How to Breathe

Nope, not a sappy love song** written by Taylor Swift or the like, but actually how we breathe! We learned this in class and I felt it was blog worthy:

The brain has parts. One of the parts is called the medulla. To keep things simple, part of the medulla  makes us breathe by ramping up a signal and then makes us exhale by stopping the signal for 3 seconds. Repeat forever until death. Cool. But cooler than that, the medulla has a lot of inputs to tell it to change the way we breathe. Here is an example:

In our nasal mucosa, or as I like to call it, nosehole, we have nerve endings that sometimes get irritated. These nerve endings are sensitive to different gases, smoke, perfumes, and even cold air. When they get irritated, they produce chemicals and send info back up to the medulla. The medulla then tells the lungs to take a deep breath, hold it, and then VIOLENTLY EXPEL all of the pressurized gas, and hopefully the irritants along with it. ACHEW! That's right, that's why we sneeze.

Ok maybe I'm the only one who thinks sneezing is cool, but I had a cold last week and sneezing was pretty relevant. On a public health side - sneezing is gross, and it may expel irritants but it's spreading those irritants along with viral particles (including the common cold) around so other people can catch them. Not cute. So make sure to catch those sneezes in your cubital fossa - or as I like to call it, elbow pit!

**On another note, and to sound like another sappy love song, I held a heart in my hand today. Learning the heart has been fun, but physiology of the heart and lungs reminds me a lot of physics - not my strongest subject. 

But Thursday I finally get to break out my brand new stethoscope and listen to some heart sounds / learn how to take a blood pressure. Woot!

Doctors That Suck and Perfect Patient Populations

My classmates and I recently had a discussion about how all doctors suck. Then we decided to make a pact that we wouldn't suck when we were doctors, but I had a terrifying realization.

Kind of like with anything else (teachers, celebrities), some people like some doctors, and some people don't like those same doctors. So some (potentially many) of my patients just won't like me.

I never liked being disliked. I guess nobody does, but I mean I reallllly don't like being disliked. I try to be nice and sweet and charming so that people like me, and honestly because there is enough mean, nasty, bad, evil, greedy, and cruel going around in the world that I don't really want to contribute to that pot of words / feelings. But I also like to be honest, and sometimes that can be mistaken for mean / insensitive.

But anyways - how can we, as hopeful future doctors, appease the masses of patients that we see? Obviously we will just have to do our best.

Dr. Altman, one of the primary care docs we see a lot (he also specializes in nutrition, and gave us a lecture that resulted in over half of our class buying natural peanut butter, Kashi Go Lean, and Omega-3 eggs) said that eventually the patients that like you will become your patient population. The people that like you might tell their friends how great of a doctor you are, and their friends will most likely also like you, and the cycle will continue. Conversely, people who don't like you will definitely tell their friends (and even lawyers), and you won't see anyone they know (except maybe their lawyers). Eventually, you will see lots of people that work with your personality.

I will have to wait and see if this is true, and all I can do now is hope that Dr. Altman is right. I have a lot of training left before I actually see patients on my own, and I am sure I will acquire tools that will help me work with different types of patients so that I don't have too many that don't like me. Until then, I guess I need to just do my best, and hope that when I am an actual working doctor, I find my perfect patient population sooner rather than later!

Bad Bloggers Take Big Breaks

And Medical School students get two weeks off for Christmas / New Year's.

But I'm back. With the following random thoughts:

I am so thankful to the man who donated his body to science to allow me to learn. My dissection-mate showed me that he has a depression where his wedding band was and it really broke my heart because he is somewhat young and unlike previous cadavers, looks stunningly alive and healthy. So this post is dedicated to him. And his brachial plexus that I spent 2 hours dissecting and figuring out today (see later thoughts).

Medical school is ludicrously hard. I know that people think that medical school is hard, but I am going to admit, confirm, and even insist that it is true. I don't know how much learning a brain can handle in one day, but medical school pushes my upper limits of daily brain capacity, which causes me to do things like forget birthdays and lose my keys. Just a thought.

Other things are also ludicrously hard. I am in an accounting class and boy did I have trouble doing my assignment. And there are so many things I just don't understand / know. Like all of geography. And most of history. So props to the people in other fields who don't get recognized for how hard their subjects are too.

I am going skiing this weekend with a lot of other medical students. We just studied the legs, and most of the fractures we learned about are most commonly caused by snow/ice activities. I even broke my humerus (upper arm bone) by falling while ice skating. I am a little nervous, and predict at least 1 bone from 1 classmate breaking this weekend. I hope it's not me and my bone.

This is a brachial plexus. It's what allows your entire upper extremity (doc term for arm) to move and sense. Take a look:

 

If you can't see the labels, thank me later. It's like a bunch of merging and splitting highways that all lead to the same five roads. Very confusing. But kind of cool. We dissected it out of the arm today, and it took a long time to find everything.  

I really should get back to reviewing, so that's all for this week!