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

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.

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.

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.

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.

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.

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.