Medical School Musings 1: An introduction

The human body is beautifully designed; each part seemingly has a purpose and every part comes together to create an all-encompassing machine which needs nutrients, rest, exercise and interaction. In an ideal world, this is all the body needs to survive, but unfortunately, as we find ourselves having to replace batteries on the remote control or a pesky bearing in our cars, humans also need tune-ups and sometimes replacement of parts. It is when our bodies work against us and our parts have lost their harmonious interaction, then we get a frightening wakeup call acknowledging our own mortality.

I've always considered that there was only one rule to medicine; For every anatomy, there is a corresponding pathology. It's quite frightening to think of things in this picture and even more frightening when you realise that the diseases you learnt in school may one day affect you or a loved one (if it hasn't already). There is a common phenomenon in medical school called "Med Student Syndrome" in which we develop (or perceive to develop) striking similarities to the disease that we are studying, for example, I could have sworn that I had a brain tumour when I had a throbbing headache. Perhaps our bouts of hypochondriasis are just subconscious mechanisms we employ to commit these diseases to memory through (supposed) experiences of our own.

http://closeted-intellectual.tumblr.com/post/81876739854

Regardless, we are all human and we will all eventually have to experience disease. It is important that we do not forget this and it is even more important for us to realize that there is a certain degree of compassion and patience that the ill deserves. At the moment, I am in my third clinical rotation (Psychiatry) and I have seen a bit of disease in both adults and children as well as physical and mental diseases. These rotations have cemented the importance of being a good doctor; one that can not only identify and treat a great variety of diseases but to actually build a rapport with one's patient thereby creating a meaningful relationship. 

Thoughts on Tolstoy: Part One- War & Peace: Volume One, Book One

Version of Book: War and Peace by Leo Tolstoy (Translated by: Louise and Aylmer Maude) -Three Volumes in One 

In book 1 we are introduced to the aristocratic families of the novel: The Kuragins, Bezukhovs, Rostovs and the Bolonskys. Tolstoy intricately ties in all the interfamilial associations adding great depth to the many characters mentioned. Pierre Bezukhov who was once the Count’s bastard becomes legitimate and inherits a great deal of money to the dismay of the Kuragins, namely Prince Vasili. The dispirited Vasili tells Pierre, “How often we sin, how much we deceive, and all for what? I am near sixy, dear friend…I too….All will end in death, all! Death is awful…”

The Rostovs are another family which enjoys great wealth and social prestige and represent the carefree life of the Russian aristocracy. We are lastly introduced to the Bolonsky family in which Nicholas has a close relationship with his son Andrey who shares his arrogance and detachment. This greatly contrasts to his relationship with his daughter Marya who is deeply afraid of her father and seeks comfort through religion. Andrey leaves for war despite his pregnant wife’s great objection and theatrical outbursts. 

Thus far, I can tell that Tolstoy is a master storyteller to have developed all these great families and characters so well. I find that although the time that this book has been written, human nature has not changed greatly as greed for power and wealth as well as conflict and war still plague modern day society. 

"Life and Work of Leo Tolstoy"

I've started reading War and Peace and I decided to look up a few documentaries on the great Leo Tolstoy and this one interested me greatly. It laid a good foundation for me to understand the content of his novels as well as his trend of thought. It also strengthened my admiration for him as a great influential figure for great leaders such as Gandhi and Martin Luther King Jr.

National Geographic's "Lincoln's Secret Killer"

Now, we all know the story of Lincoln's assassination by John Wilkes Booth at Ford's Theatre on April 14, 1865 (Good Friday). John Sotos, "Dr Zebra" is a cardiologist with special interest into the 16th president of the USA. He hypothesised that Lincoln suffered from a genetic defect resulting in cancer was the subject of The National Geographic's documentary "Lincoln's Secret Killer". He sourced some articles which were kept as mementos subsequent to his assassination which may have DNA. From whatever DNA that could have been salvaged, they sought to determine whether he had a MEN 2B (Multiple Endocrine Neoplasia Type II) or Marfan syndrome.

They ruled out Marfan  syndrome, as although he had abnormally long appendages, he did not seem to have ophthalmic or cardiac deficiencies which are associated with defects in the FBN-1 gene.

Unfortunately, due to the passage of time, the samples obtained were either unusable as the DNA was greatly degraded or the one sample (which questionable reliability) which was amplified actually didn't show a defect in the MEN2B gene.

Abraham Lincoln's tall frame 6' 4" with his disproportionately long arms and legs

Here are links where you can learn more about the documentary and facts about the diseases in question:
NGC: Lincoln's Secret Killer Documentary

NGC and Cleveland Clinic

Multiple Endocrine Neoplasia type-2

About Marfan Syndrome

Read more about John Sotos here

I think it's quite interesting that at this day and age we can link science with history to try to create a clearer picture of what has already occurred. I was also excited to see applications to a few things we learnt in Medical School such as the PCR testing and the usage of genetic markers to determine disease causation and presence.

1 book I highly recommend (a novel) Marker by Robin Cook who is an excellent medical thriller writer explores some of the implications of genetic testing. You can read more about it here: https://www.goodreads.com/book/show/66465.Marker 

Introduction

I created this blog so that I can share a bit of my thoughts and experiences both as a medical student and as a laid back intellectual of sorts. These posts will be random and may be scarce at times, but bear with me as I offer my 2 cents into the wonderful world of cyberspace.