Happy Turkey Day

A quick post to wish all of you happy readers out there a Happy Thanksgiving. I'll be using this weekend to cram my face with turkey as well as cramming my brain full of fun tidbits of pharmacology, virology, and pathology.

So feel free to indulge this weekend. 3 out of 4 doctors* recommend at least 6 servings of turkey per meal...and don't forget to "double-up" on the gravy.

*by doctors I mean medical students

Let Us Get it Schtarted*

Lets face it. Indian accents are funny (Indians from Asia, not America). I never really thought about it prior to medical school. But I have noticed lately that many of my professors have very THICK Indian accents. Currently, 2 out of 4 lecturers have an Indian accent (like my Wirology* professor). I only point this out because of a comical incident that was had today in class. We were discussing the appendix (the organ, not the list of words at the back of your book). Our professor stated that in 50 million years humans would evolve to not have an appendix. I'll come back to that point shortly. He also claimed that our "pinky toes" are unnecessary as well which would cause them to fall off, at which point we would throw a celebratory extravaganza. Yipee. Just then another professor walked in the back and we were lucky enough to hear this little gem:

"Dr. Haiku, welcome. We were just talking about losing our little toes and having a party!"

Now imagine that all of the "W's" are pronounced with "V's" and any "T" sounds like he is trying to say "tart". Hilarious. I let out a huge "belly laugh". It was classic.

OK, back to my appendix. So I guess my professor is trying to imply evolution. An interesting point but I have a couple of questions. If we really are "evolving" and came from monkeys...why are there still monkeys? AND how come we don't see any "monkey boys" popping up all across the country from those dumb little monkeys evolving into humans? I guess I must have slept through that part of lecture or that entire course of biology in undergrad. If evolution does exist, I want a pet monkey boy. So until I get one, evolution will always be a mout point to me.

Well, until this gets straighted out, I guess I'll just concern myself with more important matters...laughing at funny Indian accents.


*Indian accent implied

Hello Jerry...

I was watching Seinfeld last night and a classic episode (which one isn't) came on. It was the one where Jerry and George have to meet Elaine's father for dinner. She is late (of course) and the episode circles around the awkwardness of their meeting. Well before they leave for dinner George starts singing a song from the production, Les Miserables. It goes a little like this:

Master of the house
Doling out the charm
Ready with a handshake
And an open palm
Tells a saucy tale
Makes a little stir
Customers appreciate a bon-viveur

Glad to do a friend a favor
Doesn't cost me to be nice
But nothing gets you nothing
Everything has got a price!

Catchy, I know. But as you would expect, now I have this stupid song stuck in my head. I'm singing it everywhere. Just like Costanza!! And to complicate the matter even worse Jerry warns George of this very thing. He tells George that Schubert went crazy becuase he couldn't get a tune out of his head. Now I believe that I'm going crazy becuase this little ditty of a song is stuck in my head and the little leprechaun prancing around the house is telling me to "Burn Things". How does a "show about nothing" always seem to pertain to something? Darn you Mr. Seinfeld and your uncanny understanding of the human psyche.

Quote of the Day

"Ah Jota, I'm having trouble hearing the lecture. Can you please turn your shirt down?"

-Montgomery


Apparently my friends don't approve of me wearing bright pink shirts to school. Hypocrites.

Ambivalence and Me

I can't believe how uneventful my weeks have become of late. I meander to class, then to the library, then come home and annoy the Hunny Bunny with my antics. Thankfully she loves me and puts up with me. Someday I'll learn how to not push all of her buttons...all the time.

Anyways, the bulk of my weekly entertainment has been coming from my preceptor. It seems I can always get a good laugh from some old fashioned scatological humor. Normally its just me and the Doc, but this week was busy. We had 2 residents farting around with me. One seemed as if he had been around a few years and had a funny name so we will refer to him Vladimir. Well Vladdy apparently likes to ask questions, which led to me getting "pimped" for nearly the entire time I was there. For those of you unfamiliar with that term in the medical setting, I will define it for you:

Being "pimped" is when an attending physician/resident/wife gives you the Third Degree in front of everyone. They just keep asking question after question until you run out of responses. Its a very humbling (and uncomfortable) situation that you want out of as soon as you can.

After a couple hourse of this, we finally came to our last patient of the day and I assumed the position so I could be "pimped" again. The patient was a referal from another doctor in the hospital who had hydronephrosis (the patient, not the doctor). I was grilled for a good 10 minutes on what could possibly cause this. I rambled off a good 2 answers and my brain juices were exhausted. That obviously was not good enough and Vladimir gave me another 10 to match my 2. We also had the luxury of looking at her CT scan before going into the room. As we browsed the films we noticed splenomegaly (enlarged spleen) and some unknown mass at the back of her abdomen which her referring doctor claimed was "Idiopathic Retroperitoneal Fibrosis". This was the mass that was pushing on her ureter and giving her hydronephrosis. It was now time to see the patient and see if the doctor was right...

Now that the spotlight was off of me, we asked the patient a series of questions trying to get the bottom of her problem. In the midst of the exam we asked if she had experienced any recent weightloss. She answered yes and said it had been about 20-30lbs in the past couple of months (Red Flag). She also complained that she "hasn't felt like herself" (another Red Flag) and that foods just haven't "tasted the same" (yet another Red Flag).

I thought back 20 minutes to when I was being grilled by Vladimir and one of our possibilities for this mass was cancer. In that short 2 minutes of information I knew that the previous doctor was wrong and this poor woman had cancer.

Thus, enter my ambivalence. On one hand I was elated becuase everything that I had learned in Pathology had just been manifested right before my eyes in an actual patient. She had all the symptoms I'm supposed to think of when I think about cancer. I felt for once like I was a medical professional. Yet on the other hand this was an actual human being. It wasn't some made up scenario or example out of a book. I was sitting two feet from her, I knew her name, and had her entire history on the table in front of me. And now we had the job of telling her that we now had to seriously consider that she had cancer.

As I think about it even more, thats what medicine is all about. Its the study of disease. Its what we love to do becuase it fascinates us to think about how the body can go awry and given the right circumstances, our intervention can actually help a person get better. But its still grounded in reality. Medicine is not a game becuase these are real lives and we can't take them for granted or treat them as a disease and not give these people a name.

As for this woman, a round of tests and a few more doctors await to just delay the inevitable, the official word of cancer. But in Vladimir, the Doc, and my mind...we already know what is coming.

Ambivalence is a funny feeling...unfortunately, I think it's here to stay.