Category: Medicine

Good news ladies, bad news ladies

First the good news (possibly). Boffins (to use the appropriate official top gear nomenclature) have figured out how to create sperm from female bone marrow cells. Now, in theory at least, women can reproduce without the aid of men, although as the page points out, we’re still useful to keep around for mowing the lawn and fixing cars. The technique sounds pretty high risk (from the stand point of the proportion of the sperm that have cellular structural (and thus presumably chromosomal or genetic) defects, but as with all science once the concept has been proven the wrinkles usually get ironed out pretty quickly).

The bad news is that even if they can reproduce sans men, they are still going to get forgetful when it happens. Ozzie scientists have proven that so called pregnancy brain is a real phenomenon, although they have not tried to speculate on what the actual cause is. This is all quite funny because I’ve been listening to Simone complain for a few months now about how she keeps on forgetting things and feels generally somewhat more wooley brained than usual. One of her old bosses said that she didn’t realise how bad it was until after she had had her baby and her memory came back. Perhaps it is supposed to serve an evolutionary purpose, helping women forget just how unpleasant pregnancy can be so that they can do it multiple times and advance the species…

What was really like a drug were the drugs…

Today I had a “sick” day, to go and get a gastroscopy done (gastroscopy = camera down into stomach to look for problems).

This all results from me being married to a surgical registrar, who when I mentioned that I get reflux a couple of times a month started insisting that I should get a gastroscopy to make sure that there wasn’t anything like a huge ulcer in my stomach causing it all. Typical doctorish scaremongering really, but as is always the way in marriage eventually the poor meek husband gives in to the pestering of his domineering wife and does whatever she wants, and so I went and got the scope done.

Now the whole process involves an hour of amnesia (ie I have no memory of anything for about an hour after they put the drugs in) sandwiched in between 2 two hour blocks of unmitigated boredom (firstly waiting for the procedure in a waiting room with lowest common denominator breakfast television blasting loudly across it, and then sitting in the recovery area with nothing to do while they wait for the drugs to wear off to their satisfaction before they let you go).

The other downside was that while I was out to it on the good drugs John Howard was doing one of his “visit the rural hospital so you can pretend you care about the bush and sick children” things in the same hospital, about two rooms from where I was. If things had been planned a bit better they could have put me earlier on the scope list so that while I was recovering I could have filled in the time by giving old Johnny a frank and honest (not to mention vitriolic and possibly obscene) piece of my mind (and later I could do a Hollywood star job and call my own press conference to blame the whole thing on the prescription drugs that my doctor had just given me), but unfortunately it was not to be.

Anyway, no big holes found, and nothing that needs fixing at the moment. And in 5 years time I get to do it all again. I wonder if I can fit it in with the next election…

Respiration

At the moment I’m going through quite a bit of respiratory physiology, and I can’t help noticing that I constantly become consciously aware of my breathing. I get that thing where I suddenly notice that I’m breathing, pause mid breath, and then have to think for a tic before I remember what comes next and I start breathing normally again.

It doesn’t happen when I’m studying any other kind of physiology, which is why it’s so curious.

Flight of ideas

One of the things I am living about being in Dunedin is the exposure to Academic medicine, with our lecturers as often as not being dual clinicians and researchers. They really know the stuff, and keep on hinting at the bits that are still unresolved, or those tidbits that have recently arisen from exciting research breakthroughs. Having gone through the UQ Med school and worked for Queensland Health (neither of which have administrations even remotely interested in research) it’s unbelievably refreshing to be around other minds who are interested in how things work, not just the fact that they do. (and who do research that involves more that glorified counting and stamp collecting).

For the first time in what seems like years I find myself wandering along a million miles away deep in contemplation of how I could solve some of the problems in Medicine, how I could improve myself, and how I could come to take over the world (or at least become a giant in my little corner of it). I used to get it all the time when I was doing my Biochemistry undergrad degree, but haven’t felt it much since starting studying medicine, and I had forgotten how invigorated and vibrant it made me feel to know of all the big holes that exist in our knowledge just waiting for me to devote a happy life to figuring them out.

Progress

The other day I ran into a question on the college’s practice question bank, which amused me:

A surgeon is planning to mobilise the stomach into the chest to form a conduit after an oesophagectomy for cancer. Which blood vessel will she preserve to maintain its vascularity?

It shouldn’t strike me as surprisingly progressive in this day in age where graduating med classes are 50-60% female, but the colleges have traditionally be quite, well, traditional, and so it was to my mind an amusing and positive indication of acceptance of the changing reality.

Inside my skull

Things appear to be getting to me a little.

I’ve been studying hard, and to put myself to sleep at night, reading my way through the harry potter books (reading fiction while lying down = dave asleep in 10-15 mins, which is a good system really).

Anyway, the last few days I’ve been having some odd dreams while I’ve been resetting my body clock after a week working overnights.

Firstly I woke up the other day from an afternoon sleep with a strange sense of foreboding, and a non-specific feeling of concern for Neville’s wellbeing. I explained this to Simone, who said “Neville who?… … Longbottom?”, and I said yes. She wasn’t sure which was more wierd, me dreaming that Neville needed help, or that she immediately knew who I was talking about.

Then yesterday morning I awoke after a dream where I was reading through my anatomy book, and found 4 pages that I had somehow missed, which in really tiny print listed the names, nerve supplies, actions and attachments of about 200 muscles in the arm, and I suddenly realised why I didn’t understand how the arm worked, and that there was no way I could possibly learn all those muscles. And then I woke up…. sweating…

No beer and no TV makes David something something.

Curious possibility

Something I was reading a while back that I thought was a fantastically interesting possibility was the notion of using Propranolol (a beta adrenergic receptor blocker drug, most commonly used to treat high blood pressure and heart disease) to treat PTSD (post traumatic stress disorder).

I first saw it on 60 minutes (which is of course always such a bastion or journalistic reliability and cautiousness), but afterwards I had a look on Pubmed for any published scientific articles on the topic, and while there weren’t many, and they were mostly case studies or case series, it did seem that this was not as unsupported and crazy as I had initially suspected it might be.

The 60 minutes article and several papers talked about using the drug for short courses (days to weeks) at what seemed like comparatively high doses, in conjunction with cognitive therapies and emotional stimulations relating to their specific PTSD situation.

The patients reported that while it did not remove the traumatic memories, there was no longer the intrusive emotional and physical responses associated with the memories.

There were some “experts” (philosophers and some psychiatrists) who were voicing concerns about the use of drugs to effectively modify memories, arguing that it was a dangerous precedent, since we formed bad emotional associations to stop us making mistakes repeatedly, but those who were researching this treatment made the counter argument (which I agreed with) that PTSD is not a normal response, and if we see someone with a broken arm we don’t deny them pain killers because it will cause them to miss out on the full experience of having broken a bone, so why would we consider it any different to contemplate withholding treatment for someone’s emotional pain?

Ick!

One of the things they tell you about in Med school is the ability of certain medications to give you a metallic taste in your mouth.

Previously I had always though: “Metallic taste, that’s not that bad. I wonder why they make such a big things about it”.

That changed a few weeks back. With lunch I inadvertently had a glass of water that had come out of a copper pipe and it wasn’t until I’d finished most of the glass that I noticed the blue tint to the water and then started to taste the metallic taste. As the afternoon wore on I’m not sure if the taste got stronger or if I just became increasingly conscious of it, but it became highly unpleasant. Drinking water or tea didn’t decrease it. Eating didn’t decrease it. Even brushing my teeth didn’t help things. Eventually it disappeared (overnight I think), but it quite startled me just how unpleasant a situation it had been.

Another thing I suppose that I can learn to take people a bit more seriously about when they report it as a symptom…

Oops, I cured cancer

In what surely has to be one of the more amusing lab “accidents” a researched may have accidentally stumbled onto a cure for a number of different kinds of cancer.

She was working with cancerous epithelial cells while researching treatments for inflammatory bowel disease when she made a mistake and added too much of one of her test drugs.

Afterwards she found that all the cancer cells had died. Initially she was irritated at her mistake ruining her experiment until one of her co-workers pointed out that perhaps “it killed all my cancer cells” was actually a cause for excitement.
So we’ll have to wait and see if it makes it to clinical trials, but it’s a pretty cool story.

Neuroanatomy makes brain go splat

Well, I’m officially into the study for the surgical part 1 exam, and I’ve been reading all about neuroanatomy, and it makes my brain hurt.

I find myself looking forward to going to work, so I can give my brain a rest, and try and loose the feeling that there is someone standing beside me as I study slowly packing more and more cotton wool through my ears into my skull.

That said I am beginning to wonder why they weren’t more insistent that we learn this more thoroughly when we were in med school. I still feel that there’s not much point in forcing everyone to learn detailed anatomy if they’re not going to use it (similar to making everyone learn biochemical pathways they’ll never use again), but the chapter I am currently reading would have been a good thing to examine, because it lays the groundwork of general principles and basic details that everyone would probably benefit from.

I keep on having “Oh, right, that makes sense”, and “Riiight, so that’s how that works” moments, and I can only assume that I will end this year an awful lot more knowledgeable than when I started, having finally been forced to read all the text books that I was too slack to read properly while I was at med school (it also presumably helps that I have a better practical contextual framework to place the knowledge in now than I did then).