Tuesday, March 29, 2011

In Color

I'm starting to understand why graphic pictures on cigarette packs are so effective.

We are studying pathology, which is the human body gone wrong.  The photos--taken from autopsies--are gross, meaning their structures can be seen with the naked eye.  Cirrhotic livers are littered with bumps and scars, the heart dies and leaves a band of black tissue behind, the lungs are stretched so far that they can't pull in the air they need.

There is something very different and disturbing about seeing things that you can actually "see"--as compared to the symbols and cartoons that we use to represent molecules and pathways on a micro level.  Even when we observe microscopic slides of real damaged tissue, it is easy to underestimate how dysfunctional things are.  We see waves of immune cells, distended vessels, air spaces filled with dark masses (bacteria).  Yet these light and dark splotches, lines, and dots are still too abstract to scream "disease" to the novice eye.  Looking at a slide of a healed pulmonary embolism (blood clot in the lung), one of my classmates asked how we could be so sure it had even been there.  It looked like a bump, an outpouching of the vessel it blocked--a slightly different shade of pink, with a few wavy layers of scarring.  We squint and analyze, trying to distinguish it from "normal."

The instructor then showed a gross photo of a similar "bump" at autopsy.  It was big.  It was brown.  It looked rotten.  It was impossible to miss.

Color is important.  Microscopes show our bodies in hues of pink and blue from staining; textbooks are overzealous for learning's sake and use the colors of rainbow to differentiate.  However, real color is difficult to forget.  A gangrenous foot turned black.  A yellow scar on the heart, refusing to pump blood.  A vessel spilling bright red blood into a cavity reserved for fluid or air.  The sickness is sickening--to any eye.

Wednesday, March 9, 2011

"Med School Just Got Real"

There's nothing like a massive physiology exam that sucks all the words and thoughts out of you. They're somewhere inside my brain, but the nuances of respiratory/cardiology/renal/GI/endocrinology keep rising to the top. That, and the desire to nap for the umpteenth time today.
I believe this is the first course that has broken the barrier between student and student-doctor. It's not biochemistry, or anatomy, or epidemiology, or health policy--it's medicine. The nuts and bolts of how our bodies function. The exquisite mechanisms our organs and cells use just to stay normal. Integration. Complexity. Regulation. Secretion, absorption, growth, flow. Feats of chemistry, physics, engineering (premed requirements make a cameo!). How we can meddle with it all when something goes awry.
It's fascinating how far research has come in explaining how everything works--and still, how much is conjecture, yet to be elucidated via a precise pathway or even concept. It is humbling to learn about the big picture... but frustrating to study the pixels.
We've covered a textbook's worth of physiology content in just over a month. Some sticks, some bounces away. Thank goodness they tell us we'll re-learn this in future classes, and on the wards as well. My brain's RAM is nearly maxed right now.  The last few days have been mundane--hanging on by a thread to pass that next exam. I suspect I'm not alone, but others seem to be hiding it well.
As one of my classmates said, "Med school just got real."