17.12.04

homunculus




Little man, sequestered in the greymatter sprawl –
Droopknuckled ape, opressor unwitting.

I am his prisoner,
mouthpiece, muse. His numbness
clasps tight the strings of my
Feeling –

His blindness wills my gaze – Silence
tugs at my tongue. I am governed deftly in his paralysis.

Yet, should I fall at last to calm –

Peel back the layers and, with great care,
open his glistening ivory chamber.

I have been his prisoner,
he the mute unquestionable habitant
Within, poised atop hills I could not mount –
Now fugitive, defeated tyrant in a desolate country.


stupid blogger won't render the line and word spacing quite the way i want it.. i am notoriously picky about that, but it's 1:30 in the morning and i've still got far too much to do. (definition of blog: procrastination enhancer)

13.12.04

the irony, it hurts



So cute and fuzzy. You too can buy the common cold (or any of a variety of plush microbes) at ThinkGeek.com, for a mere $5.99! Or you can just visit me and take a swish out of my Nalgene bottle, as it is undoubtedly festering with the cute little guys.

Not only is he cuddly, soft and blue, he has impeccable timing. In my case, he shows up uninvited (and with a vengeance) promptly for final exams. In your case, you can coordinate his arrival with a range of shipping options.

Can we say opportunistic?

*sniffle, cough, sigh* Off in a weary attempt to study, useless Coricidin in hand.

12.12.04

transformation

Thanks to Dr. Charles for (in a roundabout way) giving me the kick-off for this entry.

When I first began having mysterious and inexplicable health problems, I still possessed some modesty. Each time I was asked to change into a gown for an exam or procedure, I cringed inwardly. Blushing behind thin curtains, I would awkwardly fumble out of my clothes and into the standard geometric-print johnny, open-to-the-back-dear. It took only a short while of this before my sense of modesty lit out for greener pastures – leaving me more and more often unmoved in a paste-colored hospital shift, ass flapping in the breeze, face as dull as a spoon.

Four years later, I can go from clothed to gowned in 5.2 seconds flat, no blushing involved. I am so familiar with the standard bedside neurological exam that I frequently get ahead of whichever poor lost med student has been sent to look me over. The things that make me cringe now are not bare skin but bare stupidity; not sensitive questions but patronizing ones – etc.

Certainly the more pragmatic patient allows for more efficient medical care and use of resources. Yet in some ways I hate to look back over my transformation, I think because it has been so frighteningly necessary. In her memoir, Lucky, Alice Sebold says, “You save yourself, or you remain unsaved.” In no part of my life has that rung so true as in my experiences as a patient.

My modesty fled in short order, and unfortunately in many cases my trust was not far behind. Surely the two are not so inextricably linked?

11.12.04

may substitute

A couple of years ago, I was talking to an anesthesiologist at a well-known tertiary referral center. This pediatric specialist had a quick wit and a sparkling sense of humor. As we moved through the peds pre-op area, he motioned to the walls, doors and ceiling, which were all decorated with cuddly-looking animals and fluffy clouds. "Take a look at all this."

Many of the animals were suited up in medical garb, I suppose in an attempt to make the decor seem relevant. Who thought of this??, I wondered, looking at the raccoons' surgical masks. It seemed almost macabre: the filthy, carnivorous, dumpster-diving animals showing up on the OR scene.

"A while back, they had to re-paint some of this. See that teddy bear there?"

I looked around. It took a moment to spot the teddy bear, as it was right at kid's-eye-level, well below the line of sight for my 5 feet, 9 inches. When I found it, I let out a little puff of air. "You mean the one holding the gigantic syringe???" The cute little detritovore was holding a crudely painted hypodermic that looked to be about the size of the average toddler's arm.

He chuckled. "Yes, that one. It used to be holding a scalpel. Apparently someone caught on that a huge scalpel right at eye level might be a little disconcerting for a child about to go into surgery."

Huh. So they replaced the scalpel-wielding bear with a syringe-wielding bear. Great call!

9.12.04

It's Thirsty Thursday... Do you know where your brain cells are?

Ah, that time of week again, when 98% of my fellow college students rush out to pickle themselves in jug upon jug of cheap vodka. Rubinoff: taste the plastic, mmm.

I will wake up feeling hung over tomorrow morning, guaranteed. The twist, though, is that I am not drenching myself in alcohol tonight. (Or any other night, for that matter.) My new meds make me feel even more hung over than I would if I were out slamming shots. Not the most thrilling sensation in the world when, a: these meds are supposed to be helping me and, b: I feel like I am 9000 years old to begin with anyway. BLAH

Tomorrow I must make up three quizzes for my bio lab, said quizzes having been missed while I was in hospital. I am also supposed to turn in a microbiology lab, complete with data from the gel electrophoresis I ran. Only problem is that this lab makes NO sense whatsoever to me. I'd like to think I am a reasonably intelligent person, so what is going on here? The one thing that comes to mind first is the little detail that, oh, huh, we never even talked about this stuff.. Not once. That still does not answer what my problem is, though. I can generally read something and assimilate the basics independently of anything else. So why is this not penetrating? BLAH again.

Only 9 pm, the partying has barely begun, and I am ready for bed. The joy of being the grandmotherly-type in college. :)

7.12.04

the little things

Overheard recently, an MD talking to an RN at the start of what promised to be a busy day in clinic:

MD: Even the cleaning lady is giving me assignments now. The cleaning lady! I mean, people who shouldn’t even be talking to me!

Forgive my inarticulate expression, but my first thought on hearing this was, wtf?! I then turned off my ears, afraid of what else I might overhear. No wonder my blood pressure was a little high when the assistant eventually got to me.

Looking back, I have to wonder how many of the people this MD deals with every day, are just that: people with menial jobs, people who make minimum wage, people who speak little English. People who shouldn’t even be talking to him.

Had anyone else been in the waiting area, they surely would have heard his remark as well. But I was alone, he was not my MD, and so the words floated off into the morning – small and harmless and unremembered, save for this entry in an obscure blog.

5.12.04

from regularity to.. spinal cord injury?

It’s everywhere – in cosmetics, oven cleaners, such lovely products as GoLYTELY and Miralax, and even as wood stabilizer...

It’s polyethylene glycol (PEG). This über-useful polymer recently jumped into the public eye, after a study conducted by researchers at IUPUI and Texas A&M yielded some intriguing results. In this study, newly paraplegic dogs were injected with PEG as part of their initial treatment. Almost 70% of the canine patients were able to walk again within two months.

According to Purdue’s Richard Borgens, PEG acts as a sort of “molecular Band-Aid,” spreading out over damaged tissue in the spinal cord and protecting damaged cells while they recover. (see this article from the Chicago Sun-Times)

See the article abstract from the Journal of Neurotrauma here .



There is a fairly significant body of literature regarding the use of surfactant polymers in neurotrauma, but to my knowledge this is the first major mainstream media coverage of such things. Will this be the wave of the future for spinal cord injury?

p.s. For an interesting comparison, read the description of PEG as used to stabilize green wood – then read the description of PEG’s action in the spinal cord. Kind of cool, eh?

4.12.04

what is is: the terminology of life, death and dying

Euthanasia is a pressing, though hardly new, issue worldwide. “Assisted suicide,” is legal in both the Netherlands and Belgium, and is decriminalized to some extent in a number of other places.

The debate surrounding euthanasia is obviously fraught with religious and moral hangups. On a more basic level, and I believe more importantly at this juncture, it is haunted by the insufficiency of semantics and overly flexible terminology. How does one even define euthanasia? Is the witholding of supportive medical care in a terminal patient to be considered euthanasia? What about patients (infants, the mentally handicapped, the comatose) who cannot weigh in on their own fate? The devil is in the details.

The uneducated masses present a great obstacle for the professionals who must deal with these dilemmas on a daily basis. In order to overcome this obstacle (insofar as that is possible), professionals must first solidify their terminology... Whether we agree or not, we must all at least begin on the same page. The first step toward a more rational debate is the establishment of a universal linguistic baseline.

Euthanasia in the News


One issue of growing concern involves euthanasia of infants – a practice that some refer to as “post-birth abortion”:

This article in the BMJ details an October decision by the British High Court, allowing doctors to withold further life-sustaining treatment in severely brain-damaged infant, Charlotte Wyatt, despite her parents’ wishes to maintain their child’s life at all costs.

Growing in notoriety is the ‘Groningen Protocol’ – A set of guidlines developed at the University of Groningen Hospital for the euthanasia of terminally ill and severely disabled infants. This Dutch hospital recently disclosed its creation of said guidelines, and reported the euthanasia of four such children carried out at the facility last year. Read more from the Times Online.

Public awareness of so-called suicide tourism is also growing. The recent case of Mrs. Z, a British woman suffering from a degenerative neurological condition, is one high-profile example. Mrs. Z and her husband traveled to Switzerland with the goal of ending Mrs. Z’s suffering. According to the Times Online, Mrs. Z obtained her wish this week. Her husband may face criminal charges for assisting her in her travels.

Also see, A Merciful End: The Euthanasia Movement in Modern America, written by Ian Dowbiggin and published by Oxford University Press.

3.12.04

came out clean

So, my previous attempts at blogging have sucked. A lot. Once again I am attempting to redeem myself by purging the awful old entries. All two of them.

This blog is my perspective both as a patient and a pre-med student. I have unfortunately had more than ample opportunity to see things from the receiving end of medical care.

Medicine has always fascinated me -- long before I had any known health issues. My health problems have proved catalytic, though, teaching me a hell of a lot that I wouldn't otherwise know. I am currently studying behavioral neuroscience, and am particularly interested in the neurophysiology of addiction, social predictors of drug abuse, and CSF dynamics. [i know, the last one seems like it came from left field, but hey. that's me. :) And no the addiction stuff has not been drawn from personal experience.. I just find it fascinating. ]