Monkey Kidneys & Ethics

Surprisingly, monkey kidney cells are very expensive (I am being sarcastic). What kind of underworld, black market shady dealings do you have to perform to get "monkey kidney"? I presume very unseemly indeed if the acquired monkey kidney tissue is frequently unreliable.

Basically my question is, can you kill monkeys in America?
And if yes,
were these monkeys free range?

Obscure Medical Condition (1/2)

Several weeks ago I woke up in the middle of the night. I wake up in the middle of the night a lot--I've never been a good sleeper. Usually when I wake up in the middle of the night, I resign myself to the fact that I'll either be awake for the next two hours or I'll take another benadryl and I'll be asleep within the next two hours. But this night I notice something unusual when I swing my feet over the side of my bed to get some benadryl: I can't feel my right foot.

At first I assume this is just a thing, like how your appendages--arms, feet, hands--lose sensation in a variety of situations. But once I've taken my benadryl and am sitting on the side of my bed, I begin rubbing my foot and I still can't feel my middle toe. After about two minutes I begin freaking out, or as much as one can freak out in the middle of the night: rocking back and forth, mumbling prayer-esque incantations, crying.

The symptom, the chief complaint if you will, is Peripheral Neuropathy.

I pull up a differential diagnosis in my mind. Top of the list, do-not-miss: Diabetic Neuropathy. This is terrifying because I am twenty-three years old. Statistically, I have a lot more life to live. I don't want to live it without my legs. But there are more diagnoses--less depressing than diabetic neuropathy, but still depressing.

Chronic Alcohol Abuse. I drink a lot. I assumed I was safely staying within my Federally Mandated limit of two drinks a night. But maybe I was drinking much, much more than that. Although alcohol abuse and pancreatic cancer aren't directly tied to one another, I am still pretty terrified that I will get cancer, and over drinking to the point of developing peripheral neuropathy seems like over drinking enough to give me some type of cancer. Even worse: Alcoholics can develop Korsakoff-Wernicke's syndrome. Now Wernicke's aphasia would be awesome! But the Korsakoff part of Korsakoff-Wernicke's leads to being delusional and "confabulation." I don't need to be any more delusional than I already am.

[Question: Why does chronic alcohol abuse lead to peripheral neuropathy? Answer: A) Alcohol dehydrogenase requires oxidizing agents and can quickly use up important molecules like thiamine (Vitamin B1) or B) Drinking distracts your liver from doing other important things, so that it can't send out as much cycling lipids as it should. Neuron helper cells can't keep producing myelin, and you lose nerve conductance. At least I think this is how it works... If you have a better way of explaining it, please share!]

Malnutrition. I had been on a diet the entire summer. It was great: lost 15 pounds, and now my BMI is 22--super normal. However, there were days when I went "overboard." I tell myself it takes a lot of willpower to only eat 565 calories a day, but it's still probably not a good idea. Being able to lose a pound in a day feels awesome! But really, you should be losing that much in a week, if not even over longer time periods. I tried to eat well, the little I did eat was healthy, but it's possible my body needed more and began shirking its biosynthesis responsibilities, resulting in me losing sensation in one of my feet.

So what do you think I have?

Patient History

Patient is a reliable, 23-year-old diabetic (DM type 1).

CC: Patient's chief complaint is an inability to feel her feet.

Past Medical History

Patient has been diagnosed with:

sickle cell trait (congenital)

exercised-induced asthma (age 8)

seasonal allergies (age 8)

Diabetes Mellitus Type 1 (age 13)

anemia (age 15)

hypertension (age 18)

hyperlipidemia (age 18)

depression (age 19)

Medication

Patient is currently on:

Humalog (short acting insulin)

Lantus (long acting insulin)

Nasonex (seasonal allergies/allergic rhinitis)

Fexofenadine (seasonal allergies)

Atorvastatin (hyperlipidemia)

Vitamin B12 (2000 mcg/day)

Social History

Patient denies recreational drug use. Patient admits to smoking cigarettes, about 8/year and having 1-3 drinks/day, occasionally drinking more (6-8 drinks/night) on weekends. 

Patient exercises about 30 minutes everyday.

Family History

Patient's father is alive, has hypertension that has been controlled by diet, and glaucoma.

Patient's mother is alive, has dyslipidemia, and had breast cancer in 2007. Currently in remission.

Both patient's sisters are alive and healthy.

So what do you think I have?

Campus Security

Prompted by a reader, I now publish the entirety of a warning sent to our school through e-mail from the Director of Campus Security:

Today at 1215 Campus Security received a call from a lab that a suspicous person was looking into labs and offices on the 3rd floor of the BSB.

The individual was tracked by camera and eventually approached by security after he walked through the 2nd floor and part of the Lower Level.

He stated he was looking for two individuals he met at a club. Neither person was in our database.

We have his name and Driver's License number.

He was advised that he was trespassing and warned not to return.

Please make sure you keep your office or lab secured when not occupied,personal belongings secured and call Security immediately at X3288 if you notice anyone or anything suspicous.

We have a serious problem. Lab assistants have enough time to go to clubs.

some of my friends are talented...

Yes. I have friends. 

I don't know what the general public thinks medical students are like. But some of us are pretty cool. Including my friend Colin, who for some reason really likes turning designs into t-shirts. I don't think I've ever seen any design or artwork from him that wasn't already on a t-shirt when presented to me. 

Quite. Fascinating.

Now we just need to sell these beauts. 

Powerpoint Presentations

I really miss jazzy powerpoint presentations. It's not that this material is boring, per se. Most of it is actually fascinating. I know our professors work hard, but I want physical proof that they are working as hard if not harder than me. Selfish, I know, but medical school is pretty lonely and isolating. I want to think that our professors' lives are also spent toiling away reading and re-writing notes.

But in all actuality, I just want a beautiful powerpoint presentation.

Last year, in Biochemistry, for the protein section, our professor put in actual sound effects to explain various ways proteins could be manufactured through transaminases. It was corny--(the sound effect was usually one of a chime)--but it was also awesome.

AND THEN! One of our physiology professors actually explained the molecular basis of muscle contractions by using, and illustrating, actual pictures of famous people (and one professor) through a powerpoint presentation. Amazing.

Today in Micro we got the above. It was great.

....I'm worried Medical School has lowered my standards of what certifies as "exciting."

Gotta Catch 'Em All

I only have to collect heart, kidney, liver, and lung disease before I win something!

Got my flu shot today. It was actually awesome for two reasons: 1) it was the first time I ever got to check yes to the question: "Are you a healthcare worker?" and 2) needles just keep getting smaller! It was literally painless.

It was also, somehow, free. So thanks America, for always having my back (it's the least you could do after you presumably gave me asthma.... we need cleaner air damn it!!!) But still, Walgreens' Pharmacy, specifically at my Walgreens, is always a pleasure and has re-instilled my faith in  health care.

Now I just need to find a family physician... to deal with my multitude of health problems (see above).

Smiling Segs

I just want that polychromatophilic erythrocyte to know that there is nothing funny about three hours of anemia-centric lecturing.

And that it should stop smiling because it's making everyone else feel bad.


[8:47 am, Sep 24 UPDATE]: That's actually not a polychromatophilic erythrocyte: It's a polymorphonuclear leukocyte, a neutrophil if you will (hehehe, half-rhymes). Regardless, it's a good thing I know that now, because I have an exam in less than five hours. Hurrah.

Retinoblastoma (gross)

Pathology, you have a penchant for understatement. 

A Cholesterol Guide for Beginners

To explain: My sister asked me about her cholesterol levels. In response, I spent an hour making a presentation.

As you all know, I want to be a medical/health writer. There's something so alluring about communicating health to the greater public. Even the simple, often corny health pamphlets in hospital waiting rooms are so fascinating.

My mom was on the evening news once, talking about breast cancer, and I thought it was the coolest thing ever. I aspire to do something similar someday. 

There's no black or white answer to the question: "Are you studying?"

existentialism 'n stuff

Ah! I am pretty excited right now. We are talking about mycotic diseases. Translation=fungi! And funguses are pretty cool because A) they're not an animal, a vegetable, or a mineral and B) they're an important part of ecology and my love of that study will never die. 

On a more spiritual note, I thought of this during our first hour of microbiology, the hour we were introduced to virology, which has a complexity I'd never really thought of:

Clicker Farm

 Some people don't live in North Chicago. But to get extra credit you have to use your clicker in 70% of the classes. Consequently, a lot of clickers end up mysteriously in class, on the desk of someone who doesn't own them.

I hope PETA doesn't get upset about this, because the clickers are treated with the upmost respect.

This is what makes studying bearable:

Our second exam of the year is this monday. I have now been in the library, at the same wooden cubicle, for over five hours. My back hurts, I haven't eaten anything in eight hours, my carpal tunnel is flaring up, and I am literally itchy all over (study-induced pruritus, probably).

That being said, the soon-to-be-tested-upon material is, by my estimates, twice as cool as anything we learned last year and an infinite amount of times more useful because last year we didn't learn anything clinical. Last year was just cram, cram, memorize these dumb facts about obscure biochemical pathways.

How helpful has this year already been for me? I'll tell you:

Just a little biased....

GUESS WHICH GENETIC MUTATION I HAVE!

Time "Well" Spent

Today was a relatively difficult day, with me waking up--unwillingly, seriously, my alarm was set for 9:30 and I woke up two hours earlier--in time for my first class. My first class of six. Of course, most of that miscellaneous time was spent making a pie chart for my blog. What is more depressing? The fact that I spent more time in our lecture hall than I spent sleeping? Or the fact that I spent 52% of my day "studying"?

Well regardless I'm proud of myself. I'm not a type A person, so the fact that an entire seven days before my exam I'm already pounding the books... is either a great sign or a desperate call for help. Did no one see me in the library?! Because I was totally there. Totally studying. Totally not an Elora thing to do.

Watches

Since early last year I've been dying to get a watch. I do not know why I associate professionalism with watches, but let me speculate:

1. Pulling out a phone to check the time is "disrespectful" (your older professors will assume you're getting a quick round of "words-with-friends" in).
2. Being successful but also professional means having functional bling. If I get a doctor's bag, it's going to be the most abstract Vera Bradley pattern I can find. If I have an excuse to have a watch, it will be like a crazy beautiful watch. It won't be like I'm "dressing" up (which would be unprofessional) because I actually need a timepiece (... well I mean technically. I think I can make the argument that I need a time piece).
3. It just feels like a doctorly thing to have. I want to be standing over a patient, taking their blood pressure, their heart and respiration rates, and instead of staring at a wall, I want to be looking somewhat at the patient so I don't seem distant. I also feel like there are a lot of portraits of doctors looking at their watches while assessing a patient's vitals.
4. Also, most obvious: being late is unprofessional. You can lose "professionalism points" from our clinical reasoning course by being late to lab. So yea, punctuality is professional.

Consequently, I've been obsessed with finding a watch. Stylistically, I'm pretty "out there," so the challenge is to try and find something that expresses my personality but doesn't force my personality onto others (or worse, offends people). I also don't want to drop much more than $100, so I went to overstock.com because it's really difficult to find cool watches for women. I guess time is more of like a "dude thing." I don't know and I didn't really care, until, after scrolling through about 500 watches I see this atrocity:

Not only is this thing disgusting, it also asks a very important question: why isn't there a "whimsical women's doctor theme white leather watch"? I do not think I want to put on an air of "whimsicality" when I begin rotations next year, but dammit, I want a doctor's watch made for my womenly wrists!

Well, I have since searched overstock.com for a doctor's watch, and they don't have any. I tried searching for "professional" watches, and of the 40 results I got, 39 of them were men's watches. The one female watch was for "professional divers." Which I guess is cool and stuff because hey! I would've never thought women could descend to the same depths as men due to their whimsical womenly constitution's and other almost-trivial-but-still-obnoxious sexist b***s***. 

Anyway, rant over. If you're curious, I bought the above two watches. The one on the right is transparent, which means I've finally gotten something that's actually my skin tone.... which is another thing I could complain about. But I won't. Since like, I'm in medical school and am like, totally busy and schizz.

Read Between the Lines

We have a pathology professor--he seems like a nice, funny man--who's voice slowly deteriorates from a standard, older person's grumble to a dying, dehydrated, lip smacking affair. It's his third hour of lecturing. I get it. You need water. I understand this.

WELL THEN GET A DRINK OF WATER.

I should explain. I can't stand several things in this world of a billion annoyances. But the thing that bothers me a lot and is also quite common is hearing. people's. mouths. Mouths are disgusting, disgusting places. In general I can't stand the sound of people eating. This bothers me to no end. I have had to yell at people to stop, I have gotten into so many annoying fights with my little sister who--is an amazing person--but who needs to understand that I simply can't stand listening to other people eating and no, I will not get over it. F*CK that. I AM ACTUALLY ENRAGED RIGHT NOW. Because I am sitting in class and my professor, teaching pathology--an amazing course--keeps making eating sounds over his goddamn microphone. I swear to God I might leave. I want to leave. Maybe I'll put in headphones.

I have put in headphones. I no longer want to pay attention in class, however, and am pretty upset. The only other times I feel this irrationally upset, I am usually PMSing. I know it's irrational, but I am clearly having a physiological response. My breathing is shallower, more rapid--my chest is tightening. I may pass out. 

Worst of all, this is now affecting my note taking. BECAUSE HOLY SHIT, when something doesn't make sense, I get slightly upset. When I am already upset and things don't make sense, I break down.

Medicine is not for the easily incensed.

Exemplary Professional Behavior (possible extra credit points for being a good human being)

personal accountability: dependability, initiative, dress

demeanor: humility, compassion, adaptability

ethical behavior: honesty, fairness, confidentiality

relations with others: respect, communication, acceptance

relations with the community: teamwork, service, stewardship

Yes, what is immunotherapy?

Seriously though.... #stockphotofail

Lazy Leukocytes

I love it when medicine gives serious conditions funny names. Personally, I'm offended by the term diabetes, because it sounds super cute with all those "eee" sounds. But clearly egregious is the "Lazy Leukocyte Syndrome." Leukocytes (white blood cells of the immune system) are incapable of migrating from the circulating blood into tissues to fight infections. It's a serious, serious condition because it is fatal. Newborns either receive a successful bone marrow transplant or they die. Thanks science.