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Archive → July, 2008

A Week Too Late ……

[sarcasm] Sorry I was a little late to the party…. My slow kuwaiti doctor brain takes a week to absorb things, and my “chicken scratchings” were very hard to read …. it took me a while to type this up …. [/sarcasm]

I’ve always loved how mass media makes everybody feel informed, knowledgeable and smart. People think they are Mechanical Engineers because they’ve watched 3 or 4 episodes of top gear and think they are historians because they’ve watched the history channel for a week straight.

They also tend to think of themselves as afecianos* , critics and official card carrying members of the “I can give you free medical advice that is better than any dumb doctors” club or the “those damn doctors don’t know what they are doing; I’ve seen scrubs and E.R. There should be somebody more senior (preferably male, with grey hair and a white coat) watching over you flunkies” club  especially if any members of their family happen to be doctors. This is usually where things start to get a little wonky to say the least …. 

A recent article in the British Medical Journal has taken up the task of dispelling rumors, myths and plain old lies spread by people who think that they have any right to criticize and to a lesser extent practice in a profession without having spent more than a couple of hours in a given hospital (those hours usually spent chastising a nurse who they confuse with their house maid)

The article goes through things like why everyone says that we should drink 8 glasses of water when most researchers suggest that our bodies water requirements are highly variable and very dynamic and may vary between 2-4 liters per day and are usually split between food (such as rice, jam and even jello) and ANY other liquid including that frappacino you have 4 times a day. 

Another good one how your hair will grow back coarser, thicker and darker once shaved (I myself fell victim to this one a number of years ago and sported “the peach fuzz” for a whole summer straight to no avail).

They also tackle the notion that we only use 10% of our brains; there was no evidence in any medical textbook, zeitschrift or journal over the past hundred years that clearly states that we only use ten percent of our brains. Infact current neuronal imaging techniques suggest that we have very little (if any) of our brain that we wouldn’t miss. (We can however technically SURVIVE with 10 percent of our brains as decerebrate animals = brain dead)

The article does not touch on the difficulties faced by healthcare professionals when such a person comes storming in and screaming like a banshee while you are trying to resuscitate their loved one(s) at 4 in the morning. I’ve been in situations where people have demanded that I use adrenaline, intubate and begin CPR on a fully conscious patient who is awake with a couple of bruises (if I had followed their orders the patient would have been killed by the adrenaline).

Another example I’ve read lately is a recent rant which seems to imply that an ankle fracture is more important than a head contusion and multiple rib fractures which contradicts most of current traumatology theory  including those mentioned in ATLS (Advanced Trauma Life Support) guidelines. (Besides it doesn’t take a rocket scientist to figure out that a brain injury and ribs that have ripped through your lung will kill you faster than than an ankle fracture.) If that person would have read up on the topic he would have found out that ankle fractures can be left untreated for upto 6 weeks in order to wait for the swelling to go down with very little effect on mobility or recovery post-op.

Don’t get me wrong; I’m all for criticizing things ( it’s the only way things will ever get better in this country), I just think you should know about the topic you’re ranting about and not pass judgement on a place you’ve never worked in or a field you’ve obviously never read up on. A person who had read up on trauma management may have suggested a statistical analysis reviewing all cases managed and the effect of early vs late intervention in fractures on patient mobility and quality of life. This study has been done over and over and over again with results which suggest that there is very little difference (apart from hospital stay time) in delayed and early management and most agree other injuries may be more urgent especially ones in the thorax or head ……

But to each his own I suppose. I’ve often fancied my self an architect, interior designer and expert in tae kwon do* as well as a banker because I live in a house, have a distant relative who is an interior designer, have cousin who has a black belt in something or other and a banker in the family ……

Take home message … more webMD, less E.R. and Scrubs ….. 

*Couldn’t find the correct spelling for it

 

We’re getting spunk powered and micro-chips and I still can’t drive a flying car ….

With oil prices climbing higher and higher and the research into “alternative energy” grinding to a near halt, researchers have had no choice but to look to one of the most freely abundant commodities on the planet ….. sperm….

You see sperm have a rather unique trait; they can control their range and direction of movement of their tails and can convert sugar (or more correctly ATP) and use it in this process (i.e. they can feed themselves by them selves without the need for a blood supply similar to the way a leech can). This is achieved by a set of ten enzymes (think of them a molecular blenders) which break up atp (essentially the US dollar of the body, it is the most basic unifying currency in the body and is used for energy exchange) and produces movement in the tail. (The process is called gylcolysis; literally meaning to break-up sugar)

With this in mind scientists at Cornell University school of Vetrinary science have managed to get 3 of them to work on a microchip and are hoping to get all ten up and running. Provided that all things go well we could see nano-robots swimming all over our bodies powered by our own nutrients. These robots could be used to take samples from different areas, diagnose latent diseases and even cure conditions such as hypothyroidism and diabetes (the pseudo-robo-sperm swim around checking your blood sugar level, if it gets too high then they excrete insulin through mini pumps; I’m assuming there’ll also be a way to replenish the supply of insulin).

Another application is in industry, these enzymes could be the start of many micro chip driven, carb hungry appliances that should (in theory) mean that we use fossil fuels less and less. (imagine feeding your ipod … classic) as most electricity comes from kinetic energy anyway (over simplified I know).

The responsible, headed by Alex Travis have already patented the idea and are obviously looking for any company willing to invest. (Somebody is prolly going to make a killing over the next couple of years …. )

Oh and props to Delicately Realistic ! Couldn’t have done a better job myself … (high fives) (an Obama bump it is; still a fan of high fives though ….)


 

 

Remembering the Man who Put Tights in Our Hearts and Leggings in Our Bellies.

The original post has been polished a little. For more interesting and relevant reading please refer to the wikipedia article on which this is based …… 

This week saw the death and mourning of Dr. Micheal DeBakey (1908-2008) a man who was a pioneer, philanthropist and true healer; stuck in a profession filled with money minded, hypocritical, over-achievers who spend their whole lives looking for the day they can open their private practice or will be asked to become partner in one.

You see when Dr. DeBakey (or as his Lebanese parents knew him, Michel Dabagh (name changes were probably all the rage back then) began his career back in 1932 there were 2 areas you definitely didn’t operate in, the heart (because you needed it to keep moving) and the aorta (because the patient would bleed to death in seconds, it’s kind of like a mono-rail for all the blood in the body). By the time he died (last week) he had invented the heart lung machine and the Dacron Graft (also used for tights, leggings and speedos; a devils tool indeed) and thus devised the following procedures (he also managed to modify others):

  • Open heart surgery: Technically do-able but never really took off until his machine was made, it was first used in a stab wound injury, the patient managed to survive*
  • Coronary Artery Bypass (CABG, Cabbage): This is when you use a vein to bypass a blockage in the arteries that feed the heart. I think he did about 70,000 of them, our boys couldn’t do 7,000 hemmoroidectomies in a life time.*
  • The carotid endarterectomy (with synthetic dacron patch): DeBakey devised a procedure that would remove all the clots from the main vessels which supply the brain; thus preventing strokes.He would make a whole in the vessel, and use the surgical equivalent of an plunger (well not really, but very similar to one) to scrape the inside of the artery and use the Dacron to patch it up. (Something tells me he may have been a plumber in a previous life)*
  • Dacron aortic aneurysm repair: Debakey would repair burst aortas by essentially patching them with stockings. The idea was pure genius and not only allowed doctors to operate on the aorta but also to fix things should other (dumber) doctors manage to cut a hole in one. To this day 1 in every 10 people die after undergoing the procedure ….. this wasn’t one of his better achievements…..

He also invent the Mobile Army Surgical Hospital or M.A.S.H. which prevented a couple of deaths during the Korean war and more importantly inspired one of the coolest T.V. shows ever! (You’ve got to love the idea of working in shitty hospital with shitty patients in the middle of a shitty place and having to drink yourself to kill the boredom….. that was the premise of the show and sounds eerily familiar ….)

DeBakey is even famous for proving that cigarettes are bad for you, he spent a whole year in 1939 trying to prove it but never could …. it was later proved by someone far more presistant a couple of years later.

It’s hard not to admire someone who has done so much and is such and inspiration, he continued to practice medicine until the day he died and I’m sure he wouldn’t have had it any other way…..

Despite all of his work the only thing that got named after him was the DeBakey forceps and some pre-med highschool for nerds, geeks and dumb parents with too much money.

I just can’t see why people should do their best and sacrifice if all you can hope for is having a your name used on a pair of tweezers and by some school as a cheap way to hoard money with the educational equivalent of the George Forman grill ….. 

* His work eventually became divided into 2 different disciplines, heart surgery (valves, arteries, viens of the heart) and vascular surgery (fixing all the rest)

 

Drunk on Life…… [longest post on the planet]

I love it when people set their sites on the unreachable and unfathomable; and that’s exactly what Dr. Aubrey de Gray a gentleman scientist (an old, debunked term for self-funded scientist) is doing. An engineer by trade, de Gray has spent the last 6 or so years of his life trying to make us immortal and has published a rather impressive set of articles/books on the various solutions he proposes.

He has also established the Methuslah Foundation which has raised a 3 million dollar prize for anybody who can extend the life of mice. De Gray, an engineer by trade has based his theories on a very simple notion, if you can control cellular DNA and RNA (think of it as the bodies HTML and Javascript) and keep them mutation free then you can live forever* (or until you get a blood clot somewhere).

I’ve also always had a rather myopic (= immature) view of life, life seems to be nothing more than a journey in which you get faced with problem after problem and challenge after challenge until one of them kills you or or an organ gives out from the wear and tear of it all.

Your life expectancy (how long you’ll live) is largely dictated by a combination of how much you are willing to put up with, dumb luck and whether you get admitted to a kuwaiti hospital or not (don’t get me wrong a healthy diet, not smoking, drinking in moderation etc does help; it just doesn’t help alot unless the thing you are doing or not does reduces cellular wear and tear)

You see a toddler starts life in a pretty healthy state but s/he has to put up with parents who fill her/his stomach with stale, bacteria laden milk making her/him feel queasy; they then shake him until he throws up and chokes on his own vomit.

Provided you survive the first 4 years of your life and numerous episodes of choking and near drowning on said milk you are then faced with another (more daunting) set of problems ….. walking across a jungle of crap that you’ve never seen before and is usually twice your size and will end up scaring you into falling and sustaining a number of stitches, juvinile fractures and burns.

If you do reach your preteen years unscathed, you’d then have to face a myriad of psychological attacks including bullying, scolding and generally fucking up.

Your teens will then be met with a whole load of teenage angst and a somewhat awkward montage of aching moments involving the opposite sex (or in some cases same sex). Provided you live into your late teens and twenties you should have already went through and probably survived a whole load of expermentation with various drugs and of course alcohol and sex (unless you are in this country in which case you’d spend your teens and twenties trying to kill your self and others with your car but not to worry you’ll still be a virgin, be sober and pure).

You’ll then begin to “build your life” namely:

  • Marry someone you think you may or may not love but seems okay and may make a good mother/father.
  • Have kids which you’ll never have enough time to bring up thanks to your and your other halfs’ job and social engagements.
  • Get into mounds and mounds of debt trying to sustain a quality of life you cannot afford with an ever rising inflation rate.

This “life building” exercise lasts about thirty years, the stress and frustration brought on by a lack of emotional development within the family unit and the debt is what eventually kills you.

Despite all of this turmoil, destruction and bedlam life seems to have a pretty good fanbase and as a result immortality is largely seen as one of those unreachable goals that scientists should aim for. Should you have any questions regarding Dr. de Grays rather interesting body of work feel free to ask him yourself …..

 

* I know I’ve over simplified things; I’m not a biochemist or gerontologist by trade and therefor lack the ability to appreciate the more minute aspects of his thesis.

 This post is far too long and I wouldn’t be offended if none of you read through the whole thing.

Medical Terms, as interpreted by Jessica Simpson

 

Looking back on Jessica Simpsons pictures circa 1999 one can’t help but notice how “polished” she looks lately and although the benefits of tuna* (or “cheackeyn oaf thie seay” as she calls it) have been well documented none of them include bigger lips or firmer breasts over the course of 2 news cycles. Which leads me to believe that she may be spending a fair share of her time at the doctors office and as with any “intelligent” (I use the term loosely here) person she has probably developed and understanding for various medical terms used in day to day practice. What follows is pseudo-account of her interpretation of these terms.

 

ARTERY: Study of the Fine arts

BENIGN: What you do after be eight…

BARIUM: What you do when CPR and that whole shocking thing fails.

CESAREAN SECTION: The Roman district in any given city.

COLIC: A sheep doug (had to get the accent right)

COMA: A punctuation mark.

CONGENITAL: Friendly

DILATE: To live for a hell of a long time (the opposite of die early)

FESTER: Quicker

G.I. SERIES: The U.S. Army Baseball Series.

GRIPPE: Suitcase

HANGNAIL: A coat hook.

MEDICAL STAFF: A doctors cane (It’s true! Just watch house!)

MINOR OPERATION: Digging a coal mine

MORBID: A higher offer during an auction

NITRATE: As opposed to day rate.

NODE: Was aware of; the opposite of did not know.

ORGANIC: A church musician.

OUTPATIENT: A person who has fainted

POST-OPERATIVE: A letter carrier

PROTEIN: A person who helps out the teens in his community

SECRETION: A person who hides things.

SEROLOGY: The study of the English Knighthood

TABLET: A small table.

TUMOR: An extra pair of a given object.

URINE: As opposed to you’re out.

VARICOSE VEINS: Veins which as very close together.

This whole article is a mash up of various others and is heavily based on a combination of forwards and forums posts I’ve read on the net. It’s also purely fictional and a very poor effort on my part it must be said.

*If you don’t get it then you should really watch newly weds series 1.