Agraphia Medical Tragicomedy



So we had a really awesome lecture from this old cardiologist yesterday. I feel like we're starting to get into some stuff that could be very useful in practical applications- how to read EKG's, how to listen to heart sounds with a stethoscope, etc. He also gave us his quick primer on how to diagnose someone in congestive heart failure (CHF) from 6 feet away.

Turns out he was on a plane once, and an old, handicapped man started looking pretty bad as the flight went on. All of a sudden he starts breathing very quick and shallow. People try to get him to lie down on the ground but he won't have anything of it- he fights to stay seated. Finally, his jugular veins are totally distended and bulging out of his neck.

The cardiologist asks for everyone's belts and ties, and proceeds to tournequit the old man's arms and legs as close to the shoulder and hips as he can get. Within minutes, the guy is feeling fine.

Now that's the kind of medicine I think would be awesome to do.

In case you're wondering how it all works, CHF occurs when the heart is unable to pump blood through the lungs (often due to fluid buildup in the lungs... hence "congestive" heart failure). This prevents the heart from being able to pump the blood to the rest of the body- and you get a massive backup of blood in the venous system trying to force its way into the heart. This is why the man had distended jugular veins.

The on-an-airplane treatment (i.e. when you can't give them lasix or other drugs that will minimize the fluid buildup) is simply to prevent as much blood from getting into the heart. By tournequiting his arms and legs, the doc clamped down his veins and probably saved his life. Sweet. Turns out patients in CHF also will do anything to stay seated- lying down makes them fight for breath even harder.

Also, at the end of his talk he gave us a miniature moral lecture, on how he was a doc in WWII who helped the jews out of the concentration camps. He made specific note of the fact that in his last 40 years of practice, he's never turned anyone away from his office because they couldn't pay. People were clapping for a full minute after he finished. He was pretty inspiring... I doubt this post does him justice.

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