Hello my lovelies, time sure does fly fast, innit? I've been here winding down my well-wound whirlwind winsome wintry semester with a smorgasbord of studying. October is almost over (jeez, it feels like just yesterday she was taking her first steps and eating crayons) and exams are nigh. We have one more week of classes, then a week and a half SWOT-VAC (the ugly-guttural acronym denoting the Study WithOut Teaching Vacation period) followed by several exams. On the weekend we have our MSAT - the practical examination. What it will consist of is several stations with different tasks. It'll be 2 stations where we have to take a history, 1 station where we have to demonstrate clinical reasoning, 1 station where we do a physical exam of some sort, 1 station where we impress our knowledge of life support/procedure stuff, and then 1 communication station. Clinical reasoning is the one that's different from last year and is pretty cool. We get a sheet of paper with a fake patient's medical history and then the history of what brought them here. We then give our top differential diagnoses, defending and pointing out holes in those decisions, and then get narrowed down by asking about physical exam stuff and investigations and what those lead to. It's almost like being a doctor... weird. The communication one will be a bit trickier this year. Last year it was pretty much "talk to the patient who has some non-medical problem and don't be an asshole". This year it's going to either be breaking bad news to a patient (you have cancer! your son has 1 year to live!) or doing what's known as motivational interviewing - the process that assesses how willing someone is to change habit X (their obesity) and trying to get them to understand why it's bad (because they're fat) and how to fix it (stop eating). They're both pretty tricky to do. The life support/procedure thing will probably be okay. It'll either be advanced CPR plus defibrillation and giving them adrenaline/epinephrine or setting up and reading an ECG. Hopefully.
Several days afterwards we have our written exams. Now I'm going to admit something that I'm really embarassed about. In fact, I have not talked about it with anyone who's not in school with me because it makes me feel ashamed. *deep breath* We write our own exam questions.
Our school got some grant to do some sort of psychological assessment on students' anxiety and stress associated with exams and are trying to test and see if students will be less stressed out if they've written and seen the questions and answers ahead of time. This is apparently an existant area of education research in which our School is dipping its feet. I wish they had given me the $26,500 grant and I could have told them, "yes, it will lower our stress". So the actual practicalities of this project is that each of the 40 small groups in our year had to write 1 multiple choice question and 1 short answer question. We also had to write a model answer and reference it, as well as decide what's the minimum amount of info to pass the question. We uploaded all these questions and their answers, after minute screening by the powers-that-be, and they are available for all. We were told that 25% of our final exams will consist of these questions. So essentially, everyone's memorising all the questions and the answers, because it's guaranteed to be a huge hit on the exam. There's SO much material we cover in a year and so a big problem is trying to study everything well and knowing what's important and so this is helpful. Yes, stress reduced. Duh. The project has met some criticism and in my opinion has some issues of its own. Some of the people in our year are total jerkfaces and write ridiculously specific questions that, had most people got on a regular exam, would be very tough to question. Some people are the kind of jerkfaces who don't actually put a real amount of work into it and therefore post a question with the answer being incorrect. Now is where it gets really annoying and tricky - once the questions are posted (up to a certain date) the school is legally bound to keep them up there, with whatever answer was written and therefore bound to give credit for whatever answer is online. This means, especially for multiple choice questions graded by a computer, that you have to memorise the wrong answer to get the point! The mechanism of ways a mind can get boggled is complex and poorly understood.
So there's that.
I've been studying a lot... it equates to everyother day being a late night. Monday was til midnight. Tuesday I had class 8-6pm and so took it easy afterwards. Wednesday I diddle around during the day and then had dinner with a friend and then went to another friend's night-shift work thing to keep him company and study. Studied til 3:15 which is far-and-away the latest I've ever studied. I was never one for all-nighters, choosing instead to follow the early-to-bed adage and make sure I'm functional in the morning for the eventual exam. His place of work was pretty cool and another shining example of good policy that they have here and it lacking in the US. It's a needle-safety program located in the heart of the city, with 24hour staff/nurse, that gives 100% for free and anonymously sterile needles, water, swabs, education, condoms, etc. They ask a few question for statistical purposes and then offload the 20pack of syringes the person just asked for. It's very cool and, especially on a Wednesday, chilled as well and so perfect for study. I'm afraid, though, that in the US this would be met with the same kind of knee-jerk reactions that fight giving condoms to teenagers for the risk that it will promote promiscuity. Thursday studied all day and then had a friend over for dinner. Friday class and study all day and then went out in the evening. A friend was having a fundraising thing for a trip to Africa this winter to help build schools or something and had a movie/hor'sdoeuvre's (however the fuck that's spelled) thing. I got there a bit late and quickly downed 4 glasses of wine before starting the movie. Excellent idea. The movie was called A Walk to Beautiful and was a nice documentary about an impressive hospital in Ethiopia that repairs fistulas (connections between uterus/bladder or uterus/rectum and any other combination) that occurs from long and difficult pregnancies. These women face enormous stigma and adversity in their villages and families and so, if they can, go there and get fixed and it gives them a new life. Powerful shit. Yesterday was Saturday and consisted of the usual markets, lunch, study, dinner with friends and some computer shit.
I've been having a (un)healthy addiction recently to The Daily Show and The Colbert Report lately. I discovered about a month ago that you can watch the most recent 3 weeks-or-so of episodes online, streaming, fast, with no advertisements on the show's respective website. The material has been so good recently, as well, that the episodes have no option but to shine. I'll watch between 1 and 3 episodes a day nowadays and am almost caught up with what's going on in this falling-apart world of ours.
Jesus, I didn't know that!1
Here's something that I was more than pleased to learn about: drinking diet sodas are associated with more weight gain than not drinking soda! That's right, several thousand people's drinking habits and subsequent changes in size. People who drank more than 3 artificially-sweetened beverages a day had about a doubled risk in increasing their BMI. I've tried to find why this happened and I've come to two reasonable but slightly contradictory ideas: a) the body is getting a sugar-like substance in terms of taste and so is acting like it's getting sugar (in terms of metabolism etc) but when the calories aren't there, it bumps up the craving thus promoting these people to go and get more sugar/calories from other sources and thus increase their weight or b)the body is getting this stuff that is like sugar and so is treating the rest of the intake (which isn't perhaps excessive taking into account the "0 calories" of the soda) like it is in excess and as such is promoting storage of foods into fat, getting ready for a famine or whatever. I think those make sense and am definitely happy to accept that that nastiness is not good for you. Definitely not a healthy food, considering there's nothing food-like in it.
Medical word of the post:
Anosognosia - ignorance of the presence of a disease; being unaware of one's own illness.
Saturday, October 25, 2008
Saturday, October 11, 2008
the difference between genius and insanity is measured only by a cannula
G'day. I just got out of my very first drug trial and boy is my arm tired. I've always been interested in the world (money) of drug trials and thought I'd give it a shot. There's a place quite near my hospital/main classroom that does them; a few friends have gone and said they were legit so I decided to give it a go. The way these work is that some company (GlaxoSmithKline, Pfizer, etc) has some drug in some phase of development that they need to test. They pay this company, which has the facilities and staff for monitoring stuff, to do some sort of trial on the drug. Drug trials are broken down by phases. The Pre-clinical Phase is when they design the drug in the lab and then test it in vitro and on animals, at highly varied doses, to see if there are any serious adverse effects and if it works the way they want to. Next they move on to Phase 0, where they test very small amounts of the drug on very few people, to figure out a bit more how the drug is metabolized and what pharmacokinetics (the pathways of degeneration and activity of the drug in the body) are important to consider. Phase 1 tests the drug on a smallish amount of healthy people to see what the bioavailability (how much drug is in the body after 1hr, 2hrs, 1day, etc) is like and how the drug is metabolised, as well as any adverse reactions. Phase 2 is on a larger group of people and now, in addition to the aforementioed stuff, they will also check if it has any efficacy in the thing it's actually testing for (eg high blood pressure, diabetes, etc). Phase 3 is the ultimate one: a randomised and controlled trial on a large group of people with the disease/condition on whom efficacy is going to be tested - it is this Phase that helps bring home the bacon.
I was on a Phase 1 trial for a newly released generic version of exemestane. Trade name Aromasin, this drug has been around for like 20 years, as an anti-breast cancer drug in post-menopausal women. After 20 years, a drug company loses the patent on its drug and is forced to reveal the formula, so other companies can make their own versions, especially allowing for generics to be made. One of the reasons I was cool with this trial was because the drug has already been around for a while and this is for a generic version (which I whole-heartedly approve of); the others included that I only had to take 1 pill and the timing and money situation suited me. I had to go in from 7am yesterday (Sat) until 9am today (Sun) and then come in in the morning for the next 4 days. Then do all that again at the end of the month. This gets me $1030 tax-free*. This obviously sounds annoying but I'm actually happy for it since, as I mentioned, the place is near my school and I have a problem getting up early and getting study on, so this will force me to do so.
What was the thing actually like? I got there in the morning, after being told not to have any alcohol, chocolate, caffeine, or grapefruit juice the day before and not to have eaten since 9:30PM the night before, and got a cannula put in. This is access to my veins. We were given a light breakfast and then the drug (they did the thing where they checked under the tongue/in the cheek) and then had a small amount of blood withdrawn every 15 minutes for an hour, then every 30 minutes for 2 hours, then every hour for 3 hours, then 2 hrs later, then 4 hrs later, then 8hrs later in the morning before I left. This may sound annoying but actually is not a big deal at all - the amount of blood is minute enough so you don't feel it and you have nothing to do anyway. I was idealising the experience the whole time, "Wow, I'm getting paid to have a WHOLE day where I'm fed and don't have to do anything... I can study and catch up on internet stuff and watch stuff etc." Oh, how young and idealistic we are... Here's what I did: watched half of Jackie Brown, read more than half of Trust me I'm a (Junior) Doctor, watch 1 episode of Man vs Wild, 4 episodes of The Mighty Bouche, an hour each of Blood Diamond and The Hunt for the Red October, spent an hour reading recipes/looking at pictures on tastespotting, tried to understand what's going on in the economy, and did about 30 minutes of study. Yay. My eyes hurt from all that. I also took a bit of a nap and ate a lot. I was pretty hungry when I got there (having fasted the night before and cycled to the place) and then waited for like 2 hours to get a tiny breakfast. Then 4 hours until lunch - I was quite worried that I was being treated like a post-menopausal woman with regards to her dietary needs. But then we started getting a lot more food and I was happy. I was a bit surprised that we were eating hospital food (for that was whom was doing the catering) yet how not necessarily healthy it was. I had 2 big chunks of carrot cake, 1 lemon cake w/ cream, and 1 chocolate banana muffin, plus like 4 things of orange juice over the day. Talk about diabetic risk. As far as the actual drug goes, I didn't feel anything. I had a slight headache but I would much more easily chalk that up to confined space + air conditioning + fluorescent lighting + no exercise. The only weird thing was the crazy dream I had in the morning. In the dream, I was sleeping but semi-conscious and trying to wake myself up, but I literally couldn't do it. I heard nurses talking about me, saying that I was comatose and not knowing what they should do, and I was like in the mostly-asleep phase (in the dream, remember) and tried to tell them that I was okay and I remember literally shaking myself in order to wake myself up in the dream and then eventually woke myself up in real life. So weird. You know when you're on the cusp of sleep and you semi-dream but are still conscious (the so-called hypnagogic state)? That's what my dream felt like. Weird. If that happens next time, I'm chalking it up to the meds.
So that's that. The rest of my week was pretty decent. I started it by flying too close to the sun and subsequently getting burned. Monday I was in the library until midnight and then Tuesday I was in class/hospital/study from 8am-6pm with no real break. As a result, I was pretty ineffective the rest of the week. On Wednesday I went out to a fish and chips place for a friend's dinner. On Thursday a bunch of people met up for an evening/night BBQ at South Bank - the sweet park and artificial beach that sits on top of a river across from downtown. We sat around eating and drinking and then at 11pm went for a swim. It was so beautiful - we were the only ones there, a nice night, looking at the city, playing catch with a frisbee/nerf. I was talked into going out afterwards and so only got home at like 2:30 and then had to wake up at 7 for class. On Friday I got my head shorn in time for summer (which has been put on hiatus for the last couple days for whatever reason) and then went to a fancy annual lecture thing. Each year the school of medicine tries to get someone fancy pants to talk to us about their accomplishments, as well as dole out teaching prizes to best clinical teachers of the past years. This year the guy speaking was Graem Clark - the guy who invented the bionic ear (cochlear implant). His story was actually pretty impressive... he worked hard for about 30some years and as a trained doctor had to pretty much teach himself audiology and engineering and stuff. Also everyone else around him told him that it was impossible to do. And now over 100,000 people have the thing and they can hear. Pretty incredible. Afterwards there was free booze and food but because of my damn trial I could only stuff my face until 9:30 (10) and eschew all (1 glass) of alcohol.
Today the weather is pretty miserable and I feel a bit groggy. I must tutor later and then dumpster dive - who knows what treasures the dumpster will hold?
Jesus, I didn't know that!1
Yawning, I recently learned from an anatomy tutor, is to aid in pumping an extra oomph of blood back in to the center. The action of the yawn is caused by the lateral pterygoid muscle, and this contraction physcially induces force on the veins in the face, which helps pump blood back into the heart. Muscle-induced blood pumping is one of the main mechanisms that veins have of returning blood. The calf muscles are also useful for this, which is why when you do the full yawn/stretch thing, you also plantarflex (tippy-toes) your feet to return blood that's been pooling down there.
Last week was female sexual pathology stuff and we got to learn all about periods. This contained a very ample amount of information that I didn't know. Like how menopause can be like one long 6-month period, or that a lot of women get menorrhagia (increased amount/time of bleeding) and that this can be diagnosed by: longer than 7 days; greater than 80mls/cycle; changing pad less than every 3 hours; needing "double protection" (pad + tampon); loss of clots, etc. How do you know it's 80mls? Apparently some researchers spent time weighing/wringing out pads and tampons. For your own knowledge, 1 tampon is roughly equivalent to 5mls and 1 pad is about 10-15mls.
We also got to learn about the wide-world of contraception. It's amazing how much shit there is, and all for women, to prevent pregnancy. Pills and IUDs made of copper and rings and depot-shots and implanted pieces of rubber (which is definitely the one I'd go for). We also got a definitive answer on that oft-queried problem: is it cool to skip the sugar pills and keep taking the pill in order to "skip" a period? "Hells yah! Just try to have a bleed 4 times a year," is what they recommend. I was doing a bit of my own research into male contraception and found this thing, which seems awesome and I'd be willing to try out. There are other possiblities out there but, unfortunately, nothing that's really marketed well besides condoms and good ol' coitus interruptus.
Medical word of the post:
Pseudocyesis - the false belief that you are pregnant based on physical cues (no period, morning sickness, abdominal mass), despite evidence that you are not.
*I'm supposed to declare it myself
I was on a Phase 1 trial for a newly released generic version of exemestane. Trade name Aromasin, this drug has been around for like 20 years, as an anti-breast cancer drug in post-menopausal women. After 20 years, a drug company loses the patent on its drug and is forced to reveal the formula, so other companies can make their own versions, especially allowing for generics to be made. One of the reasons I was cool with this trial was because the drug has already been around for a while and this is for a generic version (which I whole-heartedly approve of); the others included that I only had to take 1 pill and the timing and money situation suited me. I had to go in from 7am yesterday (Sat) until 9am today (Sun) and then come in in the morning for the next 4 days. Then do all that again at the end of the month. This gets me $1030 tax-free*. This obviously sounds annoying but I'm actually happy for it since, as I mentioned, the place is near my school and I have a problem getting up early and getting study on, so this will force me to do so.
What was the thing actually like? I got there in the morning, after being told not to have any alcohol, chocolate, caffeine, or grapefruit juice the day before and not to have eaten since 9:30PM the night before, and got a cannula put in. This is access to my veins. We were given a light breakfast and then the drug (they did the thing where they checked under the tongue/in the cheek) and then had a small amount of blood withdrawn every 15 minutes for an hour, then every 30 minutes for 2 hours, then every hour for 3 hours, then 2 hrs later, then 4 hrs later, then 8hrs later in the morning before I left. This may sound annoying but actually is not a big deal at all - the amount of blood is minute enough so you don't feel it and you have nothing to do anyway. I was idealising the experience the whole time, "Wow, I'm getting paid to have a WHOLE day where I'm fed and don't have to do anything... I can study and catch up on internet stuff and watch stuff etc." Oh, how young and idealistic we are... Here's what I did: watched half of Jackie Brown, read more than half of Trust me I'm a (Junior) Doctor, watch 1 episode of Man vs Wild, 4 episodes of The Mighty Bouche, an hour each of Blood Diamond and The Hunt for the Red October, spent an hour reading recipes/looking at pictures on tastespotting, tried to understand what's going on in the economy, and did about 30 minutes of study. Yay. My eyes hurt from all that. I also took a bit of a nap and ate a lot. I was pretty hungry when I got there (having fasted the night before and cycled to the place) and then waited for like 2 hours to get a tiny breakfast. Then 4 hours until lunch - I was quite worried that I was being treated like a post-menopausal woman with regards to her dietary needs. But then we started getting a lot more food and I was happy. I was a bit surprised that we were eating hospital food (for that was whom was doing the catering) yet how not necessarily healthy it was. I had 2 big chunks of carrot cake, 1 lemon cake w/ cream, and 1 chocolate banana muffin, plus like 4 things of orange juice over the day. Talk about diabetic risk. As far as the actual drug goes, I didn't feel anything. I had a slight headache but I would much more easily chalk that up to confined space + air conditioning + fluorescent lighting + no exercise. The only weird thing was the crazy dream I had in the morning. In the dream, I was sleeping but semi-conscious and trying to wake myself up, but I literally couldn't do it. I heard nurses talking about me, saying that I was comatose and not knowing what they should do, and I was like in the mostly-asleep phase (in the dream, remember) and tried to tell them that I was okay and I remember literally shaking myself in order to wake myself up in the dream and then eventually woke myself up in real life. So weird. You know when you're on the cusp of sleep and you semi-dream but are still conscious (the so-called hypnagogic state)? That's what my dream felt like. Weird. If that happens next time, I'm chalking it up to the meds.
So that's that. The rest of my week was pretty decent. I started it by flying too close to the sun and subsequently getting burned. Monday I was in the library until midnight and then Tuesday I was in class/hospital/study from 8am-6pm with no real break. As a result, I was pretty ineffective the rest of the week. On Wednesday I went out to a fish and chips place for a friend's dinner. On Thursday a bunch of people met up for an evening/night BBQ at South Bank - the sweet park and artificial beach that sits on top of a river across from downtown. We sat around eating and drinking and then at 11pm went for a swim. It was so beautiful - we were the only ones there, a nice night, looking at the city, playing catch with a frisbee/nerf. I was talked into going out afterwards and so only got home at like 2:30 and then had to wake up at 7 for class. On Friday I got my head shorn in time for summer (which has been put on hiatus for the last couple days for whatever reason) and then went to a fancy annual lecture thing. Each year the school of medicine tries to get someone fancy pants to talk to us about their accomplishments, as well as dole out teaching prizes to best clinical teachers of the past years. This year the guy speaking was Graem Clark - the guy who invented the bionic ear (cochlear implant). His story was actually pretty impressive... he worked hard for about 30some years and as a trained doctor had to pretty much teach himself audiology and engineering and stuff. Also everyone else around him told him that it was impossible to do. And now over 100,000 people have the thing and they can hear. Pretty incredible. Afterwards there was free booze and food but because of my damn trial I could only stuff my face until 9:30 (10) and eschew all (1 glass) of alcohol.
Today the weather is pretty miserable and I feel a bit groggy. I must tutor later and then dumpster dive - who knows what treasures the dumpster will hold?
Jesus, I didn't know that!1
Yawning, I recently learned from an anatomy tutor, is to aid in pumping an extra oomph of blood back in to the center. The action of the yawn is caused by the lateral pterygoid muscle, and this contraction physcially induces force on the veins in the face, which helps pump blood back into the heart. Muscle-induced blood pumping is one of the main mechanisms that veins have of returning blood. The calf muscles are also useful for this, which is why when you do the full yawn/stretch thing, you also plantarflex (tippy-toes) your feet to return blood that's been pooling down there.
Last week was female sexual pathology stuff and we got to learn all about periods. This contained a very ample amount of information that I didn't know. Like how menopause can be like one long 6-month period, or that a lot of women get menorrhagia (increased amount/time of bleeding) and that this can be diagnosed by: longer than 7 days; greater than 80mls/cycle; changing pad less than every 3 hours; needing "double protection" (pad + tampon); loss of clots, etc. How do you know it's 80mls? Apparently some researchers spent time weighing/wringing out pads and tampons. For your own knowledge, 1 tampon is roughly equivalent to 5mls and 1 pad is about 10-15mls.
We also got to learn about the wide-world of contraception. It's amazing how much shit there is, and all for women, to prevent pregnancy. Pills and IUDs made of copper and rings and depot-shots and implanted pieces of rubber (which is definitely the one I'd go for). We also got a definitive answer on that oft-queried problem: is it cool to skip the sugar pills and keep taking the pill in order to "skip" a period? "Hells yah! Just try to have a bleed 4 times a year," is what they recommend. I was doing a bit of my own research into male contraception and found this thing, which seems awesome and I'd be willing to try out. There are other possiblities out there but, unfortunately, nothing that's really marketed well besides condoms and good ol' coitus interruptus.
Medical word of the post:
Pseudocyesis - the false belief that you are pregnant based on physical cues (no period, morning sickness, abdominal mass), despite evidence that you are not.
*I'm supposed to declare it myself
Friday, October 10, 2008
Q: What's long, brown, and sticky?
A: A fucking big stick insect.
I was sitting on my veranda, innocently having lunch, when I heard some rustling in the gutters. I thought it was a bird or possum or something. Then the thing crashed next to my foot and I saw that it was a disgustingly-large stick inset. It started crawling around, pathetically, searching for relief. I ran and grabbed my camera and came back. It was obviously on its last disgustingly-long legs, after, I assume, being pecked at by a bird or something. I'd say it was about 12-13 inches long, with long legs and butterfly wings. It crawled around the veranda for a bit and then clung to the side thing. After a while, it fell to its death - tired and shattered. Incidentally, its blood was green - who knew?
I was sitting on my veranda, innocently having lunch, when I heard some rustling in the gutters. I thought it was a bird or possum or something. Then the thing crashed next to my foot and I saw that it was a disgustingly-large stick inset. It started crawling around, pathetically, searching for relief. I ran and grabbed my camera and came back. It was obviously on its last disgustingly-long legs, after, I assume, being pecked at by a bird or something. I'd say it was about 12-13 inches long, with long legs and butterfly wings. It crawled around the veranda for a bit and then clung to the side thing. After a while, it fell to its death - tired and shattered. Incidentally, its blood was green - who knew?
Saturday, October 4, 2008
it's like 12 twice
Well a lot has happened since we last had the pleasure. How are you? Oh really? Jeez, yeah.
So the day after my previous post was my birth'd day. The whole festivations started out by going out on the eve for dinner at a Korean restaurant that I liked. The weather was really eerie... it seemed like it was going to storm and weird smells and colours. On my bike ride into the city, the only other life form I saw (it was a Sunday) was a possum, a heron standing in the middle of the path, and a woman jogging in white sneakers, a nice black skirt, and a lace black bra. Fun. After dinner we went to a Belgian beer garden thing and got some fancy beer that tasted like cherry. A lot.
On Monday morning a friend dropped off cupcakes spelling out a birthday wish, which was quite cute.
School was pretty good in that vain as well. Normally I don't really care about my birthday... this time was not much different but it was still pretty cool since I actually have a decent group here and so reaped rewards. Speaking of rewards, here's what I got:
2 sets of cupcakes, 1 cake in the shape of a baby seal (long story-> short = there's an ongoing "joke" that I get off on baby seal porn), 3 bottles of wine, wood chopping board, and then an awesome package from a bunch of people of a silicon rolling pin, gift certificate to Kathmandu, and 5 movie passes to a decent cinema. Cleaned up quite well, I must admit. Let's see, what else. Oh yeah, dinners. Monday night I had a nice dinner at a friends place, Thursday had a friend over for dinner, and then the following Monday I went to another mate's place where they cooked up a sweet feast. All this culminated... or at least fruitioned... at a BBQ/picnic thing at the everglorious New Farm Park. It was a beautiful day... blue skies, lots of sun, lots of people, sitting by the river. Everyone brought so much food and I made a kickass salad + lentil burgers + roastded chickpeas. It was one of the lovelier days I've had, I must say.
So what else has happened... on Wednesday a couple of us in our clinical-coaching group when to a psychiatric hospital to get a bit of experience in taking a mental health interview. 4 of us plus a psychiatrist took turns and time interviewing 2 patients, one with schizophrenia and one with severe depression. It was very interesting and really sad. I think that, like with a lot of kinds of medicine, you must build a callus to protect yourself in order to not get too despondent with sick people. I think these ones being physically well but with these debilitating mental problems is even sadder. The schizophrenic guy didn't even know why he was in hospital; he gets brought in by the cops every couple months for doing something weird. He was valedictorian of his highschool up until 11th grade and then the condition just snapped and that is that. The woman with depression has had a number of failed suicide attempts, is ostracised from her whole family, and was sexually abused as a child. I think maybe dealing with kidneys would be easier...
Last night a friend came over for dinner and then we walked into the city to put to use my movie passes. We saw Waltz with Dashir, a nice and stylistically-cool movie about the Israeli-Lebanese conflict. However it was the wrong movie to come drunk to and drink a bottle of wine in.
Jesus, I didn't know that!1
We recently have been learning a bit about the commercialization of medicine. This is not really much of an issue in the US because, like most things there, commercializing is fair game. Here there are some pretty stringent rules as to how to advertise for a medical business (drugs are not even mentioned since it's illegal to advertise prescription medicine); stuff like making outlandish claims or guarantees, offering pro-bono things or inducements are all bad... just like claiming expertise in something you're not or bashing other doctors. We had a speaker from an organisation that deals with advertising and communication and he discussed a suit against the company that sold those ab-electric-belt-stimulator-things as a weight loss device. Apparently, according to witness testimony, those belts, in 10 minutes, burn as many calories as walking 1km/hr for 1 second. Lolicans. Anyway it's been interesting to think about, though apparently not to write about...
In addition to commercialisation of medicine, last week we were studying sexual dysfunction and that kind of fun stuff (the context was clinics advertising guaranteed erections etc). One funny example about lame companies and sexual dysfunction was the fruition of a relatively new diagnosis hypoactive desire disorder. Something like 20-30% of women (and 10% of men) suffer from a reduced sexual desire (reduced compared to what? I dunno). And so a company developed a testosterone patch that may increase libido but in order to make it approachable/necessary/desired/acceptable first had to medicalise this condition. So they released data compiled in cohoots with doctors and released information etc and essentially invented a market for their drug. Bastardos.
Speaking of sexual dysfunction, it was interesting to read about all the ways to treat erectile dysfunction. 1st line treatment is viagra and similar drugs, as most people know, and then it goes downhill from there. The next treatment is called alprostadil and it needs to be given locally in order to function which means either a "urethral suppository" or an injection straight into it. For some reason people don't like those that much... What's funny/scary about it is that if you aren't careful with dosing (your first injection has to be done at the doctor's) then you can develop priaprism: an erection that just won't subside. If it's around for several hours, then the first thing doctors try to do is give a decent amount of pseudoephedrine (the ingredient in Sudafed that's closely monitored and used to make meth) and wait around. If that doesn't work, then you get to physically drain it. Yay!
Medical word of the post:
tumescence - a protruding or swelling; specifically used to describe the penis in the pre-fully-erect phase.
So the day after my previous post was my birth'd day. The whole festivations started out by going out on the eve for dinner at a Korean restaurant that I liked. The weather was really eerie... it seemed like it was going to storm and weird smells and colours. On my bike ride into the city, the only other life form I saw (it was a Sunday) was a possum, a heron standing in the middle of the path, and a woman jogging in white sneakers, a nice black skirt, and a lace black bra. Fun. After dinner we went to a Belgian beer garden thing and got some fancy beer that tasted like cherry. A lot.
On Monday morning a friend dropped off cupcakes spelling out a birthday wish, which was quite cute.
School was pretty good in that vain as well. Normally I don't really care about my birthday... this time was not much different but it was still pretty cool since I actually have a decent group here and so reaped rewards. Speaking of rewards, here's what I got:2 sets of cupcakes, 1 cake in the shape of a baby seal (long story-> short = there's an ongoing "joke" that I get off on baby seal porn), 3 bottles of wine, wood chopping board, and then an awesome package from a bunch of people of a silicon rolling pin, gift certificate to Kathmandu, and 5 movie passes to a decent cinema. Cleaned up quite well, I must admit. Let's see, what else. Oh yeah, dinners. Monday night I had a nice dinner at a friends place, Thursday had a friend over for dinner, and then the following Monday I went to another mate's place where they cooked up a sweet feast. All this culminated... or at least fruitioned... at a BBQ/picnic thing at the everglorious New Farm Park. It was a beautiful day... blue skies, lots of sun, lots of people, sitting by the river. Everyone brought so much food and I made a kickass salad + lentil burgers + roastded chickpeas. It was one of the lovelier days I've had, I must say.
So what else has happened... on Wednesday a couple of us in our clinical-coaching group when to a psychiatric hospital to get a bit of experience in taking a mental health interview. 4 of us plus a psychiatrist took turns and time interviewing 2 patients, one with schizophrenia and one with severe depression. It was very interesting and really sad. I think that, like with a lot of kinds of medicine, you must build a callus to protect yourself in order to not get too despondent with sick people. I think these ones being physically well but with these debilitating mental problems is even sadder. The schizophrenic guy didn't even know why he was in hospital; he gets brought in by the cops every couple months for doing something weird. He was valedictorian of his highschool up until 11th grade and then the condition just snapped and that is that. The woman with depression has had a number of failed suicide attempts, is ostracised from her whole family, and was sexually abused as a child. I think maybe dealing with kidneys would be easier...Last night a friend came over for dinner and then we walked into the city to put to use my movie passes. We saw Waltz with Dashir, a nice and stylistically-cool movie about the Israeli-Lebanese conflict. However it was the wrong movie to come drunk to and drink a bottle of wine in.
Jesus, I didn't know that!1
We recently have been learning a bit about the commercialization of medicine. This is not really much of an issue in the US because, like most things there, commercializing is fair game. Here there are some pretty stringent rules as to how to advertise for a medical business (drugs are not even mentioned since it's illegal to advertise prescription medicine); stuff like making outlandish claims or guarantees, offering pro-bono things or inducements are all bad... just like claiming expertise in something you're not or bashing other doctors. We had a speaker from an organisation that deals with advertising and communication and he discussed a suit against the company that sold those ab-electric-belt-stimulator-things as a weight loss device. Apparently, according to witness testimony, those belts, in 10 minutes, burn as many calories as walking 1km/hr for 1 second. Lolicans. Anyway it's been interesting to think about, though apparently not to write about...
In addition to commercialisation of medicine, last week we were studying sexual dysfunction and that kind of fun stuff (the context was clinics advertising guaranteed erections etc). One funny example about lame companies and sexual dysfunction was the fruition of a relatively new diagnosis hypoactive desire disorder. Something like 20-30% of women (and 10% of men) suffer from a reduced sexual desire (reduced compared to what? I dunno). And so a company developed a testosterone patch that may increase libido but in order to make it approachable/necessary/desired/acceptable first had to medicalise this condition. So they released data compiled in cohoots with doctors and released information etc and essentially invented a market for their drug. Bastardos.
Speaking of sexual dysfunction, it was interesting to read about all the ways to treat erectile dysfunction. 1st line treatment is viagra and similar drugs, as most people know, and then it goes downhill from there. The next treatment is called alprostadil and it needs to be given locally in order to function which means either a "urethral suppository" or an injection straight into it. For some reason people don't like those that much... What's funny/scary about it is that if you aren't careful with dosing (your first injection has to be done at the doctor's) then you can develop priaprism: an erection that just won't subside. If it's around for several hours, then the first thing doctors try to do is give a decent amount of pseudoephedrine (the ingredient in Sudafed that's closely monitored and used to make meth) and wait around. If that doesn't work, then you get to physically drain it. Yay!
Medical word of the post:tumescence - a protruding or swelling; specifically used to describe the penis in the pre-fully-erect phase.
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