If It Quacks Like a Quack...

The New York Times profiles Andrew Wakefield, the discredited British physician whose paper attempting to link the MMR vaccine to autism was retracted last year, and whose medical license has been revoked. Meanwhile, the number of needless childhood deaths from completely preventable diseases like measles continues to increase among the unvaccinated.

Big Time

Just discovered that Second Shift has made it to Ambulance Driver's Blogroll O'Doom. AD is one of my favorite reads, and I've taken to occasionally listening to his podcasts on my long runs. To any new readers that happen this way, thanks for stopping by!

Give Blood

Middle-aged male, history of chronic EtOH abuse, arrived via EMS for an uncontrolled upper GI bleed. Quickly intubated to protect his airway, he was hypotensive to the 50s. Piles of used blood bags formed at the base of the rapid infuser as the medical team attempted a transfusion to stabilize his pressure. With blood oozing out of his nose and mouth as fast as it could be given, he remained hypotensive, with periodic bouts of arrhythmia, for an extended period. Finally stabilized long enough to be brought upstairs, we learned less than an hour later that he coded and died.

Without donated blood products, this patient would never have even made it out of the ER. Donated blood isn't a cure-all, but it does help save lives every day.

Only 8% of eligible Americas donate blood. If you're able, please be a hero and consider donating blood.

I Whip My Brain Back and Forth

Dear High School Student,

Welcome to the anatomy lab demonstration. Your extreme enthusiasm for real cadaver parts will make you a great sociopath and/or physician healer.

I regret to inform you, however, that you are not Roger Daltrey, and that spinal cord does not lead to a microphone. Kindly refrain from swinging it as such.

Thank you for your consideration.

Sincerely,

Second Shift

Lessons Learned

Well, med school sure did get busy there for a while. I wish I could claim that I spent the last month and a half elucidating the intricacies of Chédiak-Higashi Syndrome or memorizing the effects of each and every cytokine, but the truth is that even if I had, those nuggets of knowledge would already be forgotten.

As always, the most memorable lessons come straight out of the ER.

Like, when you flee the bank with the bundles of cash you just stole, resist the temptation to stuff the bills down the front of your pants.

When those explosive dye packs go off, they're going to damage some pretty valuable real estate.

It's Not a Toomah. At all.

After endless hours studying human pathology, it's not uncommon for medical students to become convinced they suffer from a rare disease or two... or eight. During a psych block, for example, the incidence of obsessive compulsive disorder self-diagnosis among my first year class shot up astronomically.

With much of this week's schedule devoted to discussing brain tumors, I feel a bit of prophylactic cautionary advice is in order. See, in learning how to make a diagnosis, we're taught to remember Occam's razor - that, in general, the simplest explanation is most likely. In other words, that dropped pen or sudden muscle jerk in lecture probably results from dozing during class and not a cerebellar lesion.

Moral of the story: you probably don't have a brain tumor. And if Occam isn't a funny enough last name for you, take it from this guy...

The Bionic Man

Spend any amount of time in an anatomy lab and you'll quickly discover that the crisp, bright colors of a Netter's atlas are nowhere to be found in an actual cadaver.

Which means if you happen upon oddly vivd pink gums while bisecting the head, they're probably dentures. Shiny silver prongs poking within a great vessel? That would be an IVC filter. And no, that bright yellow tube left in the urethra is not another fascial plane, but a foley catheter left for you to find.

All these surprises laid in wait deep within our cadaver. Other highlight from our class included a pacemaker and an artificial hip.

Still, I doubt anything will ever top the handicap parking permit I once encountered buried in a patient's skin folds...