Today’s subject: pharmacology of diarrhea. Our lecturer, who has been quite funny in the past, could barely keep a straight face. It was, for lack of a better word, hysterical. Look, no matter how far we go in medicine, poop will still be funny. I may have to be a GI doc.

A few choice excerpts:
“For lack of a better word, it’s a… uh… large pressure head… causing explosive diarrhea.”
“My favorite laxatives, of course, are the bulk-forming agents.”
“…the disadvantage of saline laxatives is that they often produce explosive, watery bowel movements.”
“Emollients have a tendancy to leak past the anal sphincter and soil clothing.”
“Let’s just go with ‘excessive flow’. ”
“Dammit, next year I’m giving this lecture to a more junior faculty member.”

It’s my favorite holiday! Happy Thanksgiving everyone!

We had a review of gastrointestinal pathology today. At one point, our prof started listing off potential complications of a peptic ulcer. As he spouted off a list of medical terminology, I realized that I knew what he was saying.

I had a sudden flashback to a pizzeria in Perugia, during my time as an exchange student. I was the only American who knew Italian, and since the waiter spoke no English, I had to translate for everyone on the fly. In between ordering appetizers and main courses, I noticed that I wasn’t thinking about what the words meant. They just made sense to me. It was the first time that I realized I knew how to speak Italian.

That’s what this felt like, today- I was understanding Medicalese. It was kind of surreal. Don’t get me wrong- I’m definitely not claiming to be an expert in medical knowledge. What I do think is at some point over the past year and a half, my classmates and I have become somewhat familiar with the medical jargon. When I really stop to think about it, it’s amazing to think of how far we’ve come*.

*of course, it’s even more amazing to ponder how far we have yet to go. Since that’s somewhat depressing, though, we’ll focus on the positive.

I just want to point out that my friend and I (coincidentally George W. Bush’s cousin) camped out at Best Buy overnight on Saturday to get a Wii.

And it is awesome.

That is all. Feel free to come over and play sometime.

We had a very interesting talk from some Jehovah’s Witnesses today as part of a health competency lecture series. For anyone not acquainted with Jehovah’s Witnesses, they are best known to the medical community for their refusal of any form of blood transplants. They outlined the biblical basis for their belief today (IV blood transfusions are deemed equivalent to “eating blood”, which is expressely forbidden in their version of the Bible), as well as the nuts and bolts of how this particular belief interfaces with modern medicine.

Interestingly enough, the ban against blood transfusions doesn’t seem to be that big of a problem, in terms of treatment. I spent all afternoon researching it*, and while obviously more expensive, an entire cottage industry has sprung up around treating Witnesses with “Bloodless Medicine”. This has even led to the development of blood substitutes that, though currently in their infancy, may one day help with nationwide shortages of blood.

Most Witnesses carry around a card that identifies themselves as such, and expressly grants the physician legal immunity in the event of their death secondary to blood loss. This is kind of a nice touch; though I may not agree with what they believe, if giving them a transfusion breaks their pact with God, who am I to force it upon them? I know I’d still have problems letting a patient die, but at least it would be on their terms.

I do, however, find myself troubled by one major aspect of Witness-dom… and that is the issue of pediatric care. I don’t think that children should be subjected to the religious beliefs of their parents if it may cause them harm. Turns out this was established as legal precident in Prince v. Massachussetts (1944), in which a Jehovah’s Witness was found guilty of breaking child labor laws. She was accused of forcing her child to distribute church pamphlets door-to-door (what Witnesses are best known for outside of the medical community).

Now, I am not a huge proponent of the culture of life. I believe that abortion should be legal, and I don’t think that Terry Schaivo should have been kept “alive” even though half of her brain had atrophied to mush. But I strongly feel that if a child is brought in by ambulance to an ER after major trauma, they have a right to all the blood transfusions necessary to keep them alive - no matter what their parents believe.

Unfortunately, the Witnesses did not agree. They offered to take “all legal responsibility” for the death of the child, just as they do for themselves. That does not sit well with me. As far as I’m concerned, letting a kid die on the table when you could have helped them is murder… and damned** if I’m going to be a murderer because someone else thinks blood is a bad thing. Even if the law would be on my side if I let it happen.

Anyhow, I suppose this is all very intolerant of me. But I also know I couldn’t live with myself if that child’s death was on my hands.

*I do not have time for this!
**literally!