Agraphia Medical Tragicomedy


Its funny, I feel like medical school is making me do more things outside of my comfort zone wayyyyyy more often than I ever had to in the past. Tomorrow we're doing the "high risk behaviors" interview at an HIV clinic here in town. I get to ask about whether or not you:

1) Have unprotected sex all the time (vaginal, oral, anal)
2) Do drugs
3) Smoke
4) Have a drinking problem
5) Have multiple partners (see 1)
6) Own guns (you'd think it would be an odd question to ask, but it is considered a "high risk behavior" due to the fact that houses with guns in them
statistically have many more injuries than non-gun households... especially to little children)
7) Eat "normal" amounts of food
8) Work in a place that may have harmed your health in the past (asbestos removal, anyone?)

Now I ask... how do you ask someone these questions without ever having met them before in your life? "Hi, my name is Zac, I'm a medical student with the U of A, and I'd like to ask you a few questions about potential risk factors to your health.... if you don't mind, I'll just dive right in with #1!" Think about how dehumanizing some of these questions are... and then think about asking them over and over and over again until they just become another tick on a chart somewhere. IV drug user, 45 years old, multiple partners. High risk for STDs. That's what you've become.

I mean, seriously. These are not easy, normal things to ask. I'm also 22 years old. Imagine that you're an older person who is being seen by a doctor. You expect to see someone who is competent, serious, and professional- not some punk upstart 22 year old kid who's asking you about your sex life. Granted I'll be 26 by the time I'm actually an M.D., but the point is, I'm still young, and I FEEL it. It's not that I want to be older, it's that I'm realizing that youth is going to work against me at this point in my life.

Also, I feel kind of behind in school. I just haven't been able to motivate lately, and somehow the material that we're learning now (and it's still just anatomy, basically... it's mostly muscles, nerves, arteries, and veins and their actions and locations) is more complicated. Granted, we're doing head and neck anatomy. It's really, really fascinating stuff, but it's so phenomenally complex its just really hard to wrap your head around it often.

Why, you may ask?

Well, if you think about it, your arm, for example, gets sensation and motor control from a bunch of nerves that come from your spinal cord. The spinal cord then goes up through your neck and eventually up into your brain. Your legs do the same thing. Now, you also have ALL of the nerves of the face (and there's 12 of them) and neck that also track back into the brainstem.

Also, all the rest of the organs and such in your body are controlled by MORE nerves (heard of the fight-or-flight system? That's what we're talking about here) that then also track up next to the spinal cord... and meet up in the neck.

Finally, think about all of the sensory stuff in your head. Sight, taste, smell, hearing, touch (which, of course, is also present in the rest of the body) all exist in the head. They've all got to connect back to the brain somehow too. These are part of those 12 nerves from before.

What this means is that understanding where everything goes in head and neck is roughly akin to, say, ripping out the main powerline to an entire neighborhood and trying to figure out where everything is supposed to go. It's SO complicated. Oy.

Still, it's so cool I can't even begin to describe it. The reason you get a runny nose when you cry? Normally you produce tears all the time as a way of keeping your eyes moist. Your tears then drain into your nose through the two little holes in your eyelid (right next to the nose on the upper and lower eyelids) and if you cry, you overflow and make the inside of your nose wet. Hence the runny nose Nifty, eh?

Anywho, I'm off to study more. Know how when you hit your hand with a hammer you get that sharp first pain, and then the horrible, dull throbbing? That's because you have 2 types of pain nerves, and the "dull, throbbing pain" ones are slower to send their signal. That's what I'll be studying right about....... now.

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