Wednesday, September 29, 2004
Evolution and Lawsuits
Saw an awesome cartoon over at A Chance to Cut is a Chance to Cure
Click the link above to view it. It's from Sept. 25.
Click the link above to view it. It's from Sept. 25.
Tuesday, September 28, 2004
Get a Load of These...
So, you know that your mind is officially warped during Head and Neck exam week when you see the picture below and the first thing you notice is the magnificent sternocleidomastoid muscle. You can even see its attachments at both the sternum and clavicle. I put the arrows in for those of you who don't know what muscle I am talking about. Anatomy, what have you done to me...???
Saturday, September 25, 2004
Crunch Time
Went to the bar(s) last night and had a lot of fun. However, this upcoming Friday is exam day, so it's time for battle stations. I am feeling pretty confident on Anatomy, but still have no idea about embryology, which from what I gather from other students, is nearly impossible to understand. Anatomy is definitely something I will need to know for whatever I end up doing, while since I already know that I'm not going into peds or OB/GYN, I'm not too concerned about having a mastery of embryology.
Anyways, here we go.
Anyways, here we go.
Friday, September 24, 2004
The Ultimate Machine
Studying anatomy has really clued me in to how unbelievably amazing the human body is. Many structures seem designed so perfectly for their function, that no engineer could approximate anything even close. Let's look at the ear. Within the inner ear cavity there are three tubes (semicircular canals) which are arranged at opposite angles such that one can measure forward motion, one for upward motion, and one for side motion. Within these fluid filled canals, there is a small structure (crista ampullaris) which acts like like a sail, such that when the fluid pushes up against it, it sends nerve signals to the brain which then determines which way the body is moving. And this is but the smallest part of the body, so simple, yet so effective. Even more amazing is that this machine is self-generating. Imagine designing something so complex, yet able to build itself. If this isn't evidence of a higher being, I don't know what is.
Which brings me to Maimonides, a Jewish philosopher and physician from the 11th century, who noted:
"that the pious persons of his day believed that an angle of God had to enter the womb to form the organs of the embryo. How much more powerful a miracle would life be, he asked, if God had made matter such that it could generate such remarkable order without a matter-molding angel having to intervene in every pregnancy."
Wow.
Which brings me to Maimonides, a Jewish philosopher and physician from the 11th century, who noted:
"that the pious persons of his day believed that an angle of God had to enter the womb to form the organs of the embryo. How much more powerful a miracle would life be, he asked, if God had made matter such that it could generate such remarkable order without a matter-molding angel having to intervene in every pregnancy."
Wow.
Wednesday, September 22, 2004
Physician Shortage
The following article was on www.medscape.com about the upcoming physician shortage due to the aging baby boomers.
"Physician Shortage Looms, Analysts Say
By Julie Rovner
WASHINGTON (Reuters Health) Sept 15 - Policymakers and the medical profession need to recognize and take immediate steps to avert a looming shortage of physicians, analysts told a forum on Capitol Hill Tuesday.
"If we don't act soon" to take steps to increase the physician supply, "we could be facing some very undesirable conditions and fewer options," Edward Salsberg of the Association of American Medical Colleges told the forum sponsored by the Alliance for Academic Internal Medicine and the consulting firm the Lewin Group.
While the number of medical students has remained relatively constant, the need for physicians is likely to grow in the coming years, as 78 million baby boomers reach their high health-cost years, and as technology increases what medicine can do.
For example, in cardiology, said AAIM Vice President Chris Clayton, "demand catalysts" include an aging population; the rising incidence of obesity and diabetes, both of which increase the risk of heart disease; studies that show better outcomes when patients receive care from cardiologists; and the decline of managed care, which tried to limit the use of specialists.
The shortage may stem from the supply side as well as the demand side. Younger physicians, those under age 36, "are working about 10% fewer hours" than their older colleagues, said Timothy Dall of Lewin.
At the same time, half of today's medical students are women, and women are more likely to want to work part-time, said Stephanie Pincus, a member of the Council on Graduate Medical Education. Women physicians in a system that fails to accommodate their family needs are also more likely to retire early. "What a waste," she said.
"We need to think about what to do to keep physicians in the field," said Salsberg.
One potential source of relief is a growing number of physician assistants, nurse practitioners and other non-physician health professionals.
Stephen Crane of the American Association of Physician Assistants said that by 2010,there will be 80,000 physician assistants eligible to practice in the U.S., up from 62,000 this year. "Any workforce analysis that doesn't take into account non-physician health professionals doesn't just miss the boat, it will miss the ship," he said.
Reuters Health Information 2004. © 2004 Reuters Ltd. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world."
One of the things that I found interesting was the idea that by having 50% of med students be women, you are getting less than a 50% return on physicians since many of them will want to have families. Having families is something that I absolutely advocate for female physicians, however you would think someone on admissions would have thought about this. Kind of a difficult situation, because on one hand women shouldn't be discriminated against for desiring to be mothers, while at the same time medicine shouldn't be hurt because it would be deemed discriminatory to not accept equal numbers of males and females. Perhaps, there should be more emphasis on the benefits of being a primary care type physician to female med students. Many fields, such as peds, family med, and others allow a person to have a relatively flexible schedule with little or no call. Also, they typically require less training, so they would have more room in their careers for a pregnancy leave. Some fields that require long residencies and fellowships, some in excess of 10 years, in my opinion require way too much time to then take 2 or 3 years off to have children. I would like to hear what some of my female readers think, in the comments section.
Sidenote: I want it to be clear that I make my opinions based on practicality, not from a belief that women would be any less capable or successful. Those who would choose not to take time off, or those who would have a husband able to take care of the children, wouldn't necessarily apply to what I was saying. However, it would be unfair to tell a residency director one thing, then further down the road decide you changed your mind.
"Physician Shortage Looms, Analysts Say
By Julie Rovner
WASHINGTON (Reuters Health) Sept 15 - Policymakers and the medical profession need to recognize and take immediate steps to avert a looming shortage of physicians, analysts told a forum on Capitol Hill Tuesday.
"If we don't act soon" to take steps to increase the physician supply, "we could be facing some very undesirable conditions and fewer options," Edward Salsberg of the Association of American Medical Colleges told the forum sponsored by the Alliance for Academic Internal Medicine and the consulting firm the Lewin Group.
While the number of medical students has remained relatively constant, the need for physicians is likely to grow in the coming years, as 78 million baby boomers reach their high health-cost years, and as technology increases what medicine can do.
For example, in cardiology, said AAIM Vice President Chris Clayton, "demand catalysts" include an aging population; the rising incidence of obesity and diabetes, both of which increase the risk of heart disease; studies that show better outcomes when patients receive care from cardiologists; and the decline of managed care, which tried to limit the use of specialists.
The shortage may stem from the supply side as well as the demand side. Younger physicians, those under age 36, "are working about 10% fewer hours" than their older colleagues, said Timothy Dall of Lewin.
At the same time, half of today's medical students are women, and women are more likely to want to work part-time, said Stephanie Pincus, a member of the Council on Graduate Medical Education. Women physicians in a system that fails to accommodate their family needs are also more likely to retire early. "What a waste," she said.
"We need to think about what to do to keep physicians in the field," said Salsberg.
One potential source of relief is a growing number of physician assistants, nurse practitioners and other non-physician health professionals.
Stephen Crane of the American Association of Physician Assistants said that by 2010,there will be 80,000 physician assistants eligible to practice in the U.S., up from 62,000 this year. "Any workforce analysis that doesn't take into account non-physician health professionals doesn't just miss the boat, it will miss the ship," he said.
Reuters Health Information 2004. © 2004 Reuters Ltd. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world."
One of the things that I found interesting was the idea that by having 50% of med students be women, you are getting less than a 50% return on physicians since many of them will want to have families. Having families is something that I absolutely advocate for female physicians, however you would think someone on admissions would have thought about this. Kind of a difficult situation, because on one hand women shouldn't be discriminated against for desiring to be mothers, while at the same time medicine shouldn't be hurt because it would be deemed discriminatory to not accept equal numbers of males and females. Perhaps, there should be more emphasis on the benefits of being a primary care type physician to female med students. Many fields, such as peds, family med, and others allow a person to have a relatively flexible schedule with little or no call. Also, they typically require less training, so they would have more room in their careers for a pregnancy leave. Some fields that require long residencies and fellowships, some in excess of 10 years, in my opinion require way too much time to then take 2 or 3 years off to have children. I would like to hear what some of my female readers think, in the comments section.
Sidenote: I want it to be clear that I make my opinions based on practicality, not from a belief that women would be any less capable or successful. Those who would choose not to take time off, or those who would have a husband able to take care of the children, wouldn't necessarily apply to what I was saying. However, it would be unfair to tell a residency director one thing, then further down the road decide you changed your mind.
Tuesday, September 21, 2004
Saw the following on Hippocritis.com, thought I would pass it on. Post a comment, let me know what you think.
"Obituary: Common Decency died in agony yesterday when a family insisted their severely demented 96 year-old loved one be intubated for recurrent aspiration pneumonia and have a feeding tube placed. The death was accompanied by the loss and debility of thousands of children who cannot afford health care. "
"Obituary: Common Decency died in agony yesterday when a family insisted their severely demented 96 year-old loved one be intubated for recurrent aspiration pneumonia and have a feeding tube placed. The death was accompanied by the loss and debility of thousands of children who cannot afford health care. "
Saturday, September 18, 2004
Snap Crackle and Pop
Got queasy for the first time in lab this week.
We were making a saggital cut through the cadaver's head using a hand saw. So basically, we were using a saw that one would cut down a Chistmas tree with, to cut a head in half from the top of the skill, between the eyes, splitting the nose in half, and going down to the throat. This in and of itself wasn't particularly bothersome, however we hit a road block when we got to the teeth. The saw just wasn't cutting through the enamel of the teeth. To alleviate the problem, I proceeded to take some small bone cutters, (they look like wire cutters), and pull out the impending teeth. They snapped out surprisingly easy. Having done about 3/4 of the cut, I decided to let my partner take over.
As he continued the cut, he encountered the same problem with the teeth. Now it was his turn to remove some. For some odd reason, watching him do it, and hearing the resulting noise, I my stomach flipped a little. Nothing big, but there was definitely an aversion to it.
It doesn't surprise me that I found it more difficult to watch than perform this procedure. It has been my experience thus far that many procedures are much less bothersome when you are the person doing them.
We were making a saggital cut through the cadaver's head using a hand saw. So basically, we were using a saw that one would cut down a Chistmas tree with, to cut a head in half from the top of the skill, between the eyes, splitting the nose in half, and going down to the throat. This in and of itself wasn't particularly bothersome, however we hit a road block when we got to the teeth. The saw just wasn't cutting through the enamel of the teeth. To alleviate the problem, I proceeded to take some small bone cutters, (they look like wire cutters), and pull out the impending teeth. They snapped out surprisingly easy. Having done about 3/4 of the cut, I decided to let my partner take over.
As he continued the cut, he encountered the same problem with the teeth. Now it was his turn to remove some. For some odd reason, watching him do it, and hearing the resulting noise, I my stomach flipped a little. Nothing big, but there was definitely an aversion to it.
It doesn't surprise me that I found it more difficult to watch than perform this procedure. It has been my experience thus far that many procedures are much less bothersome when you are the person doing them.
Thursday, September 16, 2004
Ball O' String
God may have created the body, but I am convinced the Devil designed the head and neck, specifically to torture medical students.
Thought process, "Let's see, how about we put like 40 arteries and nerves in there, and each one can have about 10 branches, with another 10 branches. Also, to trip them up, we'll have some nerves ride with other nerves, only to dip in an out irregularily."
My analogy to those of you who haven't experienced this pain. It is like having a ball of string in front of you. One that is about 6 inches across maybe, wrapped pretty tightly. Ok, every time the string is crossed by another string, it gets a new name. Now memorize everywhere they cross, and remember all the different names for the same stupid string. Better yet, I'll put some hemostats on one of the strings in the middle of the ball (and of course you can't even see what string they are attached to), then I'll ask you a question like, "The following are branches of this string EXCEPT?" And then, I'll give you 80 more similar questions over 3 hours, until you are so braindead you couldn't tie a shoe. Finally, because some super genius gunner spent 24/7 studying that, got them all right, and screwed up the curve, I'll give you an "average" score for getting 85% of the questions right.
But hey, that's anatomy, what can you do?
Thought process, "Let's see, how about we put like 40 arteries and nerves in there, and each one can have about 10 branches, with another 10 branches. Also, to trip them up, we'll have some nerves ride with other nerves, only to dip in an out irregularily."
My analogy to those of you who haven't experienced this pain. It is like having a ball of string in front of you. One that is about 6 inches across maybe, wrapped pretty tightly. Ok, every time the string is crossed by another string, it gets a new name. Now memorize everywhere they cross, and remember all the different names for the same stupid string. Better yet, I'll put some hemostats on one of the strings in the middle of the ball (and of course you can't even see what string they are attached to), then I'll ask you a question like, "The following are branches of this string EXCEPT?" And then, I'll give you 80 more similar questions over 3 hours, until you are so braindead you couldn't tie a shoe. Finally, because some super genius gunner spent 24/7 studying that, got them all right, and screwed up the curve, I'll give you an "average" score for getting 85% of the questions right.
But hey, that's anatomy, what can you do?
Wednesday, September 15, 2004
I was on this abreviation site
http://www.abbreviationstation.com/medical/index.html
looking something up when for some reason I clicked on "DO".
For those of you who don't know, DO is for Doctor of Osteopathy, a person who practices osteopathic medicine. Compared to an MD, or person who practices allopathic medicine. DO's require the same level of training, the only difference for the most part is that they are more primary care oriented and have a more wholistic philosophy.
The website's definition:
DO in your text. -->Doctor of osteopathy: A doctor of any bone disease.
Definitely insulting to the DO's out there, they are not doctors of bone disease. Bone doctors are orthopaedic specialists.
My favorite, "I'm interested in orthopaedics",
"ohh like braces and retainers"
"no, that is orthodontics, a dentist does that"
http://www.abbreviationstation.com/medical/index.html
looking something up when for some reason I clicked on "DO".
For those of you who don't know, DO is for Doctor of Osteopathy, a person who practices osteopathic medicine. Compared to an MD, or person who practices allopathic medicine. DO's require the same level of training, the only difference for the most part is that they are more primary care oriented and have a more wholistic philosophy.
The website's definition:
DO in your text. -->Doctor of osteopathy: A doctor of any bone disease.
Definitely insulting to the DO's out there, they are not doctors of bone disease. Bone doctors are orthopaedic specialists.
My favorite, "I'm interested in orthopaedics",
"ohh like braces and retainers"
"no, that is orthodontics, a dentist does that"
The Chick
I read this tonight and found it not only profound, but hilarious. It couldn't be any closer to the truth.
From Adam Jacobi at http://www.collegehumor.com
"It's not that girls aren't welcome to watch football. That's fine. You have to realize that in the dynamic that is "The Guys," there is no room for "The Chick," unless that's short for "The Chick That Is Dave's Girlfriend," because that makes her hands-off. If she's single and wants to be one of the guys, she's in for a lot of competition for her, as if that ever works. Let's be honest. The chick that's one of the guys NEVER puts out as much as would make everyone happy. That would put her in the stratosphere of sluttiness. You never meet those types at football games, do you?
No, she doesn't want to do all the other guys. She, however, probably wouldn't mind the inevitable attention that logically follows whenever you throw a piece of ass into a group of frustrated men. Have you ever seen 6 male football fans who are all friends all try to get with one girl without really trying? It's pathetic. It makes the Real World look like a safety video about OD'ing on Ritalin.
So, ladies, do us a favor. If you're going to be one of the guys, start by being a girlfriend to one of them. Dicks who try to get with other girlfriends get weeded out of The Guys quickly. Or, do the really gracious thing and whore it up with all of us, even the fat guy who sweats when he eats. But don't bring the cleavage into play when we're watching football. It makes us act jealous, snippy, and beyond irrational. Kind of like... one of the girls."
From Adam Jacobi at http://www.collegehumor.com
"It's not that girls aren't welcome to watch football. That's fine. You have to realize that in the dynamic that is "The Guys," there is no room for "The Chick," unless that's short for "The Chick That Is Dave's Girlfriend," because that makes her hands-off. If she's single and wants to be one of the guys, she's in for a lot of competition for her, as if that ever works. Let's be honest. The chick that's one of the guys NEVER puts out as much as would make everyone happy. That would put her in the stratosphere of sluttiness. You never meet those types at football games, do you?
No, she doesn't want to do all the other guys. She, however, probably wouldn't mind the inevitable attention that logically follows whenever you throw a piece of ass into a group of frustrated men. Have you ever seen 6 male football fans who are all friends all try to get with one girl without really trying? It's pathetic. It makes the Real World look like a safety video about OD'ing on Ritalin.
So, ladies, do us a favor. If you're going to be one of the guys, start by being a girlfriend to one of them. Dicks who try to get with other girlfriends get weeded out of The Guys quickly. Or, do the really gracious thing and whore it up with all of us, even the fat guy who sweats when he eats. But don't bring the cleavage into play when we're watching football. It makes us act jealous, snippy, and beyond irrational. Kind of like... one of the girls."
Tuesday, September 14, 2004
Blogger
I just wrote a detailed post and for the second night in a row the web page messed up and I lost it. Blogger is starting to piss me off. It's on probation, maybe I need to look for an alternate.
Nice Title Yahoo
The following article was on the Yahoo homepage under the title
"Patients using medication to battle pain"
what the hell... the person who came up with that should be shot. Holy cow, breaking news, stop the presses, people are using medications to stop pain. They're only about 5,000 years behind the ball on this one. Anyways, the article was actually about arthritis medications. Read it if you wish:
http://news.yahoo.com/news?tmpl=story&u=/ap/20040913/ap_on_he_me/arthritis_meditation_2
"Patients using medication to battle pain"
what the hell... the person who came up with that should be shot. Holy cow, breaking news, stop the presses, people are using medications to stop pain. They're only about 5,000 years behind the ball on this one. Anyways, the article was actually about arthritis medications. Read it if you wish:
http://news.yahoo.com/news?tmpl=story&u=/ap/20040913/ap_on_he_me/arthritis_meditation_2
Lunatics
I am one of the types of people that need absolutly zero distractions while studying. No sounds, sights, and certainly not the internet. If it was possible, I'd stick a desk in a blackhole and turn it into my study room. It is amazing what I find myself doing instead of studying sometimes. I have noticed that the only time I actually clean my apartment is when I should be sitting down and studying. For this reason, I always go to the medical library, since I can get twice the material covered in half the time. This means that I spend a significant amount of time there.
However, I am continually amazed with some of the med students in there. There are a few who are always there when I come, and remain after I have left. Mind you, I am talking about personally being there from 7:30pm-12 many nights, and class gets out at 5-5:30pm. The fact that these students can devote so much time to studying is beyond me, and I give them a lot of credit. I wish I had the ability to do that. I tend to be mentally fried after 5 hours of studying, compared to these histology and anatomy marathoners. I hope they are getting damn good grades.
I personally have come to the conclusion that I won't be going crazy with studying considering this is really the only time I have left to be "young." I am in my early-20s now, and by the time I finish my schooling and residency, I'll be in my early-30s.... frightening. Considering things won't be any easier in the future, might as well try and enjoy today.
There is definitely a balance, considering a knowledge of this material is essential to becoming a superb physician. It's not like undergrad anymore where the only reason to study is to get good grades in order to get into a good med school. This is the real deal, life or death. Well... off to bed for me.
However, I am continually amazed with some of the med students in there. There are a few who are always there when I come, and remain after I have left. Mind you, I am talking about personally being there from 7:30pm-12 many nights, and class gets out at 5-5:30pm. The fact that these students can devote so much time to studying is beyond me, and I give them a lot of credit. I wish I had the ability to do that. I tend to be mentally fried after 5 hours of studying, compared to these histology and anatomy marathoners. I hope they are getting damn good grades.
I personally have come to the conclusion that I won't be going crazy with studying considering this is really the only time I have left to be "young." I am in my early-20s now, and by the time I finish my schooling and residency, I'll be in my early-30s.... frightening. Considering things won't be any easier in the future, might as well try and enjoy today.
There is definitely a balance, considering a knowledge of this material is essential to becoming a superb physician. It's not like undergrad anymore where the only reason to study is to get good grades in order to get into a good med school. This is the real deal, life or death. Well... off to bed for me.
Thursday, September 09, 2004
Doritos, mmmmm
Yesterday we busted out the old autopsy saw
http://store.medicalresourceusa.com/cc-0005.html
and removed the skull cap in the process of extracting our cadaver's brain.
Observations:
1: Sawing through bone smells like burnt Doritos, I think it will be awhile before I have those again.
2: When we first removed the calvaria, or skull cap, I was the first person to see the inside. I found it rather impressive to think that I was looking something over 80 years old that nobody else had seen. I felt like an astronaut or explorer. How many times does one see something that nobody else has.
3: The brain is heavier than I thought.
4: No matter what the Neurosurgeon says, the dura (outer brain covering) is not that thick, no match for the autopsy saw.
http://store.medicalresourceusa.com/cc-0005.html
and removed the skull cap in the process of extracting our cadaver's brain.
Observations:
1: Sawing through bone smells like burnt Doritos, I think it will be awhile before I have those again.
2: When we first removed the calvaria, or skull cap, I was the first person to see the inside. I found it rather impressive to think that I was looking something over 80 years old that nobody else had seen. I felt like an astronaut or explorer. How many times does one see something that nobody else has.
3: The brain is heavier than I thought.
4: No matter what the Neurosurgeon says, the dura (outer brain covering) is not that thick, no match for the autopsy saw.
My Plan
So, I guess I lied a couple weeks ago when I said that I was back. Well, the past month and a half has been rather intense as I started med. school. For awhile I decided that the days of this blog were over, considering there isn't enough time for studying in the day, let alone priorities 2 and 3, sleeping and drinking, respectively. However, I realized that I had so much cool stuff to say, and everyone I speak to always wants to hear some of the crazy things I am doing. Thus, my plan is to try and post a sentence or two every day or couple of days about something interesting.
I am sad that I had to go back and delete some posts describing my new school, but I thought it important to do so for the sake of privacy. Those of you who had already read this, or know me personally can just rejoice in knowing exactly where I am.
And so, here we go...
I am sad that I had to go back and delete some posts describing my new school, but I thought it important to do so for the sake of privacy. Those of you who had already read this, or know me personally can just rejoice in knowing exactly where I am.
And so, here we go...
