Saturday, 3 December 2011

Of Poisons




Poison. It's always a poison. You hardly ingest a poison intentionally, although many people do, but it mostly sneaks in, or gets sneaked in.
When did you first get poisoned? I don't know. Some of these are slow killers. With small doses over a long time, it's hard to tell when it first got into your system. Even if you could remember when you started feeling that something is going wrong, it won't necessarily be an accurate way to tell. You could have been unwell for long before and were just too busy to notice.

Bottom line, you got poisoned. And suddenly you realize that for a long time you haven't been the person you've known for all your life. The things that used to interest you just don't anymore. New things are catching your attention. Your view of things is changing. You are doing things you've always considered yourself too smart or too good for doing. You realize that, just like everybody else, you too got poisoned.
Why would I call such a process "poison"? True it might seem like just change that happens normally to anyone. It might well enough be change, but a change that turns you to a stranger you don't like is definitely worth calling a poison.

So what was it? What was your poison? What thought crept into your mind? What words did you hear?Something must have triggered all that. There is no such things as auto-antibodies against your mind and soul, but there has always been a poison.

How did this poison work? I'd know if I knew how you perceive the knowledge of things not good for you and keep yourself away from them (and turning knowledge into full perception on which sensible action is based is not always the easiest thing to do). They are not necessarily wrong for everybody else but you know your old self enough to know that these things won't be particularly good in your case. You know that but somewhere in your head doesn't perceive it well enough and continues to push the rest of you towards the-in-your-case destructive targets. That part seems like where self control exists, for despite the fact that all the other parts of your head perceive the fact very well, they still obey the pushing of the stray part driving you while being completely aware of it to destruction. And that part, that pan-controller part, is exactly where the poison has hit.

The good news is that admitting the existence of a disease is the first step towards curing it. But is there such a thing as an antidote in such a case? Unluckily your brain cells don't regenerate, and if the poison has killed them we probably can't get them back for you. Implanting new ones won't do any good either, because then your self control will never be the same as your old self, which doesn't place you anywhere better than where you are now. Hope is that they are not dead yet, they're just inflamed and flaring like mad and can be soothed to calmness and sanity once more.

Thursday, 1 December 2011

Round #3: Cardiology



Yes, I've noticed that last time it was Round 1, but seriously, Round 2 has been Dermatology. And if you found the post about Chest Medicine boring, I assure you that talking about glancing at people's hands for 2 weeks would have been infinitely more boring (not to mention the bore of having to physically exist there for 2 weeks). So let's just pretend it's never happened.

We're almost done with Cardiology. A fascinating science that I would have loved to spend more time on. The thing is that you spend like 9 days with wide opened eyes and dropped jaw every time anybody tries to make you understand anything, and just when you're about to understand what you are supposed to be doing in the first place, your time is up! and you have to move on to another Round where you spend another 9 days of wide open eyes and dropped jaw.

Cardiology is basically like Maths. The heart is a machine that works according to the most accurately synchronized rules in your body, and even when it's sick, it obeys another set of sickness rules. Once you grasp  these rules you can workout any clinical issue you're supposed to solve.
Assuming you get through understanding and remembering all the rules, you have to get through the hardest part, that is clinical examination. You have to auscultate the heart and detect events that occur in fractions of seconds. You have to differentiate sounds that overlap each other and tell what happened before what. Rumor has it that these things get easier by practice, but 2 weeks is not enough time to practice anything at all.
But truth be said, who would have ever thought that we have a "heartman"? A doll that is adjusted to simulate auscultatory findings of different cardiac conditions. After auscultating the doll, we thought everything perfectly made sense and that we could go back to the ward and immediately be cardiologists and start diagnosing cases. But the next day brought our senses back. The doll shows the standard typical sounds described in books, has a longer cardiac cycle and slower breathing rate than that in humans, which gives you time to hear well and analyze what you've heard, making the experience completely different from that you'd have with real life patients. So it's practice, practice and only practice, the key to learning any clinical skill in medicine.

Diagnostic and therapeutic techniques in cardiology  are constantly under development. Even beginning to understand how the technique works and how to interpret its data takes many hours as well as many textbooks. We're only taught crumbs of course.
 
One of the branches I'd tag "to be considered".  And who knows? May be someday.