herd. There will be a few members who are naturally resistant (there is always a small percentage of people with natural resistance to some disease), but the rest of the herd will be devastated. Getting your child vaccinated is less about their protection than it is for the rest of your kids class. Some vaccines don’t matter for kids, but for adults. Children don’t develop symptoms when infected with Hep A, but they can spread it to adults, where it causes serious illness.

This is what comes to mind when I think of “herd immunity”

3. I’m so worried that I have the swine/avian/llama flu! Everyone is going to die!

Actually probably so. If there is a total disaster to worry about, it would be a mutated influenza virus. We all remember the H1N1 outbreak a few years ago, and ever more recently new mutations like last years H7N9 virus caused concern. Should a strain of influenza develop easy transmission between humans as well as the ability to easily cause disease or death, it will be scary. Influenza changes and evolves quickly enough already, which is why there is a new flu shot every year. Millions of people died in 1918 during an influenza outbreak, where massive global troop and refugee movements allowed it to ravage the world. Despite the present lack of a world war, we have a constant state of travel and mobility, both internationally and regionally. Scary scary.

4. Have you heard about all of these new resistant bacteria? MRSA, VRE, CRE? It’s going to be the end of medicine!

Image

Surely you have heard of these new “super bacteria”. Are they scary as well? Yup. Are they the end of modern medicine? Nope. That link above was shared by a friend but written by a lawyer. Antibiotic resistance is certainly a problem, but it’s one that we will solve. I have had antibiotic resistance pounded into my head for the last six weeks. When to use antibiotics, when to hold them, how to identify resistant strains, combination drug therapies, etc etc. I can remember a high school teacher from years ago talking about MRSA, how terrible it was, and how that would be the end of modern medicine. Multiple resistant bacteria have developed since then, nastier than MRSA, even. Why am I not worried as much about CRE? First, because its nosocomial (acquired while in a hospital). These super bugs don’t exist everywhere around the world. They usually only infect people with extended hospital stays and invasive therapies (like catheters). Second, they will be beaten as well. People far smarter than me are always working on drugs to combat these resistant strains that develop. A resistant infection is never a good thing, but in order to find yourself developing one of these you would probably already have had something pretty serious going on.

What do you think? Let me know in the comments below or at sortadrwordpress@gmail.com

Thanks for reading

Floating Along

Welcome back to my blog! In reality, I was the one who took a brief hiatus over the holidays, and I don’t regret it at all. I would love to say that I spent my two weeks off deep in thought, drafting blog posts, and learning all of the things I forgot immediately after taking my final exam on December 20th, but that would be a lie. Instead, I spent most of my break at home with family and friends, and the rest of it being as lazy as humanly possible. On the plus side, I am refreshed and ready to tackle another semester of medical school.

Just kidding…I actually laughed after typing that last sentence. Let me do a little catching up on what medical school has done to me recently. In late November we started Pharmacology and Microbiology. I prefer to call it “Bugs and Drugs”. The courses are taught simultaneously, which is actually helpful because we get to learn the organisms that cause disease around the time that we learn the drugs that can treat said disease. I use the word “learn” very loosely here, because really they just throw hundreds of drugs at us and we get to sort out what they do for a few days before the exam. In the week before Christmas we covered around 220 antibiotics, antifungals, cancer therapies, and other drugs in about 4 days before taking an exam on Friday before break. That was my hardest week of medical school yet. While attempting to learn all of those drugs, we also had to learn information on bacteria, viruses, their associated structures and pathology, some information about other organisms (mycobacteria), and take an exam on that the same day as pharmacology. Have you seen Christmas with the Kranks? Remember the scene where Luther is leaving the shop in the beginning and the water canopy breaks, drenching him in water even as he stands in the pouring rain? That was a pretty accurate description of me during this course.

This is not an area of strength for me, either. I had great undergrad anatomy experience to support me during med school anatomy. I did take immunology and pharmacology as well, but both courses were incredibly easy. Most of what I remember from immunology was “viruses are scary”, and I don’t think I remember anything at all from pharmacology. So learning information at the insane pace set by the course directors required long, long days of studying at home. In the winter. In the cold. By myself. Very depressing. But hey, I have passed everything so far, and am 1/8 of the way toward completing my MD.

While talking to an actual doctor, I learned the dirty secret of pharmacology. None of us will remember all of these drugs after this year (I already knew that part). We will really learn them again during third year and beyond, when we begin to prescribe and work with drugs in a practical setting. The goal of this class is to make sure we have heard of these drugs at least once.

In other news, I have now interviewed and presented my own patients. The dermatologist I have been shadowing is letting me see patients (with a resident keeping a close watch). This allows me to demonstrate my complete ignorance of dermatology for both the patients and the residents, but has helped me start to develop my all important “bedside manner”. I have a feeling I will be much better at interviewing and taking histories when I know roughly what I am hoping to find.

Of course, this is kind of what I expected from medical school. I’m busy and I’m challenged, and I like it. At this point in undergrad I was already bored (and still on winter break). The pace is grinding, but is also what keeps school interesting. It’s like sightseeing from a bullet train. While it’s impossible to see everything that flashes by, there are so many interesting things to see that the view is still captivating. Some semesters of undergrad felt like sightseeing from a snowplow.

I have been sending Facebook messages back and forth with a friend who is considering medical school. Most of his questions centered around the difficulty of the classes and exams, the pace, the hours, etc. I understand the worry from potential students, but I don’t understand the doubt. I have never once, even for a second, thought I would fail/drop out/give up during medical school. I would say that trend is strong among my friends as well. Despite the deluge of information and massive investments of time and money, I don’t think anyone is legitimately worried about dropping out. It’s fine to ask “how”, but counterproductive to ask “what if”.  To be honest, most of my classmates are generally happy people. Maybe this is because of our pass/fail system. Maybe our class is different. This is just an honest opinion from what I see on the days I go to class (instead of watching lectures online from home). If you think you can do it, you probably can. Just my opinion. Of course, it wouldn’t hurt to read up on this before you go applying, just in case 🙂

I have other topics I want to write about (vaccinations, antibiotic resistance, books and movies, and a stunning realization I had ordering dinner over break), but I really need to wrap up this little update of a post and call it day.

Thanks for reading!

sortadrwordpress@gmail.com

What I Wish The World Knew About Christians

I was raised in a Christian home, and have grown up involved in Christian churches and ministries. I am intimately familiar with the church, both the good it does and the shortcomings it possesses. Despite my familiarity with the culture of American Christianity, I have always tried to see my life and decisions as they would appear to an outsider looking in. It just so happens that the Christian church today has lots of misconceptions and stereotypes, and I want to talk about them. Here’s five things I wish the world understood about Christians.

1) We Don’t Have All of the Answers

Most often, people will turn to the church in times of trouble. This leads them to ask the hardest questions they will ever face. “Why did _____ have to die?” “Will God heal my mother?” “Why do bad things have to happen?”. These are huge problems that have faced humanity for generations. They call in to question the nature of God, the quality of man, and the course of each persons individual life. Does that sound like the kind of question that will have a succinct answer? These are the kinds of questions that may not ever have a complete answer, and even the most intelligent minds of our generation will continue to wrestle with them. Small wonder people often feel unsatisfied by the answers they receive, once they have troubled to ask. But that’s okay.

Honestly, that’s the way it should be. I only trust in a God I can’t comprehend. While Christians believed that God reveals Himself through the Bible, directly through his appearance on earth, and even through the world He created, that does not translate to a comprehensive knowledge of his ways and thoughts. Thank goodness. Our desire to ask hard questions and to understand our God may be related to our information-age mindset, with answers to everything just a click or two away. If I believe in a thing that I completely comprehend, that “thing” is a really lousy God. If I believe in a God who is all knowing and all powerful, I should expect to be a little bit puzzled every now and then. Being a Christian does NOT mean that you have everything sorted out nicely.

2 ) Christians are People Too

Have you ever been to a church, maybe around Christmas time, and someone there was rude to you? Ever known a Christian that was hypocritical? How about some Christian who lies regularly? Join the club….because that’s everyone. We believe that Christ’s death on the cross has saved us from the punishment of our sins, but that doesn’t preclude us from continuing to sin. Christians are ultimately human, and humans make mistakes. That’s all there is to it. Some people have it in their heads (or get the impression from other Christians) that Christians are “holier than thou”, somehow better people for their faith. I know many Christians that are devout, loving people who live such good lives that I do feel somewhat unworthy, but they are the exception. Truthfully, most Christians struggle with the same issues as the rest of America. The church, at its best, is like a hospital…don’t expect to find a bunch of healthy people there. In fact, if you walk in to a church that actively cares for people in its community, you will find people who fight and struggle against drug addiction, alcoholism, marital troubles, domestic abuse, abusive relationships, and every other vice known to man. Why? Because as people, that’s what we do. Christians and non-Christians alike have the exact same issues.

This applies to Christian ministries as well. When reaching out to others, there are going to be problems. People help others out of the goodness of their hearts and their love for God, but they often offend others out of their own weaknesses and insecurity. Christians have those, too. It doesn’t matter if they are home with their families or volunteering at a shelter for the homeless.

3) We Argue About Retarded Issues

There are so many denominations in the church. How many can you name off the top of your head? Lutheran, Methodist, Presbyterian, Baptist, Christian, Wesleyan…..the list goes on. What are the differences that caused these splits in the church? I have no idea. Why are there six Baptist churches in your town? No clue. All of these denominations of churches, though they might seem to be miles apart in theology, probably agree on 95% or more of their beliefs. Actually, I’ll raise that to 98%. Without diving in to specific comparisons, most of the splits are caused by differences in interpretation of just a few verses or issues. Is baptism required for salvation, or is it an act of devotion? That’s the kind of question that causes a split in churches. Admittedly, all of the different denominations can be a little disorienting.

But wait, it’s worse than that. Churches can split for even more terrible reasons. I know of a church that split because they couldn’t agree on a carpet color for the new worship auditorium they were building. Churches develop factions that follow a specific pastor or worship leader, rather than committing to the church. It’s ridiculous. Why does it happen? See #2 above. Christians are still just people, and people mess up a lot. Leaders in a church are no less immune to the problem than the people they lead. Surely you’ve heard the gossip that goes around when a pastor suddenly quits his job for personal reasons. We think it’s shocking because he was a pastor, but doctors get sick just as often as regular people do.

4) The Bible is Rated “R”

There are lots of misconceptions about the Bible, far more than I could cover in a single post, but I want to point this out for now. The Bible is not  just a rulebook, a series of do’s and don’ts for life. The Bible is not just a book of judgement and damnation. The Bible is also not just a poetic book of prayers and praise. It’s actually a little bit of everything, and you would need an adult or a fake ID to see it’s movie if you were a kid. I could throw out a list of references that would make you blush, or at least double check to make sure you were still reading your Bible. Incest, prostitution, murder, slavery, and explicit sex are all in the Bible. Frequently. I personally have read the Bible cover to cover six times, and done additional reading in it as well. I am still amazed at the things I find in the Bible. I’ve also read big chunks from other religious texts, and still can’t believe what I read in the Bible. If you think the Bible is irrelevant, outdated, or unreliable, I would encourage you to step back and read it, cover to cover. That leads to my final point

5) Christians Have the Best Story

How appropriate that I get to write this a few short weeks from Christmas. I wrote yesterday about stories and how they develop, and I want to look at the beginnings of Christianity as if I were telling you a story. I love beginnings and origins, because I think there is much to be learned by looking at how something came to be. The birth of Christ was prophesied and came to pass. Jesus himself ministered for just three years before being crucified and rising from the dead. Shortly thereafter, he rose into heaven and his apostles founded the Christian church. That’s crazy! A popular preacher has said that for Jesus to have the impact he did, there are only three options. Either He was a Liar, a Lunatic, or Lord. Since he claimed to be God, often and loudly for all to hear, he could have been a fraud, crazy, or telling the truth. A liar would not likely go through the horrific process of crucifixion and death. A lunatic might, but would not have gathered such a following or risen from the dead. He must have been God, the reasoning goes.

While I like that line of thinking, I have another for your consideration. Let’s pretend you wanted to start a religion. If your name is Bob, you want to found Bobism. You would have to go through certain stages in order to get people to believe that your religion was legit, and thus would demonstrate certain signs to history. You would likely need longer than three years. You would need to recruit followers and weaken your enemies (preferably recruiting prominent, skilled, influential people to be your followers). You would need incentives for your followers and recruits, and a way to organize them and grow more powerful. As Bob, you of course, would need to control all of this, so that Bobism stayed pure to your beliefs as Bob.

By this thinking, I begin to see problems with religions that demonstrate these signs as they grew. Islam, for example, spread by the sword. Killing enemies is a good recruiting tool. I am also dubious of religions that establish one man in a position of prominence, power, or comfort. Mohammed did this while establishing Islam, as did Joesph Smith when he received his revelations and founded the Mormon church.

The beginnings of Christianity look nothing like this. A central leader who claims to be God Himself, rather than his prophet or assistant, is killed only three years after beginning his ministry. His followers, who were by no means impressive people with status, don’t run for cover and ask for their old jobs back(actually they do hide for a few days). Instead, even in the face of oppression by the government, they spread themselves all over the known world, many of them jailed repeatedly and killed violently. That’s quite a story. What did the first apostles have to gain by sharing the story of Jesus? What did they see that drove them to jail and torture? That’s what makes the beginnings of Christianity a story worth telling.

Feel free to leave a comment below, or send it directly to my face at sortadrwordpress@gmail.com

Thanks for reading

/

The Anatomy of a Story

I  love stories. Ultimately, life is best expressed as a story. As long as people have gathered together, we have related to each other by telling stories. Our stories make us unique and form part of our personality and worldview.

But have you ever tried to create a story? I mean a real story, like a book or movie, even a short story written for a composition class in school. Have you ever created individual characters and let them live out their own little stories inside of your fictional world?

That’s one of the things I have been trying to do lately, specifically hoping to one day finish a novel of my own. I missed out completely on NaNoWriMo, thanks to medical school anatomy during November. I still wrote and brainstormed and thought about my book, even if only a little bit of it got written down.

So how is a story made? In my mind, I want to frame the whole story from beginning to end, then go in and fill in the details as a write. I want to “construct” the story, and then build it methodically. NaNoWriMo gave me a different idea, however. If I had completed NaNoWriMo, my story would be nurtured. I would start writing with a vague outline and ideas, then watch the story grow as I wrote it. To stick with the growth analogy, the story could then be trimmed and revised after it was fully grown in order to reach its final shape.

However it’s written, I have gained a lot of respect for great storytellers over the last few months as I labor on my silly little book. It took Tolkien something like two decades to finish The Lord of the Rings and have it completely published, but in that time he created a complete universe (including languages and cultures for multiple races) and set his story in his world. I have always enjoyed reading Tom Clancy’s thrillers, which were well known for being meticulously researched and technical, which made the stories more believable and enjoyable. I am slowly reading my way through the Game of Thrones books right now, and I can’t imagine how long it would take to create a sound plot that involves a huge cast of characters and multiple kingdoms (even though his main plot twist is to kill main characters every other chapter).

We each get to write our own story for our life, as well. I had a unique opportunity when I moved halfway across the country in the middle of high school. Because I had gone to school with the same people since kindergarten, I feel like I had acquired enough “labels” in my early high school years. You know how high school students can be. Halfway through high school I moved 1500 miles away and started at a completely different school. It was during that summer I realized that I could be whoever I wanted to be, as no one in this new city knew me at all. While I could have been anybody, I did some growing and maturing and just became myself (which is an entirely different story).

This brings me to my last point about stories, specifically our own stories about our pasts. I’m not convinced it’s the contents of our stories that matter, but the way we see and interpret them. I had a psychology professor tell me once that after every disaster, there are victims and there are survivors. After a hurricane (I’m pretty sure it was a hurricane), some people will have their lives shattered and never be the same. Others treat it like a setback and press on. I’m not sure what her point was after that, but I’m using that story to illustrate my point. There are people who are products of their environment, and there are people who overcome their circumstances and rise to greatness. I think the difference is in the way they told the story of their life.

Thanks for reading.

/

Tales from Anatomy – The Long Post

I just finished anatomy. The last eight weeks have been a complete blur, but last Friday I took the final exam and most likely identified enough body parts to pass the class. I needed to get 38% on this final test in order to pass anatomy. Because of how hard the test was, I am not completely sure I got 38%, just reasonably sure. The test was hard. My score will likely be the lowest score I have every received in my life. Ever. On anything. To sum up my experience this final week of anatomy, I have to share this screencap someone posted on our Facebook page before the test. This should go on our class T-shirts.

I spent this last week studying hard, spending extra time in the lab, and cramming “high-yield” study tips. I studied with my dissection group, with random people, with lab TA’s, and anyone else who would help me. My wife quizzed me on insertions and innervations of muscles, and my little puppy was intent on helping however she could. Admittedly, she has a tiny brain and no thumbs, so she wasn’t much use. She’s mostly a ten inch tall Roomba (with a slightly lower chance of tumbling down the stairs to her death), trotting around the house and eating anything she finds on the floor. Even after all that studying, I still felt really dumb at the exam. Anatomy has a way of doing that to me. I would study all week on assigned materials, then drive in to take the practice exam on Sunday. Number 1 would say “What is this thing?” and I would have absolutely no idea. Was that even assigned to us?

I also realize I was fortunate during this class. First of all, I took a tough anatomy course in undergrad, so I was roughly familiar with most subjects. Second, I have a quick memory and uncanny ability to remember pointless details from lectures several weeks ago. We seem to get tested on pointless details all of the time, so I get those questions during the exam (most of the time). I also learned anatomy the hard way. I did the dissections, pored through atlases, and did the leg work required to learn relationships and functions. Compare that to a certain member of my lab group, who we will call Leo. Leo doesn’t dissect. Leo doesn’t even help his group during dissection. Instead, he drifts around the lab like a knowledge mosquito, stopping briefly at each groups table and learning a few factoids from each group. Then, during exam week, he becomes the king of mnemonics (more on those below). He has mnemonics for everything. He has primary, secondary, and tertiary mnemonics to remember his mnemonics. He confuses his mnemonics with others, and ultimately forget it all and have to relearn it. Also, he probably can’t problem solve as well when he mostly knows mnemonics.

There are two kinds of anatomy geniuses. The first kind was my dissection partner. He could study a picture and a cadaver, then somehow reconstruct everything into a mental, 3-dimensional structure that he could then picture anytime, from any angle. He was always oriented, and always knew where structures came from and where they were going. It must have been awesome to be him. The second kind of anatomy genius (and the kind I actually understand) are the ones who understand relationships. There is no intricate mental picture stored in their super-brains. Instead, they know where a structure is based on the structures that surround it. They can use the context to identify what a specific structure is, much like confirming the location of your house by locating your hoarder neighbors house. Yes I used to live next to a hoarder.

I also used mnemonics, which are tools to help you remember something. For example, there are 13 cranial nerves that every medical student must memorize. Here they are, in order: Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Vestibulocochlear (auditory), Glossopharyngeal, Vagus, (Spinal) Accessory, and Hypoglossal.

Here they are demonstrated on a cartoon brain.

That’s quite a list to remember. Instead, we first memorized “On Old Olympus’ Towering Top, A Finn and German Viewed Some Hops”. We then knew the first letter for each nerve in order (OOOTTAFAGVSH). Any sentence works, really, as long as the letters fit that pattern. There are incredibly dirty mnemonics I won’t post here, and some creative ones involving Harry Potter, the Hunger Games, and certain faculty members at the school. Everyone uses these to some extent, but I think students like Leo (not his actual name) ended up getting buried in mnemonics, so they are only somewhat helpful.

So what were my “takeaway lessons” from anatomy? I definitely liked it, enough that my interest in surgery has been validated. I enjoyed working with my hands and learning how knowledge of anatomy is applied to procedures and therapies. I also gained an appreciation for all of the material I still don’t know. We learned a vast amount of information in just eight weeks, and no one learned everything that was assigned to us. That amount of material isn’t necessarily unknowable, but it is probably unlearnable over the course of two months. I know that I will need to go back and re-learn critical areas during rotations, and should I decide to become a shoulder surgeon I will learn that anatomy at an even more detailed level. Lastly, I am even more amazed at the intricate design and daily function of our bodies. Even studying a single organ, like the kidney, is absolutely fascinating, totally reinforcing my decision to attend medical school.

Of course the good news of anatomy being done is that I can spend more time on my favorite activities, one of which is blogging! I have this entire week of Thanksgiving off, which will be completely glorious. There is nothing for me to study. Nothing at all. I will likely pick up the pace at which I post here, because I have a lot I want to discuss. I read some blogs that are easily categorized. There are “mommy blogs”, “medical school blogs”, “tech blogs”, “political blogs”, etc. While the general theme here will always be medical school, I can and will branch out write about whatever is on my mind. I’ve gotten a lot of support lately, despite my complete lack of regular posting, and I really appreciate it.

Two weeks ago I made the unfortunate decision to start reading Game of Thrones when my friend (so he calls himself) lent me the first book, which I promptly read in one week. Now I’m hooked, on book 2, and have thousands of pages left to read (and probably hundreds on main characters yet to die, if the next books are like the first). I am also doing a lot of outside reading on religion, so expect posts as I finish reading other religious texts. I realized that despite my college education and multiple classes on world religion, I had done little firsthand reading of any religious text besides the Bible, which I have read cover to cover multiple times. I am now working my way through the Qur’an, the Bhagavad Gita, and the Pearl of Great Price, with more to come afterwards. That was a good decision, since even my early readings were very interesting.

Of course I will also spend time playing Call of Duty, training my puppy, and eating at the new Chick-fil-a that opened RIGHT BY MY HOUSE. I may or may not have camped out and received 52 combo meals, which I am eager to claim for delicious free chicken. Finally, as I get ready to publish this post, I can see that all of the recommended posts from WordPress are posts that I wrote myself. Weird. I’ll leave you with another picture of my cute puppy.

Displaying photo.JPG

Thanks for reading! sortadrwordpress@gmail.com

/

Amazing Reasons You Stay Alive

Welcome to day 2 of NaBloPoMo! Today’s post discusses my favorite subject: our bodies. If you don’t consider yourself a “science person” please stick around because A) this is interesting B) it will make you sound smart someday in the future and C) I promise I will make it fun. It’s a longer post (at least 25 tweets long) but it’s worth it! Let’s go.

1- Exposure Control

Think about this. For all animals, exposure to the environment is both absolutely required for survival and incredibly dangerous. We MUST get food and oxygen from the environment, but we need to protect ourselves from all of the hot/cold temperatures, radiation, toxins, and dangerous aspects of our world. The main way we do this is generally called homeostasis, which I have talked about briefly before, but it essentially means maintaining a cozy internal environment regardless of what’s going on outside. Your skin does a fantastic job of keeping water in (or out), blocking most UV radiation, regulating temperature, etc. Everything inside your skin is air conditioned in the summer, heated in the winter, and packs a light sweater in the spring. Keep in mind that your skin is aided by many other organs/body parts, like your muscles, blood vessels, and organs themselves.

While we are nicely protected from the outside world, that has its downsides. Too much isolation and our ability to gather the necessary materials to survive is severely diminished. Like drinking through a stir straw when you’re really thirsty, you need access to the dangerous world to survive. Our bodies are able to give us both access AND protection. While our skin keeps most everything out, our main avenues for food and air are the intestines and lungs. We absorb these inside of our body, but it helps to think of the lungs and intestines as hollow tubes of “outside” that temporarily pass into our protected “insides”. The lungs have small sack-like structures called alveoli that fill with air and are surrounded by blood vessels. This is where we unload CO2 to breathe out and load up on O2 from outside. By doing this process via millions of alveoli, we have the surface area of a tennis court available for gas exchange in a lung the size of a softball (or youth league football).

This will be important here in a minute

Surface area is the key here. Trees have leaves with great surface areas to enable photosynthesis. Microbes need huge surface areas relative to their tiny size to obtain nutrients. Humans have a lousy exterior surface area compared to our size, and we can’t breathe through our skin like frogs. Gas exchange in the lungs occurs like two lines of people trying to simultaneously leave and enter a building through a revolving door. How do you speed that up? Build more doors. Our lungs are so good at gas exchange for the same reason Sonic has great ice in their drinks. The ice is crushed, so it melts more quickly, cools down your drink faster, and keeps it cooler than big old cubed ice. That reason is lots of surface area. Your small intestine is important for absorption of all the delicious food you eat, but it is actually about 22 feet long, allowing you to pull everything you need to survive from your dinner and get rid of the rest.

Recycling –

This is one of the things I have learned in medical school so far that has amazed me. Your body is incredibly efficient. The mechanisms by which we convert food to usable energy are very good. Compare that to a light bulb or car engine, both of which require tons of energy and turn just a fraction of their input to output (with most energy given off as heat). The other amazing part is that when a cell dies, it doesn’t get flushed and ejected overboard. Nope. The cell is degraded, chomped up by other cells that have a striking resemblance to Pac-Man, and it’s parts get sent to other cells for them to use. This efficiency is great for us as a species, but if you are reading this blog you won’t ever need these superpowers. I am sitting about 10 feet from about 30,000 calories worth of food, ready to be eaten. This efficiency is probably left over from the days when people had to work or hunt for food as a survival mechanism. Regardless, we are great at it.

Efficiency at work!

Brains!

What makes us unique as humans, compared to other animals? Brains! (maybe thumbs). Why do we have huge heads? Brains!

You get the idea. As humans, we have enormous skulls and enormous brains to keep inside them. Everything else comes naturally after that. I could go so many directions with this discussion, but I will stick to the highlights.

Humans give birth to helpless little useless babies, while other species give birth to babies that can walk on their own within hours. Why? Babies have huge heads and need to get out before their heads are too huge. Why? Brains.

I have actually used this picture in my blog TWICE now!!

Most of our senses are average at best, often terrible, compared to the rest of the animals. Our vision is decent, but many of us would be blind without glasses/contacts. Our sense of smell is bad. Our hearing runs from average to awful. Taste is pretty good, and our sense of touch varies. In addition, our bodies are quite fragile, we are comparatively weak, and we run slowly (but can run for a long time). So how are we at the top of the food chain? Brains!

Compared to any bird (or dragon), our sense of vision is pathetic. What makes us special is that our eyes feed data to an enormous visual cortex that interprets and understands the world around us in a way that is unmatched by any other animal. Without going in to detail about the mechanics of sight, it is interesting to me that we perceive two things incredibly well: contrast and movement.

Compared to any kind of dog, our sense of smell is terrible. Mine is especially terrible, after spending four weeks breathing formaldehyde fumes I really can’t smell much of anything. Our sense of smell is cool because it is unfiltered. Most of our senses (except smell) pass through a structure called the thalamus, an awesome part of the brain that decides what gets your attention and what doesn’t. My elbows have been sitting on my desk while I have been typing for around thirty minutes, but I didn’t realize it until I started typing about it because I was desensitized to it. The thalamus is like a filter/switchboard operator/control tower for the billions of signals fighting for your brains attention. Smells, however, get to skip that step. That’s why you can smell something, even faintly, and BAM!!! You can instantly remember some event from long ago with incredible clarity. Smelling things is like a nostalgia machine. I read a book about World War 2 veterans who talked about certain smells that would bring back powerful memories of terrifying moments in war and could induce panic attacks, even decades later. It’s a powerful sense.

A powerful sense with a weakness for Febreze

The last thing I want to touch on about our brain is the fact that we don’t really have any idea how it works. We understand what it’s made of (neurons). We know where it is. We also know what certain areas do (mainly by observing what stops working after an accident).What we don’t understand is how our billions of neurons can interconnect and give rise to a supercomputer. Computers are great at math and repetitive logic tasks, but their ability to interpret and assimilate information is no where near the ability of our brain to do the same thing. Our brains also give rise to a personality and emotions, and that doesn’t make sense. When did that mass of neurons develop the ability to love? How did you develop the ability to have compassion on others?  That’s where the mystery still is.

As always, thanks for reading. Feel free to comment below or email my face directly at sortadrwordpress@gmail.com

/