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. 

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