At a Surgery Club talk the lecturer showed a picture of a man with a cleaver stabbed though his chest, left of the sternum. When he asked which organs were potentially in the path of the knife, an undergrad piped up:

“Well, it couldn’t have hit the heart, because the heart is on the right side”.

Pharmacology scares me. Not because it’s a lot of information (which it is), because each class of drugs contain countless specific variations (which they do), or because our notes are crappy (which they are).

No, pharm scares me because what we have learned is that drugs are metabolized differently from person to person. More fat and the THC from marijuana sticks around longer (good luck with the drug test, porky!). Less liver and drugs build up in your system. There are even people who get no pain relief from codeine because they simply lack the enzyme needed to make it work.

My point is that right now I’m reading about digoxin. Digoxin (affectionately referred to as “dij” by clinicians) is used to treat heart failure, but has a very small therapeutic window. What this means is that it is very, very easy to overdose - unlike, say, on Tylenol, from which thousands of angsty teenagers have failed to die over the years. What scared me was a throwaway sentence in our notes “in women, digoxin therapy for heart failure is associated with increased risk of death from any cause”. I’ve added the italics for emphasis.

This makes me think that prescribing drugs will do more harm than good. Maybe I’ll go be an alternative doc and prescribe acupuncture for everything.

Haphazard \Hap”haz`ard\, n.

Now, I usually say hap-hazard. I’d be willing to bet all of the english speaking world does. But, as our prof pointed out today, Ha-phazard (i.e. hafazard) might actually be the correct pronounciation if you were to come across it for the first time. Everybody in my hood knows it’s phat with a ph.

I’ve been having trouble seeing lately. My vision is distinctly blurrier than it used to be and I can’t see things at a distance. I think this is because of studying.

I found this post languishing in my “drafts” folder, and figured it was close enough to being finished that I might as well just put it up. It’s several weeks late at this point.

I’ve heard stories from the class above us that our pharmacology class is horribly outdated. We routinely learn drugs that are outdated and pass over ones that are currently used.

All of a sudden, I realized that they were totally right. Why? Our prof just told us that his slides are available on a “carousel” in the library. Lets ignore, for a moment, the fact that he is lecturing us off a powerpoint (I think it’s possible he’s not even aware of that fact)*.

As he was talking about antihypertensive drugs, he started to cut broad swaths through drugs we needed to know, and drugs we did not need to know. Unfortunately, one of my classmates mentioned that she had seen two “don’t need to know” drugs on several patient’s charts just the other day.

This worries me. This worries me both for the boards (on everyone’s mind, by this point) and for 3rd year. Pharmacology is supposed to be a given: a patient tells me that they are on acetazolamide, and I need to know what it does. I think I’m stressing myself out. But when I think “doctor”, one of the things that immediately comes to mind is “someone who can prescribe medication”. How is that going to work if I don’t know what the drugs do?

*It has come to my attention that he may not, in fact, have been implying that his slides were available on a carousel. However, for the purposes of good storytelling**, my incorrect assumption shall stand.

**To claim that I’m a good storyteller, of course, would be a mistake. This statement, however, shall also stand. Hey, once it’s written, it becomes true, right?