Thursday, December 24, 2009

Everything causes cancer in California

... so you'd better stay away. The San Francisco environment commission just approved a measure requiring cell phone manufacturers to say that their products may cause cancer. The mayor is expected to approve it. Even though every legitimate scientific study has found no link. The head of the city's "Toxic Reduction Program" says...
Do you wait until you have proof of cause and effect, or do you look for indications from reputable scientific sources?

Apparently what any random person off the street says counts as reputable scientific sources, because every reputable scientific source I've seen says there is no effect of "radiation" from cell phones on human tissue. That's why everything seems to cause cancer in California, but nowhere else.

ps. Merry something-or-another

Saturday, December 19, 2009

Breaking News on CNN

Let's see, what happened today? The entire east coast is getting like 2 feet of snow, the healthcare bill got enough votes to avoid a filibuster, the climate conference in Copenhagen comes to an end, and Lil' Wayne gets arrested for pot possession... and none of these stories make the biggest headline on CNN. Instead it's Can Joel Osteen Help You Pay Your Bills? and the poll of the day is "Should information about women who get abortions be posted online?" WTF?? This is what the media has become? A big advertisement for a televangelist as the major headline and a poll that in a country that supports human rights should be 100% No?? Just when I think that US media can't get worse, it proves me wrong. I think I gotta take a tip from my friend, MadDR2 and give up on the news for a bit.

Friday, December 18, 2009

Reflections on OBGYN

Just finished the last day of the rotation. I was pleasantly surprised. I thought that I would find absolutely no interest in it, but really, it wasn't what I expected. It is a field that encompasses a wide range of patient populations and covers almost every other branch of medicine. My favorite part was OB. First, from a purely scientific point of view, what happens to human physiology during pregnancy is simply amazing. When looking at an obstetric patient, you might as well forget normal physiology and normal lab values that you learned in internal medicine (for example, the white blood cell count, which is normally below 10,000, with a really bad infection being 20,000, can go up to 30,000 during normal labor). Then there is labor and delivery. It's something that is nice most of the time, but every once in a while it gets very scary and very sad. It's the one time that people are hospitalized for something that is completely normal and the expected outcome is not to make them better, but to make sure nothing goes wrong. Delivering babies is pretty fun, but watching the emotions of the people in the room affected me more. There are some interesting social dynamics in the delivery rooms also (like the patient who wasn't sure who the father was and was waiting until she saw the skin color of the baby before giving her a last name or the woman at 43 1/2 weeks gestation who refuses any medical intervention). Overall, each patient is completely different and OBGYN is a branch of medicine that combines the solving-a-mystery aspect of internal medicine with the get-in-there-and-fix-it aspect of surgery. No, I don't want to go into it, but I definitely had a lot of fun in the last 6 weeks.

Monday, December 14, 2009

8 more hours to go

I'm on night duty on labor and delivery this week. This is my second night, and although it is cool (I've gotten to deliver a couple of babies), it is pretty damn tiring. I'm actually pretty good at staying up at strange hours and can handle being on call overnight every once in a while, but working nights day after day is not easy to get used to. I'm a med student and don't have nearly as much running around as the residents do. How do they do it? It just seems really dangerous to have overworked and sleep deprived people dealing with emergencies. I guess they get used to it (or learn to sleep during the day better than I can). 5 hours down, about 8 1/2 to go.

Thursday, December 3, 2009

Learning Abortion

We had a pretty interesting discussion about how education about termination of pregnancy fits in with resident education in OB/GYN. According to the accreditation board, no residency program can require that residents participate in a termination of pregnancy. However, all residency programs are required to accommodate residents who wish to learn about and participate in such procedures. This applies even if it's a Catholic hospital/university that provides no such services (and equates such services to murder*). Such hospitals have an agreement with another institution that does provide it. Which means that it is possible that somewhere in the country, an anti-abortion institution has an agreement with an institution like planned parenthood that provides abortion services in order for them to keep their accreditation**. I wonder what the atmosphere was at the meeting that led to that agreement. And, how stigmatized is the pro-choice resident in an anti-choice hospital, if they do decide to take this option? Also, how likely is an interested resident going to take the option if the nearest clinic providing abortions is hundreds of miles away?

Another interesting part of this discussion was that each institution has an unspoken reputation about whether it has a pro-choice or anti-choice lean. And, although it is illegal for them to use the applicants views on abortion as a litmus test, according to the attending we were talking to (who has been intimately involved in national ob/gyn resident education), these institutions do look for clues on the residents' applications about where they stand on the issue (i.e. if they said they were a member of Medical Students For Choice) in order to make decisions on whether to interview them or not. Sounds like a litmus test to me.

* though, in my opinion, they really don't. See this discussion.
** although, some of them do get around it by saying that their abortion training is "limited to patients with medical indications," which can equate to early induction of labor and is not really what most people think of as abortion.

Monday, November 30, 2009

The Intolerant Neutral Planet

The recent, blatantly racist Swiss vote banning the building minarets is upsetting, but, to me, not surprising at all. This is coming from a country where the ruling party's banners featured three white sheep kicking a black sheet off a Swiss flag with the words "For our security" under it. Although, as a non-white person, I have been subjected to subtle racism before, Switzerland is the only place where I experienced overt racism and the only place where I felt uncomfortable.
Here's my experience. A few years ago, I was at a conference in Germany and afterwords, since I'm into mountain climbing, I decided to make a short trip to Switzerland. I took the train from Frankfurt to Basel and an hour before we got to the Swiss border, I see three border guards enter my train car, talk into their radios and headed straight to me (the only brown person in the car). They asked for my passport. I showed it to them. They then asked to search my bags. Went through both my bags. I had a poster from the conference and they asked to open the tube and took out the poster (tearing it in the process). They then asked why I am going to Switzerland, for how long, who I'm staying with, whether I'm looking for a job, what kind of work I do, etc. They asked me to prove to them how long I'm planning on staying in Switzerland. I wasn't sure how to do this. Eventually, showing a print out of my return flight worked. After 45 min, they let me go and left (no questions to anyone else in the full car). Meanwhile, the entire train is staring at me (the presumed terrorist).
Things didn't improve once I got to Switzerland. Everywhere I went, I got a suspicious look. Especially in stores (every store), where the employees followed me throughout the store (to make sure I wasn't stealing anything, I guess). I started playing a game with them, where I would walk around in circles in the store and watch them follow me, to see how many laps I could make them do.
I was surprised that a country that I've always seen as so benign (so neutral) could be so hateful towards others. I suppose Switzerland's "neutralness" is really a manifestation of it's isolationism and xenophobia.

Zapp Brannigan:
With enemies you know where they stand but with Neutrals, who knows? It sickens me.

Tuesday, November 24, 2009

An unreasonably natural labor

Being in OB and expecting a child makes me see many sides of being pregnant and labor. I see pregnancy and childbirth as a natural process and think that there are some physicians who "medicalize" it too much (C-section rates are higher than the should be, people are induced more than they should be, etc.). So, I see the why people would want "natural" childbirth, with no medical interventions (like pain control). But, the extent to which some people take it is completely, in my opinion, unreasonable.

Case in point is a woman who recently delivered at our hospital (she was not my patient, so this is second hand). Things went relatively smoothly and, except for receiving a small perineal tear, she was able to successfully go through labor without any medical interventions. The baby was born relatively quickly and was completely fine. The woman just needed the tear sutured and was otherwise fine. When the resident explained that she will numb up the region around the tear with some local anesthetic before suturing, the woman became angry and was adamant she wanted a natural birth without any "chemicals."

Kind of ridiculous. But, childbirth is a highly emotional time and whenever people are dealing with emotional events, they tend to stop thinking rationally.

Wednesday, November 18, 2009

Ou se trouve le gerbille hôtel?

I wouldn't mind going to a rodent-cage themed hotel, but the hamster costumes kind of creep me out.

Wednesday, November 11, 2009

From one end to another

That's what my Pathology attending said when I said I was doing my OB/GYN rotation next. I suppose he meant from one end of life to another (it could have also been from one end of the body to another, since I focused on Neuropathology). I started OB this week. We switch teams every week or so. Right now I'm alternating between an infertility clinic and an OB clinic. I haven't seen enough to comment on (although some of the infertility treatments are pretty clever), but it is nice to be expecting our own baby while on this rotation. It not only motivates me to study a bit more, but it definitely helps relate to what the patients are going through (since I've seen Mrs. mxh go through a lot of the same already). It's also a bit reassuring, since it has made me realize that a lot of the fears and problems that we've had so far are very universal.

Wednesday, November 4, 2009

Glad I got my vaccine

Just saw this case on the pathology rotation:

A slightly overweight, otherwise healthy 50ish year-old man, 5 days ago starts feeling tired and gets a slight fever (~100 F). He goes on a trip with some friends and returns 2 days later. At that point he is feeling much more tired, his muscles ache a bit, he is starting to get short of breath and his fever is a bit worse (~102 F). He goes to the local ER where they think he might have H1N1 and because of his worsening shortness of breath he is admitted. Over the next day his condition dramatically worsens. He is intubated, his fever skyrockets (~109 F (!)) and he is transferred to a larger hospital. He dies within 12 hours of arriving at the larger hospital. He is determined to be H1N1 positive.

On autopsy, except for his lungs, all his organs show no signs of any disease or abnormality. His lungs, however, weigh about 1200 and 1300 grams each (normal, i think, is about 450 and 500 grams for left and right lungs). It has multiple areas of necrosis, hemorrhage and consolidation (like a really, really bad pneumonia). What goes beyond a normal pneumonia is that it covers the entirety of both lungs (ARDS) and even goes up the airway to the trachea, which also shows inflammation and hemorrhage.


Sunday, November 1, 2009

All you need is brains

Caught a nice documentary last night on PBS. The Zombeatles... probably the coolest thing on PBS in a while.

You must catch the riveting story of the "Fab Gore"

Tuesday, October 27, 2009

Cleaning up

With a (much) lighter schedule, the Mrs. and I decided we should start getting ready for the baby getting here. The first order of business is to make room for the baby. This means throwing a lot of crap away. Most of the "crap" was notes and folders from undergrad and the first two years of med school. I've somehow felt attached to these notes, even though very little of it is useful to me anymore (really, I don't need to hold on to my History of Jazz notes). But they had to go. And as I was throwing things away, I saw my Calculus 3 notes and flipped through it and I was amazed that at some point in my life I knew how to do triple integrals. Then I thought, holy shit, what a waste of time. I haven't used it since and will probably never use it again. Was it all a waste? I wonder how much of my education is a waste?

Saturday, October 24, 2009

Done Surgerizing

As you could probably tell from the frequency of posts in the last 2 months, surgery was not the most leisurely of clinical rotations. But it wasn't too bad. Maybe it is just our school (or just my experience), but the hype over how much work it is and how much pimping is involved is a bit overblown. Yes, it sucks getting up at 4:30 am everyday, but once your there (and awake) most of it isn't "difficult." I rarely got pimped (in fact there was only one time where I may have felt uncomfortable), I was rarely given any scut work and (this may have been a fluke because of some national conferences) I actually had time to read. Still, I quickly decided (after about 4 days) that it's not what I want to do with my life. What I loved about medicine was the opportunity to get a complete mystery and solve it with clues from your history, exam and labs. In surgery (for the most part) that is already done for you. It's a much more get in there and fix the problem kind of job. Don't get me wrong though... most of the surgeries were really cool. There are a lot of clever approaches to fixing otherwise very disabling problems (like making a bladder out of intestines). And there's nothing like cutting apart someone, hacking at bones, chopping up intestines and seeing the person functioning pretty much as normal a few days later. Here are some quick goods and bads:

1. Most of the procedures are awesome - something not too many people get to be (somewhat) actively involved in.
2. There actually is thinking involved - surgeons have a lot of thinking on their feet to do when something unexpected happens intraoperatively. It's not just for jocks.
3. Results - for the majority of patients, the surgeries actually work! It's amazing to see the overnight transformation in patients.

1. Hours suck - When med students are violating national hour-limit laws, I don't want to know what the residents are doing.
2. Not much to do for the student - unlike medicine where you can follow labs, actively discuss your patient, in surgery the most you get to do is throw a few stitches, hold retractors and get to open your mouth once every half an hour or so. There is a lot of standing around not doing anything, which sucks when you have to get up so early.

1. Ask questions, very few people are enough of an asshole to call your question stupid (you'll figure out who those people are and avoid them).
2. Try to do as much as possible, ask (if you actually think you can handle it) if you could do it. This isn't a rotation to be quiet and timid on. You'll have a pretty boring experience if you don't try to actively get involved in whatever the team is doing.
3. Don't kiss ass. This goes for most rotations, but students interested in surgery tend to be the worst. Everyone ends up hating the person (including, I presume, the attending).
4. Don't fret over studying for pimping. Study what is important for your exam, but don't spend hours reading about details of an operation that you'll never think about again. The reputation of pimping is overrated... it is not what you should be worried about.
5. Always have something to read in your pocket. That way you'll read what you need for the day in your downtime, giving you more time to eat and sleep when you get home.
6. Don't volunteer for scut work just because you think it will give you a better grade. It won't and it'll be a complete waste of your time.
7. Have fun. You may never get to experience being in the OR again, so try to make the most of it. This is especially important to remember towards the end, when you're completely burnt out.

Despite the fact that it wasn't too bad... I gotta say, woohoo!! My two (supposedly) most difficult rotations of medical school are behind me. Now I get a relative vacation with 2 weeks of pathology before starting OB/GYN, something I have no interest in, but at least having a baby on the way will somewhat have me caring.

And remember, Jesus is with you... though he'll definitely get yelled at by the scrub nurses

Thursday, October 15, 2009

You know you're a racist when...

you have to tell people how many black friends you have.

Here's what a justice of the peace in Louisiana said after refusing to give a mixed couple a marriage license:

"I'm not a racist. I just don't believe in mixing the races that way," Bardwell told the Associated Press on Thursday. "I have piles and piles of black friends. They come to my home, I marry them, they use my bathroom. I treat them just like everyone else."

Wow! He must really not be a racist, if he thinks that black people are clean enough to use his bathroom.

Friday, October 9, 2009

Liberal Swedish Bastards

This happens every year. The Nobel Prize goes to some undeserving person for political reasons. It's all a left-winged conspiracy and a big F-U to George W. Bush. I mean what has Willard Boyle done to deserve the Nobel Prize?? Nothing. Sure he invented the CCD, but isn't it a little premature to be awarding him the Nobel Prize? What do Willard Boyle and the psychotic, and (possible) cat-killer Erwin Schrödinger have in common? They both won the Nobel Prize. Clearly it's a sham.

Every year it's the same... Yoichiro Nambu, Peter Grünberg, John C. Mather, all liberal hacks who have gotten the Nobel prize only because those liberal elitists at the Nobel Foundation want to give a big middle finger to George W. Bush.

Friday, September 11, 2009


In medicine, you barely have enough time for TV. In surgery, you barely have enough time to eat and sleep. Not for me.

Although taking this monster out of someone's neck is pretty cool

Saturday, August 29, 2009

The end of internal medicine

Well, at least the end of it for me (for now). Wednesday was my last day of the internal medicine rotation and the last two days were the end-of-rotation exams. The rotation itself was actually pretty fun. There was some waiting around not doing anything and there were times when I felt pretty useless. But, overall, I learned a lot, saw a lot of interesting cases (and a lot of not so interesting cases), got to feel like I was the part of a team taking care of people, and got a chance to get to know some interesting people.
Do I want to go into internal medicine? It's hard to say since I only got to experience what life is like for hospitalists. I only saw the specialists tangentially. I wouldn't want to be a hospitalist (things are too hectic and once you see something interesting, you call a specialist). However, from what I saw on the wards, infectious disease and rheumatology appealed to me the most. There is a lot of detective work in both of them and a diagnosis could quickly lead to an effective treatment (Interestingly, these were the two fields that I felt I was the worst at when it came to exam questions). Radiology is still at the top of my list, but going through a more patient-based rotation does make me consider other options. We'll see as the year goes by.

Some advice...
- enjoy your time, at least with my experience, there really wasn't any pimping. There's no reason to feel stressed.
- don't let your first few days' experience set your mood for the rotation. Every time you have a change there is some awkwardness and confusion. It will also take a few days for your team to get warmed up to you. You'll find your place soon.
- don't feel like you have to stay on the wards forever. If someone tells you to leave, leave... it's not a test. You've got a lot of studying to do, and everyone on your team understands that. If nothing is going on, ask if there's anything you can help with, the answer will be "no", and you could leave.
- Spend extra time with your patients. You've got the luxury to actually spend time with your patients. If they're up for it, spend some extra time with them. The more you know about your patient, the better resource you are for the team (plus, the patient will trust you more than the rest of the team, if they've made a connection with you).
- If your school allows it, try to get some experience in a different hospital. It'll give you a better idea of what's constant and what's variable in internal medicine.
- prepare to feel defeated if you're taking the SHELF (nationally standardized) exam. Holy crap the SHELF exam sucks ass. None of my studying prepared me for that test. Even knowing what the exam was like, I don't think I could have effectively studied for it. It is not a good assessment of how much you've learned on the wards. I've never came out of an exam seriously thinking that there's a possibility I could fail until now. Luckily, everyone else in my class felt the same. And from people who have taken it in the past, the results end up being better than you expect.

Now I get a whole weekend off before Surgery starts on Monday. I start with ENT, then have Orthopedic surgery, followed by a month of general surgery.

Old song, but it's been stuck in my head ever since I saw a patient with Wenckebach heart block last month

Wednesday, August 19, 2009

Informed consent preventing testing?

I recently saw a patient that had pneumocystis pneumonia - an infection that pretty much only occurs in immunodeficient people and is an indication for HIV testing. In many states written consent from the patient is required prior to HIV testing. Consent prior to HIV testing dates from the late 1980's when HIV was a new, stigmatized disease that was essentially a death sentence. States enacted laws to protect patients from health care workers testing them for the deadly disease without them knowing. Now, however, HIV is a treatable disease that, if caught early could allow the patient to live a relatively normal life. The greatest barrier in decrease of HIV-related mortality and the decrease in the spread of HIV is knowledge of HIV status. There was a recent study in the American Journal of Preventive Medicine that showed that states with a written consent law have a decreased rate of HIV testing than those without. And another study showed that the cumbersome requirement for obtaining written consent from the patient has discouraged physicians from performing HIV. I personally think that that HIV should not be singled out as requiring written informed consent prior to testing (I think it continues the stigma associated with HIV). Either all testing for sexually-transmitted or blood-borne infections should require written informed consent or none of them should. But, it's pretty bad that physicians are avoiding the test only because they have to obtain written permission from their patients.

Sunday, August 16, 2009

Jesus is my co-surgeon

The hospital that I'm working at now (St. XXXX) is affiliated with the Catholic church. I am not a big fan of mixing religion with anything, but I really think that it's unfortunate that so many church-affiliated hospitals exist. For most patients it's not a big deal and it rarely affects them. Sure, there are crosses in every room, Bible quotes in the hallways, and bright notes on the front of charts saying "Sacrament of the sick given" (apparently that's more important than "Allergic to penicillin"), but I pretty much see that as (really bad) decoration. There are some things, though, that I think are not appropriate in a place that is meant to take care of the entire community (especially since people in this half of the state really have no other choice in a major hospital).

One is that there is a rather long, loud morning prayers on the intercom every day (usually at a time when we're rounding on patients). It's not just, "let's take a moment of silence" or something else equally nonspecific... rather it is usually a five-minute sermon on what Jesus or some saint said. Even though it's a rural part of the country, not everyone is Christian or religious (and they're definitely not all catholic). The last thing I'd want to hear when I'm sick in bed (especially if it's during the five minutes that my doctor is talking to me) is what Jesus wants me to do.

What really bothers me, though, is the fact that church doctrine dictates medical decision making. Catholic-affiliated hospitals (which care for approximately 20% of the patients in the US) all follow the US Conference of Catholic Bishops' Ethical and Religious Directives . Since it affects a fifth of patients in the country, it's a must read for healthcare workers. Some of the more striking parts are:

- #24: The institution ... will not honor an advance directive that is contrary to Catholic teaching.
- #25: Each person may identify in advance a representative to make health care decisions as his or her surrogate in the event that the person loses the capacity to make health care decisions. Decisions by the designated surrogate should be faithful to Catholic moral principles.
- #36: A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum.
- #41: Homologous artificial fertilization (that is, any technique used to achieve conception using the gametes of the two spouses joined in marriage) is prohibited when it separates procreation from the marital act in its unitive significance
- #45: Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo.
- #47: Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child. (pleasantly surprised about this one)
- #48: In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion.
- #52: Catholic health institutions may not promote or condone contraceptive practices but should provide, for married couples and the medical staff who counsel them, instruction both about the Church's teaching on responsible parenthood and in methods of natural family planning.
- #53: Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution. Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.
- #54: Genetic counseling may be provided in order to promote responsible parenthood and to prepare for the proper treatment and care of children with genetic defects, in accordance with Catholic moral teaching and the intrinsic rights and obligations of married couples regarding the transmission of life.
- #61: Patients experiencing suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.

Painting in physicians' break room. Yeah, Jesus has helpful tips for the surgeon, but when a luxurious long hair from his uncapped head falls in the peritoneal cavity, the patient won't be too happy.

Sunday, August 9, 2009

I take (some of) it back

So a week into my rotation in a more rural setting, I'm feeling a bit better. Last time I complained about several things, the most worrying of which was a lack of effort in teaching by the residents and attendings. I don't think I was being completely fair, since comparing a large academic hospital with a smaller rural hospital is not appropriate. The residents and attendings don't see too many medical students, so it makes sense for them to not know where we fit in the scheme of things. It took a few days, but things are going more smoothly now. Although I don't feel nearly as productive as I did at my home hospital, I also don't feel like the burden that I did for the first few days. Also, I know it's difficult for them, but they've gotten better at thinking about what would be beneficial for a med student to see or do. Hopefully the next three weeks will continue moving in the right direction.

P.S. paper charts still suck

P.P.S. everyone really is a Republican, but the blatant anti-healthcare reform postings have been removed.

Monday, August 3, 2009

More rural internal medicine

I am now in a different part of the state, in a relatively small town at a hospital catering to small town communities spread over this region of the state. I'm not exactly happy with the differences in how things are run from the major academic institution that I'm used to, but I'm hopeful about what I'll gain here. Here are some differences:

1. Less specialists - there are still consults, but (so far) the consult team seems less like they run the show than they do at my academic institution. Patients with an MI are seen by cardiology, but are not necessarily taken care of by a cardiology-specific primary team. This is good news for me because I will likely get exposure to a wider variety of patients than I did back at home.

2. Slower pace - my service caps at 6!!! That is considered a light day back at home. Also, you can only take patients on your call day!! As a result everything else goes at a slower pace. I thought it would be a good thing to have more time to think about, discuss and care for each patients, but really, I think the result here is that people just work slower. On the bright side, I get out earlier.

3. Teaching - I can't say much about this since I've only been with my team for a day, but people seem less enthusiastic about teaching here. I'm pretty proactive with asking about what's going on with each patient, but it seems like I've had to ask several times to get an answer. When coming up with a plan, the resident and intern usually quickly talk about it (quietly) with each other, leaving me out and forcing me to ask more questions than should be necessary (the lack of electronic charting makes it even worse). Finally, the answers to my questions are usually very short. For example, when I ask "Should we be concerned for a pulmonary embolism?" they say "No it's not a PE" versus at home where they actually explained what argues against it. I feel a lot more like a burden here than a part of the team. Maybe it was just today (or just the specific people I've been working with), so hopefully I'll feel better about it when I get more familiar with how things are run in the next few days.

4. Paper charts - I don't care what people say about electronic charting, but paper charts just plain suck. We live in the 21st century and shouldn't have to hunt around through dozens of pages of poorly written and half-torn sheets of paper to find what we're looking for.

5. Everyone's a Republican - I expect this in more rural parts of the state, but everyone (nurses, attendings, and patients) leans pretty far to the right. I just can't respect a physician who actively watches Fox News in the break room (actually, I fear for their intelligence) and I'm really concerned about the fact that propaganda against health care reform is posted all over the nursing station. It's not fun to work in a politicized environment, especially in such a hierarchical system as a hospital.

Hopefully my opinion of this half of my internal medicine rotation changes in the next few days, but if it doesn't, at least I'll appreciate going back home (even if it is for surgery).

Wednesday, July 29, 2009

Equal education?

Throughout third and fourth year of med school, students work with a team of residents and attending physicians either alone or with another med student. At least in internal medicine, each student has his/her own patients and reads up on and follows those patients. Different teams may specialize in different types of patients and even within a single group, the types of patients followed by one student (by chance) could end up being very different from those followed by the other. This leads to a lot of variability in what each student learns from their experience on the rotation. For example, most of the patients that I've followed in my internal medicine rotation so far have had liver disease or a bile duct/gall bladder problem. I've read up on these conditions a lot and think that I'd do a pretty good job at examining, diagnosing and treating a patient with these disorders. But other students on the rotation with me have completely different patients, some have more cardiology patients, others have more kidney patients, and each (I assume) are more familiar with those conditions than I am. I hope that it evens out soon... these practice questions that I've been doing for the final exam really shows the bias in my experience with patients. I switch teams (and hospitals... and cities) next week, so I hope to get some exposure to the type of patients that I haven't gotten a chance to see yet.

btw... (can't believe it's already been a month, only 22 more to go).

Monday, July 27, 2009

Social Health

3 weeks into medicine now and things are pretty busy, but I'm having a lot of fun and learning a lot. I'm still missing a lot of the knowledge, but I definitely feel more comfortable around the hospital and with patients. One thing I've noticed though is how important social situation is to health. Yeah, it seems obvious, but working in the hospital really opened my eyes about it. Of the dozens of patients I've seen, only two of them have a stable living situation. The major reason behind this is lack of access to healthcare. People who are living stable lives likely have the resources to take care of their health and even if they have a problem that can't be prevented (like a genetic clotting disorder), they can keep a close eye on it and live a relatively healthy life that doesn't require them to be hospitalized much. People who have unstable social situations have bigger things to worry about than why their stomach hurts when they eat or why they're slowly starting to turn yellow. They don't catch their clotting disorder until they get a large clot in a major vessel (i.e. the portal vein) and get life-threatening (and much more costly) health problems like losing their liver. A little early education and a $4 a month drug could have prevented a hospital stay of several hundred thousand dollars and a death in the 20's.

Saturday, July 11, 2009

72 hrs later

So, as I mentioned before, we were told that we'd feel a bit more comfortable about starting the wards 72 hrs into it. Well, I just got back from my 3rd day in the wards and I do feel a bit more comfortable. I've figured out the basics of the computer system and I've gotten a little bit better with rounding, presenting patients and writing notes on my patients. So, after 72 hrs here's my impression on internal medicine (and maybe being a 3rd year med student as a whole):

The goods (in no particular order):

1. Getting to be where the action is.
Yeah, I don't get to actually do much, but each day I do get to closely follow a team of doctors debate and make many potentially life-altering decisions on several people.

2. Applying all that medical knowledge to real people
I finally see how many of those lists and seemingly endless facts finally make some sense. I'm far from being comfortable with them, but at least I get to see them applied to real life. And, applying it to real life goes a long way to putting those facts in memory. For example, knowing that low platelets can be an effect of liver failure is much easier when you've seen that Mr. X, your patient with liver failure needs to get a platelet transfusion before every procedure.

3. Talking to patients
This is actually the most satisfying part of going into the hospital. I get to spend some extra time with my patients and actually get to know them. They're pretty bored and enjoy talking to me. I feel that by spending more time with them, I get to better understand their expectations, fears and frustrations. It never ceases to amaze me how honored I feel when a stranger opens up to me and tells me everything about them.

The bads (in no particular order):

1. I'm useless.
I get to be part of a team of physicians that help make a very sick person well again, but I am completely useless. As a medical student, almost nothing I do has any consequence on the patient's stay, and the few things I get to help with, the team really doesn't need my help. Sometimes I feel like I'm in the way. The only part that makes me feel like I'm actually having an effect is when I get to relay the patient's concerns to the doctors because I get to spend more time with them (see the goods).

2. I don't know anything
This may be specific to me since I took 4 years off between finishing 2nd year of med school and starting 3rd year. I've forgotten a lot of facts. Everyone around me is nice and I haven't pimped at all, but the really easy questions that I get, I still have trouble answering. It hasn't all come back to me yet, but then again it's only been 3 days.

3. Studying
Along the lines as #2 and also specific to the fact that I took 4 years off. I've had no reason to memorize lists of facts in the last 4 years and I haven't bothered finding a good way to do it. I remember at one point in the second year of med school, I would learn the pathophysiology of an entire organ system in a week or so before the final exam. Now, I don't even know where to begin. I'm hoping this comes back to me also.

4. Of course, the hours
No matter what, I can't get used to getting up at 5 am (or before) every day. I've gotta learn to sleep earlier.

In all likelihood, these opinions will change in another 72 hours. Overall, I like internal medicine so far. I'm learning a lot and it's not completely exhausting (yet). We'll see how I feel about it as I get more into it. Stay tuned.

Tuesday, July 7, 2009


All right! 3rd year of med school officially started and with it, after another long orientation, I got my first patient. Unfortunately, because I showed up in the middle of the day, I had to pick up a patient who has already been in the hospital for weeks. This means going through a lot of charts (dozens per day, by various MDs, nurses, pharmacists, therapists, etc.) There are two problems with this: 1) I have no idea how to use the hospitals computer system and have to click around for several minutes before I can get to where I need to go. 2) So many abbreviations! I know that doctors like shorthand, but just with this one patient, there are a dozen abbreviations that I've never seen before. Some even have multiple meanings. I've figured a lot out from context: SBP = systolic blood pressure, but SBP treated with cefotaxime is spontaneous bacterial peritonitis... seems easy to figure out, but when your eyes are glazing over the 24th progress note, its easy to confuse the two. Others, I still have no idea... the google helps, but I'll just have to break down and ask someone about some of them tomorrow.

We were told that within 72 hours most of this will make sense, but I have a hard time believing that. We'll see. Meanwhile, I gotta figure out how I'm going to preround tomorrow morning (see the patient before the residents and attending physician does) and prepare myself to present my patient to the attending (focused, yet thorough - seems like an oxymoron to me).

mfp = my first patient

Monday, July 6, 2009

I am oriented (sort of)

It's finally here, the first day of third year. Today was orientation day... all day getting lectures about what to expect next year and how to survive through it. For the most part there was nothing eye-opening from the various lectures. A couple of things stood out. One was a discussion on how to get along with others in our "team" (attending physicians, residents, nurses, etc. that we are working with) and how to carry ourselves in the hospital. One administrator stated that we should remember the saying "When in Rome, do as the Romans do." To an extent, I agree with that, but not everyone in medicine provides a good example and we should judge for ourselves what is appropriate in a hospital setting and we shouldn't blindly imitate the attitudes and actions of those above us. (Luckily, another administrator quickly mentioned that we should also be a force of change to make the hospital a better place).

Along these lines, I was pleasantly surprised that the med school and hospital are largely aware that the environment of medical education isn't perfect and seem to be working to improve it. I wasn't surprised by the report (of med schools in general... not just mine) that abuse of students is fairly common. To deal with it, a recent addition to our school is the implementation of an on-line method to report inappropriate behavior or abuse by others in the hospital. The report goes to an ombudsperson who is not a physician and has no relationship with any medical department. Although it is sad that such a system is necessary, it's nice that a lowly student can bring inappropriate behavior to light without fear of reprisal by those above them (something several students I know who have gone through med school before me have complained of).

Anyway, enough with the bad stuff... Tomorrow is orientation for my first clinical rotation: internal medicine. I'm fairly excited to start (though not excited about the hours) and will hopefully be able to relate some of my experiences here (really, more for myself than my three faithful readers, but you guys might find it interesting also).

Tuesday, June 23, 2009

Well, I guess we've gotta keep it

Tapes of Richard Nixon discussing his views on abortion were released today. Here's one of his opinions:
“There are times when an abortion is necessary. I know that. When you have a black and a white,” he told an aide, before adding, “Or a rape.”

Only 36 years ago, an American president said this... amazing. Since I'm only "a brown", not "a black," I guess we'll have to keep my unborn child (which, by the way will - hopefully - be born late Dec or early Jan... I'm glad my tough med school rotations will be out of the way by then).

Death comes easy

I've seen patients whom I knew were going to die and I've seen patients who died after I was in contact with them, but recently, I saw, for the first time, a patient die in front of me. I'm not much of an emotional person, but I thought that it would affect me more. Instead, it felt like nothing. I suppose it could have been the fact that I never got to know the patient (she had been in cardiac arrest for a while before I saw her) or that it was pretty busy in the room with people performing multiple procedures and shouting various orders or that no one else seemed especially moved. Maybe I was too concerned with not messing up the small part I was given to save this person's life. Either way, I suppose a certain amount of detachment is necessary to efficiently (and rationally) treat the patient. I just didn't think that I would reach that state of detachment without even trying.

Saturday, May 30, 2009

I feel so dirty

Just came back from the most Jesus-filled wedding I've ever been to. It had everything, random quotations from the bible every few minutes, passing around of the collection plate, singing with eyes closed and hands in the air and even a poster for the "Prayer Force," that had a picture of an African refugee camp with fighter jets dropping bombs onto them (I am NOT kidding). I feel pretty dirty after this experience, so to cleanse myself, I just joined Americans United for the Separation of Church and State (my donation is dedicated to the Bride and Groom).

Friday, May 29, 2009

Returning back to med school (sort of)

Although I don't officially return to med school until July, I unofficially started med school this week. I couldn't fit a 2-week radiology rotation in my schedule during 3rd year, so I decided to do it now (since I have 6 weeks off and doing nothing). It's definitely a laid back med school rotation (yesterday, we were in at 9 - which is nearly lunch time for typical med school rotations and were done at 3) and there is no patient contact. However, it does give me a chance to assess how well I remember my facts from nearly 6 years ago. I am currently on the rotation with students who are ending their 3rd year, so they've nearly had a year of school, and as a result have experienced a lot and know a lot. But, besides the obscure disease that no one actually sees (except on the boards), so far, I've been able to hold my own (although, I guess I should wait until I see how I do on the exam before acting so cocky). Previous MD/PhDers have told me that it all comes back to you and I never believed them... but it does seem to come back pretty quickly (even anatomy). So, at the minimum this mini-rotation has helped me feel less anxious about the hard-core rotations that will come up soon (medicine and surgery are my first two).

But beyond that, it's made me realize that radiology is awesome! Since my research was somewhat radiology-related (I did use MRI's), it was a field I was always looking into. The fact that is has great hours, great flexibility, and (yeah, it's important) great salary, was really pushing me towards it. But without seeing much of it at work, I didn't really have a great reason to pursue it (other than research). Well, even though I've only had a few days of it, I'm much more impressed by the field. It really is a field that is very scientific. More than any other field, I think that the translation from basic research to clinical practice is the fastest in radiology. They already use techniques that are considered cutting edge (even for research purposes). Techniques that were discovered only a few years ago. I really like the fact that it has such a close relationship with the research side of things and the flexibility will make combining a life of research and clinical work very easy.

It's really early and I may change my mind, but so far, it looks like I'm going to continue telling people I want to go into radiology.

Saturday, May 16, 2009

There go my innocent days as a Mr.

So five (really) smart people decided that my work was good enough for a PhD... personally, I think I just overwhelmed them with the number of pages they had to read. I kind of screwed up a bit on my presentation (but, oh well, most people there had already heard me talk before and knew what I was doing). The closed door session went surprisingly easy. I did get some tough (or unexpected) questions (like "can you ever prove causation?"), but they tended to be questions that had no correct answer. I'm glad it's all over and thanks to those who attended it (like MadDR2, who is weeks away from his own defense... you'll do great, even if you mess up on your presentation like me, you'll get your PhD).

I get about 10 days off before I start med school (I am doing a 2-week Radiology rotation before med school actually starts since I couldn't fit it in my schedule later).

Anyway, I leave you with this (which, with my newly certified expertise, I can assure you is accurate)

Tuesday, May 12, 2009

Shouldn't medical professionals know better?

I was reading a blog in Medscape (a branch of webmd that focuses on medical education; unfortunately requires registration) in which a med student talks about homophobic comments made by her attendings (and how in medical settings, homophobic comments are more tolerated than racist comments). Unfortunately, racism, sexism and homophobia are as prevalent in the clinics as they are in the real world (after all, doctors do come from the real world), but I found it pretty surprising that in the poll attached to it, 84% of respondents have experienced a racist or homophobic comment in a medical setting (and even more upsetting was the fact that a third of those aren't bothered by it). Granted, this is an online poll with small numbers (and anecdotally, I've heard similar experiences from many other med students), but the fact that it even exists is not right. I know that there are good and bad people out there and there's nothing keeping a bigoted asshole from becoming a doctor, but it saddens me to think that people in a field that is devoted to caring about others can see nothing wrong with hating someone just for who they are.

Wednesday, April 29, 2009

It's done!!

Five copies of the dissertation > 1 beer

I just turned in my dissertation to my committee. Six months worth of writing and 340 pages certainly took its toll. Strangely, I still feel like I haven't completed my research. Oh well... now I have two weeks to sit on my ass and make a semi-decent presentation.

One thing I've realized in the last few days is that after 4+ years of research, I'm finally comfortable where I am. I know how things work in my lab. I like the research, and I've got about a million other experiments that I could do. I feel bad that I'm leaving this comfortable nest and moving to the strange, new world of med school. Oh well, if I've learned anything in life, it is that as soon as you get comfortable with something, you move on to something new and scary.

Monday, April 27, 2009

Compulsory medical blog swine flu posting

To tell you the truth, I haven't been following the swine flu epidemic (pandemic?) too closely (too busy trying to finish up that dissertation), so I'm not going to comment on it much (see here and here for the important, life-saving info). One thing that this highlights, though, is how easy it is for the media to scare the public. I'm not saying that it's not warranted now, but the media's tendency for wild speculation will probably end up making things worse, rather than better.

Update: My drug dealing wife (pharmacy student) says that lots of health professionals were calling in today asking for prescriptions of oseltamavir for their family members... lame.

Monday, April 20, 2009

Chiroquackery #1?

I love Consumers Union and their magazine Consumer Reports. They are a great, not-for-profit, unbiased organization fighting for consumer protection and they independently test the quality of various merchandise. But, they have a terrible habit of using surveys to rate things that cannot be directly tested in their labs. So, the results come up completely misleading. In this month's issue they made the claim that the best treatment for back pain was going to a chiropractor (59% were happy), followed by going to a physical therapist, in third place was acupuncture and way down in the bottom was going to a physician (a mere 34% happy). They sent surveys to a lot of people, but with a vague topic like back pain, basing your ratings by only asking "How satisfied were you with your treatment?" can only result in a meaningless outcome. They have no controls about severity of pain, underlying disease, number of visits or compliance with the prescribed treatment. Also, maybe people who have already made the decision to go to an acupuncturist or chiropractor are more likely to report having a satisfactory experience no matter what the outcome. Maybe people who see anyone once a week for a year will feel better than someone who, at most, sees someone a few times a year for their pain. The efficacy of pain treatment is extraordinarily difficult to measure. A simple survey is far from adequate. Consumers Union should know better (after all, they've got a team of statisticians). They are a very influential organization and this report is giving undeserving ammo to quacks (who are already pimping it) and terribly misleading their readers. Stick with crashing cars and breaking washing machines!

Thursday, April 2, 2009

Badmouthing the Med School

Over at Science-Based Medicine (great site), there is a post by a medical student about his/her concern with a mandatory assignment to a clinic that promotes alternative medicine (things like acupuncture to "control post-partum bleeding" and cupping). This is an unfortunate situation that is creeping into many medical schools (including mine). Dr. Gorski has a great response to the student (document everything, find other students/faculty members who feel the same, then make a formal complaint to the dean). One thing, though, that caught my eye was the following:
Unfortunately, Student X informs me that the dean censors anything said by medical students on blogs or online forums that might bring the medical school into disrepute. Were I to name his medical school and it ever became known who had complained to me, the consequences are likely to be unpleasant.

Is this legal? From the terrible experiences several med students I know have had, my plan, after returning to med school, is to document my experiences (good and bad) here, on this blog. If there's anything that the medical school does that may give it a bad reputation, they should fix it, rather than threaten their students and attempt to hide it from the public. I don't know what the official stance of my medical school is (and I don't plan on asking either), but I don't intend on holding much back.

Wednesday, April 1, 2009

Change o' Name

As fun as gamma band is, I decided it's a bad name for the blog. My research is coming to an end in a few months (it focused more on the alpha band, anyway) and I have no idea whether I'll be working on the same type of research when I come out of the other end of med school/residency in 6 to 8 years. So, I've renamed the blog, "Irrelevant Process." It still relates to my research (actually, it relates more to my research than gamma band) and it is general enough to accommodate the wildly varying topics of my posts.

Friday, March 20, 2009

Getting away is fun

I just got back from a few days in England. It was nice to get away (although, I didn't totally get away since I gave a research talk - one in which I got viciously attacked on some minor points). What was really nice was getting away from the news. I think it's good for me to pay less attention to all the craziness in the world... I will try to avoid it as much as possible from now on.

Oh, and for your entertainment here are some signs that may not have the same meaning in American English as British English:

In Windsor, near the Queen's home

In Hackney, London (voted the worst place to live in the UK)

In Oxford (No, I didn't try it - I was afraid of what 80% meat entails).

Tuesday, March 10, 2009

Remind me not to drive in Texas

In many states it's legal for the local police to seize property of criminals in their jurisdiction. This is meant to encourage local law enforcement to catch drug runners (who have nice cars or lots of cash on them) by letting them keep the booty they find. Unfortunately, some jurisdictions decided that it's a great way to steal things from minorities. They threaten the people they pull over (with bogus charges like "driving too close to the white line"), get them to sign over their property and never charge them with anything. Of the 40 people contacted by the attorney of one of the victims, 39 were black. It's not just a few bad cops, they have the whole system set up so that they could quickly seize valuables from whoever they pull over:
The process apparently is so routine in Tenaha [TX] that Guillory discovered pre-signed and pre-notarized police affidavits with blank spaces left for an officer to describe the property being seized.
It is absolutely sickening that this can be happening. The mayor (the only person who's responded to calls) says "We try to enforce the law here." Go to hell...

Hopefully the lawsuit currently against the city goes somewhere.

Saturday, February 28, 2009

We don't care if it's against your conscience

Looks like the White House will be reversing Bush's federal conscience clause rule. This move makes me more optimistic about the direction Obama is taking us. I often fear that he gives into the other side too much (especially, the religious side) and with his support of faith-based initiatives, I didn't think he'd do much about the conscience clause. This is great, but a lot of states (.pdf)* have their own conscience clause rules.

BTW, the caption of the picture on the article I linked from the Washington Post, has some reverend talking about how this "raises skepticism about the White House's talk of common ground." It seems to be the right wing's MO now... 1) Whatever Obama does, be against it. 2) Complain that whatever Obama is doing is anti-bipartisan.

*Wow, according to this, West Virginia has the least restrictive conscience rule (almost heaven?). Healthcare providers can't even legally refuse to participate in abortions.

Friday, February 27, 2009

I wonder if it helps their depression?

Apparently crocodiles can find their way back to their territories even if they've been moved miles away using the Earth's magnetic field. So, to keep them from returning to their former, human-inhabited territories, Florida officials take them deep into the swamp and attach magnets to their heads, making them lose their sense of direction. Cool, maybe next time I go to Florida, I'll bring a TMS machine with me (or at least a magnetic therapy bracelet).

Thursday, February 19, 2009

Buy more beer

According to Nate Silver alcohol sales (mostly beer) are down almost 10% in the last quarter. That's the most by far in the last 50 years (the previous low was 3.7% down in 1991). Not sure why people aren't buying beer anymore, but if there's any sign that we're entering a deep depression, that's gotta be it. How do you deal with a depression without beer?

Wednesday, February 4, 2009

Oh no... quackery counts as medical education

Here's a recent "opportunity" from our medical school:
Traditional Chinese Medicine Rotation—Preliminary Announcement

I am pleased to announce that we are again able to offer a rotation in traditional Chinese Medicine (TCM) during the Spring of 2010. This month-long rotation is possible through the exchange program between the Department of Family Medicine and FuXing Hospital in Beijing. In addition to didactic instruction in the principles and techniques of TCM (acupuncture, massage, herbal treatment), students will observe how TCM is practiced in Chinese community health centers and hospitals. Limited hands-on training in acupuncture and/or massage may also be provided.

Now that (yet another) scientific review says that acupuncture is nothing but a glorified placebo effect (and I won't even bother with the rest), aren't there more important (more proven) medical techniques that medical students should be educated in? Does the medical school really think that spending an entire month (of the mere 18 months of clinical rotations that makes up an MD) on traditional (i.e. fake) medicine will really add to their students' educations? Come on medical educators... you can't teach your students about evidence-based medicine and then allow this to count as a month's worth of credit at the same time.

Wednesday, January 28, 2009

For those who'd rather have measles, diphtheria, pertussis, polio ... still around

There are too many otherwise intelligent people risking their kids' lives by buying into the unfounded idea that vaccines cause autism. It's one of those issues that, for some reason, makes proponents blind to any chance of actual reasoning. I get upset with it too easily (after all, I pretty much consider it child abuse) to be very patient with the anti-vaccine crowd. However, a fellow MD-student at her blog, Heal Spiel, has an amazing rebuttal to an anti-vaccine proponent. Glad to see support of reason in the medical field.

Tuesday, January 20, 2009

It's against my conscience

Our former (yay!) president's administration really pushed to make conscience clauses for health professionals a federal law (and unfortunately, they succeeded). This lets healthcare professionals avoid treatment, misinform and pressure patients using the excuse of "It's against my conscience." The goal of the proponents for this is obviously to limit access to reproductive services like contraception and abortion, and there are enough nuts in medicine that it has already become a problem. The most common problem is physicians not informing their patients of the option of abortion (or refusing to refer them to another physician), pharmacists refusing to fill Plan B or birth control prescriptions. But it could get even worse, it may protect healthcare professionals when they remove birth control devices, refuse to treat LGBT patients like straight patients, refuse to treat someone based on the hunch that she might have had an abortion, or even refuse to drive a seriously ill patient to the nearest hospital because it performs abortions. It is an amazing disrespect to the autonomy of the patient. It goes against the objective healers healthcare professionals should be... and it deeply disturbs me that there are so many people in my future profession that see no problem with it (or rather, welcome it).

Hopefully our new president (yay!) will reverse the worst of it, but the nuts are out there and the politicians are on their side (many states have had their own conscience clauses for a while). I think what people should do (spread the word my two loyal readers) is to proactively question their healthcare providers about their beliefs on sensitive topics like abortion, contraceptives, ending life support, etc. If they say something you don't like, find someone else to treat you. It's better to find out by asking them now, then later when its already too late (plus it sends a nice message to the medical community).

Thursday, January 15, 2009

Magnetic Quackery

I was browsing through a book store a few days ago and I came across Kevin Trudeau's line of Natural Cure's They Don't Want You to Know About books (I must have been in the convicted fraudsters section). I usually see Kevin Trudeau on late night TV raving about the benefits of some untested treatment or another that "they" (hey that's me) are hiding from you. He's made millions and the gullibility of the American public is demonstrated by the fact that his books are always on a best seller list. Anyway, I thought I might get a laugh if I saw what's inside. I turn to a random page and what do I see? Magnetic therapy!!! Being an expert in training in real magnetic therapy, I started reading. Alas, it wasn't the 2 Tesla focused rapid brain stimulator that I work with. He was talking about wearing a small magnetic bracelet around your wrist for treating pain (and if I had read further I'm sure he would have said it will cure your heartburn, get rid of that tumor that's been bothering you and make you have a better sex life). This isn't the first time that I've encountered this form of "therapy." Several times when I've told people that I research magnetic brain stimulation, the response has been, "Oh, I know. It's like those magnetic bracelets!"

Well, I'm here to say that this:

does not work.

Let me quickly tell you why. Although our bodies have molecules that could potentially be affected by magnetic fields, biological tissue is amazingly unresponsive to static magnetic fields. The device pictured above (which you could have for a mere $17.95+sh) according to the manufacturer (if we actually believe them) contains 2 x 1000 Gauss static magnets. Magnetic fields aren't additive so let's say we're working with 1000 Gauss (or 0.1 Tesla) - though a JAMA article actually measured their surface field strengths and found them to be more like 30 to 250 Gauss. The problem is that a 0.1 Tesla static magnet (about the strength of the magnet in a small speaker) doesn't do anything to tissue. The magnetic therapy proponents say things like it affects your circulation by interacting with hemoglobin or it stimulates nerves (if they don't first say it aligns your chi). But nonetheless, valuable tax dollars were spent to test the claim that magnetic therapy is a natural cure that we don't want you to know and several studies (here are 4: 1 2 3 4) have found that it's no better than placebo at treating pain (their main use). The reason why magnetic brain stimulation works is that a very large magnetic field (around 2 T) is being delivered over a very short period of time (<250 microseconds). It's this rapidly changing magnetic field that affects biological tissue (induces current). Even then, unless you get it at the right intensity, frequency, target, angle, duration, etc, it has very subtle effects. So, unless the magnet on the bracelet produces a rapidly changing magnetic field (and if it did it would cost way more than $17.95 and would probably not be so portable), it won't do anything to nerves and it won't treat pain.

Tuesday, January 13, 2009

FTC regulating drugs?

Well, actually, they're regulating fake drugs (i.e. untested herbal supplements). I saw this on Terra Sigillata at Scienceblogs and I must say, I applaud their efforts. The FDA regulates real drugs, but "supplements" are not under their jurisdiction. It's a multibillion dollar industry that (with a few exceptions) at best only wastes peoples money. But companies claiming that their extracts can cure cancer or treat diabetes are putting people's lives in danger. It looks like the federal trade commission has stepped in to stop the worst offenders. Hopefully this trend continues and "supplements" end up getting some real regulation.

Saturday, January 10, 2009

Is it the future, yet?

Every movie about the future includes flying cars. I was promised that we'd have flying cars by 2000 and was sorely disappointed. Well, looks like 2009 might finally deliver. There's a company that's promising it by late this year. For a mere $194,000 (they're taking deposits now) you, too, can play your part in taking us into what I was promised would be the 21st century.

I wonder if it comes with it's own TSA agent.

Wednesday, January 7, 2009

No Hay Nadie Como Tú

Watch more Los de atras vienen conmigo videos on AOL Video

Ha sido un gran 2 años, mi amor.