Saturday, February 28, 2009

the inevitable

The day before my first ER shadowing experience as a part of EMIG (Emergency Medicine Interest Group) I went to ask my friend Meena, who had already had a couple experiences, what it was like. She honestly looked a little rattled. It had been the first time anybody in the EMIG had been asked to perform chest compressions, and the patient had passed away.


My visit that night was relatively uneventful. But my second visit, not so much so.

It started out quite calmly - the usual patient history, chief comlaint, labs, discussion with a million people on what it could be or how to treat it, staring at radiology images and frantically speaking with radiologists about masses and unexpected perfusions. We even had a young patient who was horrified by the prospect of her first visit to the ER so much so that she had severe tachycardia (elevated heart rate). I was also sent into a patients room all alone to determine a diagnosis all by myself, and I was jaundice. *hah* Not easy to miss. But my resident was proud of me. :) Not long after, the docs, residents, and I sat joking about an exam the residents had earlier that day.

My resident was supposed to switch shifts. I "handed myself over" to the next resident who would guide me with infallible efficiency throughout my last case of the night. A patient was wheeled in with chest pain (I can't share more details). I just stood in a corner watching information transferring from the EMT's to the attending physician. He was alert, and able to speak, except I noticed his head was very VERY pale. All of a sudden he lost consciousness. That did it for me.

I still remember saying to myself "OH my god! He's going to die! I'm not ready for this! Oh my god what if he dies right in front of me?! I've never seen ANYONE die before! He's dying!" I also still remember my body saying to itself "You need to leave this room, and go outside and sit down. You're light headed and the last thing the emergency team needs is a fainted first year medical student beside a dying patient. Hold onto the bench! Hold on to the bench! And don't lock your knees!"

Within the 5 minutes of flurry to regain balance, the patient had been stabilized, and surprisingly so did my mind..... for about ten minutes, after which CPR was begun. And I was called to do it. And I did. At 120 I got dizzy. He was a big man, and I was a little girl, watching the ECG reading blip up and down with each pump of his chest. There was nothing apart from that. Within 30 minutes of when his chest pain began, he had passed away.

I cried. I cried because I didn't feel anything. If anything, I felt inhuman. Was it the lack of personal contact? That it happened so fast? I will never know.

I said a little prayer as I left the room.

Sunday, February 22, 2009



This is probably going to be popular ALL OVER! But there are better songs! OH THE BETTER SONGS!!! :D

The People Tree:

From the drop of blood, to bones and body parts
To vital organs, forming your brain and tiny heart
You'll feed to escape the birth until puberty finally starts
Adolescence, so don't, then your elderly body rocks
It was divine decree that begun the plan
But this disease be decreed by the sons of man
Don't try to leave with the guns in hand
Understand: God's the one in command

Did we climb out of the sea?
Where did we come from, you and me?
Two legs to walk, and as you see
I'm not a man I want to be
People growing, my backyard (I'm growing in my backyard)
In my garden, in my heart (I'm in your garden, I'm in your heart)
Pink and purple, red and blue (See all the colors?)
On this sunny afternoon (It's a sunny afternoon)

Back before time was time and space was space
The ever-present eye divine so laced with grace
Decided it was time to try to chase, to chase
But what it would design, now life is taking place
Within itself, divided; now it takes some space
And it can't be found alive, the mind creates the state
Of ego, now what's mine is mine
OK, now hate will reign until the blind have eyes and lay awake in wait

How are the seeds in the ground?
How is my garden growing now?
A tender kiss, a little smile
The way a mother holds its child
Tasty little human beings (Tasty little human beings)
I grow them on the people tree (I grow them on the people tree)
I will eat them one by one (Eat them one by one)
If there's enough for everyone (Like you and you)

Born in the ever-flowing life beyond the dirt
Tell me what the purpose is for creating the earth
(Maybe we created the planet as man's habitat
Be fruitful and multiply across the planet's back)
[Well, why does hate exist?
The war and AIDS and shit?
If we're to be fruitful, why can't poor people pay they rent?]
('Cause love and hate, both sides are conjoined
Physical forms have to deal with both sides of the coin)
[Why do we die?] (So you can live!)
[Why do we strive?] (So you can win!
But why did you defy every truthful word I recommend?)
My question back, why do you recommend an ode temptationing
(So I can test your patience and tolerance in the face of sin)
But why attest when you hold all the answers to the state we in?
(For you to bear witness of imperfections of mortal men)
[So it's a lesson?] (And a blessing
Journey back to where you been
'Cause before the treatment flurry seeds must first be planted in)

People growing, my backyard (I'm growing in my backyard)
In my garden, in my heart (I'm in your garden, I'm in your heart)
If you like my garden, you might like me (Look at all the colors!)
Underneath the people tree

Wednesday, February 18, 2009

the egg (sorry, no chicken)

I showed this image to my roommate, and this is what he had to say about it:

"It's like a hostage situation at a bank!" ~Mikey

Damn, that egg's effed.

Apart from that, school is kicking my butt. We have 6 exams in the next two weeks. *flail*

It's coo' tho. Whatev.

Apart from, I sort of sat in at a seminar during one of my studying "breaks." *oops* It was a lecture on miRNA's by a professor from Stanford Medical School (Dr. Chen). I was fascinated by what he presented about how miRNA's are pretty much more important than a lot of other factors such as gene expression in regulating protein expression. I dunno how much you understand about all of this, but essentially miRNA's are capable of blocking the translation of proteins with the help of a RISC complex, pretty much RIGHT AS a protein could potentially be synthesized. It seems to me, and to Dr. Chen, and other prominent scientists *haha* that if gene expression of a protein is constant resulting in a constant/stable level of mRNA production, inhibition of translation by miRNA's has much greater potential of controlling the final protein output than anything else. In fact, increased miRNA levels have been shown to significantly block important phosphatases involved in the control of T cell receptor signaling in response to an antigen. Thereby, blockage of protein phosphorylation in the signaling cascade leads to gene expression for T cell proliferation and such an extent that numerous tumors have been shown to be induced in the presence of increased miRNA levels! *holy effs!* There was a lot more to be said about miRNA's, much of what I'm too lazy to decipher from the 5 pages of notes I took. But here's an animation I found that might be helpful to visualize what miRNA's do.

Anywho, I think I'm going to make attending such random seminar's "my thing." It utterly ROCKED my world! :D

QOD: "Just as we passed that other lamp I was going to tell you a further thing, Jack, but now I am parenthetically continuing with a new thought and by the time we reach the next I'll return to the original subject, agreed?" I certainly agreed - Kerouac, On the Road