Cockroaches

This is no excuse for my absence lately, but this has literally been the most taxing week of my life (so far). I don’t think I can get into it all with one post, but I will try my very best to creep some details in over the course of the next few days.

Let me just start by saying, RESP IS AWESOME!!!

When we arrived in class fresh and wide-eyed on the 3rd of January (I kid you not), a lot of our 2nd year class was pretty much over medicine in general. I mean, what kind of faculty expects its students to pitch up in class, scalpels and coats in hand, two days after the New Year has begun??? We were all having a very good time complaining about it, seeing the shock on the faces of MS friends at different universities–“Wow, your faculty is guite serious“–as they contemplated whether they envied or pitied us.* It was all quite dramatic.

But I have to be honest. I was way excited. I mean, first year was nice and all, but I was under no delusion that I was actually getting anywhere near being knowledgeable enough to hold any kind of intelligent conversation with a Real Doctor. So we knew a lot about drugs from Pharmacology, and we did some cool diseases in Pathology. But we really had no context. The information was purely information.

This year, however, I was excited about. Because we are moving into systems, and anything we learn in each module can and will be examined in our final years. So, there I sat, awaiting the start of my first real module of medicine.

The respiratory system, for me, has always been a fascinating bit. Mainly because 80% of all the doctors I’ve ever visited have been pulmonologists. It’s a story for another day, but I had a very personal reason to want to jump right into this module. Something in me sensed it was going to be life-changing, exciting and grueling.

I couldn’t have been more right if I was a psychic.*

Resp is amazing. Up to now we’ve done a lot of anatomy. It’s plentiful and stressing me out really, because I’m not so good at the memorization bit and a lot of what we learn in anatomy we have to memorize. We have had a lot of brilliant dissections, so that has helped make the work more practical–and thus easier for my slower mind to digest–but because of the focus of the module, a lot of the more detailed information that we’re supposed to know can’t really be studied on the cadavers. So it’s all about regurgitating at this stage.

Physiology is beautiful. I always liked Biology and PhysiChem in HS, so I’m not surprised that I’m really enjoying the physiology in this module. A bonus is the fact that our lecturer is an amazing teacher who really lets us do most of the thinking.

Histology is a snore. I swear, it must be the most boring portion of this module. Don’t get me wrong, I know it’s super important. But I’m finding it hard to stay awake while we get told a thousand times over that respiratory epithelium is pseudostratified ciliated columnar epithelium with goblet cells. Seriously. Seriously.

(The Clara cells and type II pneumocytes fascinate me, but only because in Physiology our lecturer made surfactant sound like some pretty higher-grade stuff.)

We’ve done some Radiology and at this point I’m not even pretending I understand how someone can point at a grayish-white section of a grayish-white picture and tell me that that’s pneumonia. Only to point at an identical visual two minutes later and change the diagnosis. I mean, wow.

The best part so far, though, has to be the Clinical. It’s a pity that this Monday we’re writing a major test on all-things non-clinical, because I haven’t really been able to go through much of the Clinical work after class. Clinical Respiratory Medicine should be a module all on its own. There’s just so much that we’re learning that makes everything but the cadavers seen flat and two-dimensional.

Take, for example, asthma. In this country, it feels like every second person you meet has asthma. We take it for granted that it must be like having eczema or something, just a highly inconvenient and uncomfortable disease, but nothing too dangerous or complicated. But, my word, there’s so much more to it than that! There are complications and sequelae, there’s the pathophysiology and the management. As an asthmatic, I always had the impression that Asthavent and Symbicord are the obvious treatment choices for any asthmatic. Every asthmatic I knew used the same. But then we started on the pharmacology and management of asthma, and I realized that I either grew up in a very homogeneous community or all my doctors were just very lazy.

Though I can see why they would have forgotten about the mechanisms of some of these drugs’ actions. I mean, good gracious. That’s a lot of stuff going on in that diagram, Fred.

And the fact that our country has the fifth highest mortality rate for asthmatics in the world. That’s insane. This condition is so easily manageable if doctors and patients alike just try.

Of course, like any MS, I’m as attracted to the extremely higher grade information as I am to the unbelievably insane.

Let’s look at asthma again. I nearly keeled over laughing when one of our lecturers said, with a smoothly serious face, that asthmatics should avoid Oros. Oros? A harmless concentrate juice that makes every kid as happy as can be. No way could she be serious, right?

But she was. Very. Because the preservative in Oros, sulphur-something-or-other, is chemically structured to exacerbate an acute attack. You know, those attacks that kill people.

MY MOTHER HAS GIVEN ME OROS SINCE BEFORE I CAN EVEN REMEMBER! SHE STILL KEEPS OROS IN THE HOUSE! And I just go around, all tight-chested and oblivious, because I’m used to it.

Why did none of my pulmonologists ever care to mention this to her???

That information was insane. But not as ridiculous as what followed.

Lecturer: Also, cockroaches have been known to exacerbate, or at least worsen, the symptoms of asthma in moderate to severe asthmatics. One can gauge the extend of an asthmatic’s regression by simply observing how he or she reacts to living in a place with cockroaches. Now, when we look at the pharmacological blah blah blah…

And the whole class just sat there, for the first time in ages, stunned into silence. Cockroaches? You mean, like the ones we have in  res?*

This medicine thing is turning out to be completely loony. What is wrong with this world?

That isn’t even the best of my week, but I have to go and get showered now. But ponder that if you will.

Cockroaches.

Shiver.

 

 

*I’m sure they later decided on the latter. I mean, 3rd of January? Who are these people kidding.

**Maybe the life-changing part sounds a bit dramatic. But I can actually feel myself climbing the medical food-chain here.

***One of my friends actually timidly raised her hand and asked that very question. After a moment of thoughtfulness, the lecture smiled and said, “Yes. Exactly.”
As if I needed another reason to detest cockroaches.

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