February 24, 2012
maker of heaven and earth
God is so cool: (from http://www.apologeticspress.org/apcontent.aspx?category=13&article=1118)
Q.
In Genesis 17:12, God commanded Abraham to circumcise baby boys on the eighth day of their lives. Why day eight? Is there any good, scientific rationale behind such a command?
A.
In Genesis 17:12, God specifically directed Abraham to circumcise newborn males on the eighth day. Why the eighth day? In 1935, professor H. Dam proposed the name “vitamin K” for the factor in foods that helped prevent hemorrhaging in baby chicks. We now know vitamin K is responsible for the production (by the liver) of the element known as prothrombin. If vitamin K is deficient, there will be a prothrombin deficiency and hemorrhaging may occur. Oddly, it is only on the fifth through the seventh days of the newborn male’s life that vitamin K (produced by bacteria in the intestinal tract) is present in adequate quantities. Vitamin K, coupled with prothrombin, causes blood coagulation, which is important in any surgical procedure. Holt and McIntosh, in their classic work, Holt Pediatrics, observed that a newborn infant has “peculiar susceptibility to bleeding between the second and fifth days of life…. Hemorrhages at this time, though often inconsequential, are sometimes extensive; they may produce serious damage to internal organs, especially to the brain, and cause death from shock and exsanguination” (1953, pp. 125-126). Obviously, then, if vitamin K is not produced in sufficient quantities until days five through seven, it would be wise to postpone any surgery until some time after that. But why did God specify day eight?
On the eighth day, the amount of prothrombin present actually is elevated above one-hundred percent of normal—and is the only day in the male’s life in which this will be the case under normal conditions. If surgery is to be performed, day eight is the perfect day to do it. Vitamin K and prothrombin levels are at their peak. The chart below, patterned after one published by S.I. McMillen, M.D., in his book, None of These Diseases, portrays this in graphic form.
Dr. McMillen observed:
We should commend the many hundreds of workers who labored at great expense over a number of years to discover that the safest day to perform circumcision is the eighth. Yet, as we congratulate medical science for this recent finding, we can almost hear the leaves of the Bible rustling. They would like to remind us that four thousand years ago, when God initiated circumcision with Abraham….Abraham did not pick the eighth day after many centuries of trial-and-error experiments. Neither he nor any of his company from the ancient city of Ur in the Chaldees ever had been circumcised. It was a day picked by the Creator of vitamin K (1984, p. 93).
Moses’ information, as recorded in Genesis 17:12, not only was scientifically accurate, but was years ahead of its time. How did Moses have access to such information? The answer, of course, is provided by the apostle Paul in 2 Timothy 3:16—“Every scripture is inspired of God.”
February 16, 2012
babies
Awkward moment of the day: I run from the parking lot into Labor and Delivery cause there’s a scheduled C-section I don’t want to miss. I say hi to Dr. C who I’m supposed to shadow but he just stares at me blankly. I stare awkwardly back. I say: “Dr. W sent me over for this afternoon, didn’t he tell you?” Dr.C: “Nooooo.” Me: “Oh…..” Then really awkward pause. And there’s two people watching as this goes on.
Anyway, not sure if he really wanted me there or not, but I got to see my first C-section! It’s really quite indelicate, actually the entire birthing process is indelicate, whether vaginally or not. You would think that with a baby you’d need to be extra careful when handling, but its really more like a yank and pull out kind of thing. I didn’t realize how blue the baby is when its first born. Then once it starts to breathe you can see it turn pink pretty quickly–so cool! But watching it from a medical perspective, all gowned up and with a pair of scissors in my hand, kind of destroys what you think would be a magical moment. It’s almost too sterile on my side of the blue curtain. And it all happens so fast too: one minute there’s no baby, and the next, voila it’s here! The work is all done by the OB, mom really has a very little role to play, unlike in a normal vaginal delivery. I think something about the pain (or at least effort, since so many people get epidurals) of labor, the (more) slow process, and the fact that its such a primal and unchanged process since the beginning of time lends a normal delivery to retain more of that “miraculous” aura. At least, that’s my observation from 1 vaginal vs 1 caesarean delivery.
Speaking of which, I never really put great thought into it but I’d always envisioned my future labor/delivery of my kids to be super painful, just cause that’s the way it always was. But last time I was on L&D, a woman was delivering sans any medication, and I could hear her screaming loud and clear from the nurse’s station. I think that scared me enough into definitely wanting to get an epidural.
February 6, 2012
how much longer…??
Finished 4th block last week, now on to the 5th. It’s only Monday and I already feel so drained (from residual tiredness of last week, when it was uber-test time). Auaughhhaaah. I just want to face-plant in my books and hide under the covers until this is all over. Poop. I can’t.
At least we’re doing female reproductive now. It’s probably the section I’ve been looking forward to most all year, but after today’s lecture, I’ve decided that pictures of vulvar cancers are probably the most disgusting things ever. Honestly, neither a female nor a male’s private areas are all that nice looking (not in the same way someone’s, say hands or eyes, might be beautiful). Frankly sometimes they make me gag. If people really took a good look at each other in those areas, I wonder if they’d even want to have sex.
Is it ironic, then, that I still find OB/GYN vastly interesting? I think as much I get grossed out by things, its still like a “ewwwwooooooh cool” kind of thing.
February 4, 2012
Went to Indy with a friend tonight to check out the SuperBowl goings-on and almost got trampled by an extremely rowdy crowd. Seriously…what is it about beer and football that make people crazy? Pics on fb if interested (not of the crowd, unfortunately). This is probably the one and only time Indiana is going to get this much attention. Whee Hoosiers!
January 26, 2012
interesting patients i saw today
- 1st woman looked like she was on drugs, and when taking her history, she openly admitted to smoking marijuana. “To help her sleep” she said, and apparently she gets her supply from her kids. Plus, the reason she was in was for dyspareunia (pain with intercourse). That’s a pretty common complaint, but her husband had just passed away 2 months ago. As my doc said (not in front of her of course), she’s “back in the saddle” already.
- Another came in with intense abdominal pain, poor thing. She was practically writhing on the exam table and I felt so bad for her. It was the first case of real rebound tenderness I’ve seen though, which was super cool (that’s when you press down on the belly then let go, and the patient screams in agony). A positive sign equals peritonitis, so she had pelvic inflammatory disease and we shipped her to the hospital for IV antibiotics. I’m gonna round on her tomorrow to see how she’s doing.
- A morbidly obese woman (according to her BMI, and it actually says that on the chart) came in complaining of itching and tenderness in her vagina. Actually, she outright said she was thinking it might be STDs. So we probed more into that history and found out she had been seeing multiple partners at once. (My doc later turned to me and asked “wonder if she had them at the same time”…LOL. He’s so inappropriate sometimes but its hilarious.) I got to do a pelvic exam on her…getting better at feeling for cervices! Turns out probably not STDs, maybe just yeast infection, but incidentally we also found a disgusting looking abscess on her mons pubis. I asked her if she had noticed it before, and she was like “when you’re this fat you can’t see much down there”. Heh…true I guess. Possibly staph infection.
- Then saw a 23 year old whose IUD had popped out a while ago and wanted to talk more about oral contraceptives. Actually, nothing too interesting with this patient, but as I rarely get to see women younger than 30 (my doc does only GYN now so its mainly menopausal women with things falling out of their vaginas. For serious, that’s what can happen when you get older…), a youngster was refreshing. Although the fact that she was younger than me and talking about sex was kinda weird, but I got over that quickly. You become desensitized to a lot of things in the medical world.
But yeah…southern Indiana farm country (that’s where most of the above patients came from), that’s where its at. Drugs, Medicaid, and obesity — you can practically write that on everyone’s chart. Bloomington is actually the largest hospital in practically a 2+ hour radius so we get all of those cases. Made for an interesting afternoon.
January 16, 2012
st. vitus trauma
Had our annual med school formal this weekend, titled St. Vitus Dance. This name is both apt and quite medically nerdy. When we looked up the etymology of the word last year, we found out that Saint Vitus is known as the patron saint of actors, dancers, and epileptics. Interestingly enough, there’s also a medical condition called St. Vitus dance (aka Sydenham chorea), one of the key diagnostic symptoms of rheumatic fever. I’m sure many people who observe modern-day dancing would say its not so far from an epileptic fit.
Anyway, not much to report on the dance itself. Sorry, no (good) pictures to prove I was actually there. Rather, all the excitement happened post-dance at the after party, and unfortunately at the ER. I heard this all second hand, as I was actually passed out (as in asleep, not blacked out) in the hotel room in an alcohol-induced stupor. So one of my friends JLC decided she wanted to ride the mechanical bull at the bar where the after party was taking place. (First of all, WHY would anyone decide to put a mechanical bull in a place where people are crazy drunk and bound to make poor decisions!??) She fell off, as everyone does, but in an attempt to hang on, she got smacked in the face by the bull. My other friend, ST, was there with her and thought she would be ok — no loss of consciousness, vision was ok, no obvious signs of damage. But head trauma can be pretty serious, so they went to the ER anyway. On CT, they found she had fractured THREE facial bones! And there was blood in her maxillary sinus. That’s serious stuff for real. When the rest of us heard about it, we were of course super worried, but I think we show our stripes as med students by the fact that after we finished our chorus of “omg, will she be ok??”, our next question was “so which bones did she break??” Like I even remember all the bones in the face…pshhh. Plus, I can only imagine the almost farcical situation of a group of medical students hobbling into the ER of the hospital where WE will be taking care of patients next year, with the chief complaint that one of said med students got smashed in the face by a bull while drunk at the med school formal. What’s that they say about first impressions? Oops… Oh dear future colleagues, please don’t hold this against us.
So, lesson learned from this situation: don’t ride a mechanical bull. Or if one must, at least do it sober.
January 13, 2012
bend over, elbows on the table
That’s what they say when you get a prostate exam done. And I got to do one today! First time getting my finger near that part of the anatomy, but it was pretty neat as one guy had prostate cancer and the bump(s) are quite obvious. I felt bad for the poor guys who had to have 18 fumbling medical students poke around their bums, but supremely grateful for people who are willing to contribute to our education like this.
January 10, 2012
I’ve noticed I’ve become more inclined to curse now. I don’t think its necessarily because people around me do it all the time (although that may be part of it), rather some of my feelings just seem more properly conveyed with that vocabulary. Example: previous post title “stuff is getting real” just doesn’t have the same effect or convey the same level of exasperation/trepidation as “shit is getting real”. Right? Not using this as a defense of cursing, just noting an observation.
stuff is getting real
We had a third year come talk to us tonight about what to expect/how to schedule for next year. What with being so excited to leave book studying behind me, I guess I never thought about how tough 3rd year would be physically. The girl who talked to us said that for her surgery rotation, her work days were 4am to 9:30pm!!!! Six days a week!!! OH. EM. GEE. That’s like banking hours, maybe even worse than banking hours. I get incredible lower back pain if I stand for too long, so I scared to think how my body is going to take this next year. Plus, I never even pulled an all nighter in college, so I don’t know how I’m going to handle the 24 hour shifts+calls. Holy crap…I hope I’m not constantly stress-sick next year.
Still super excited inspite of this though.
January 6, 2012
I got my hair cut yesterday because it was in serious need of a good trim. I’ve never had really good luck with stylists before so I tend to bounce around to different salons trying people out. The ONLY time I felt like I had finally found someone I trusted with my hair was the end of this summer in New York…but of course I was leaving the city so that relationship didn’t even get off the ground. And really, finding your own stylist is like finding a good husband — its hard!! So I went this nice salon in Bloomington, thinking that part of my problem before was that I was too cheap to pay for a good haircut. But after forking over the most money I’ve ever paid for a cut, and with an Asian stylist too (I don’t trust white people with my hair…its not a racist thing, Asian hair is just different), the result it that I look like a hermaphroditic Asian FOB. SHE CUT MY BANGS TOO SHORT. I wanted side bangs, the kind that sort of hides your eyes but you can tuck behind your ear, but instead they’re like ACTUAL bangs. I used to wonder what I’d look like with bangs, and now I know…not flattering at all. I really look like a boy. Especially since she thinned out the bottom too so it looks more full in the top than bottom. I have never been so annoyed after a haircut…. I’m almost desperate enough to go back to New York to see Edison (he’s my love at first sight stylist).
Oh, and we have our med school formal next weekend so now I have to figure out how to salvage my hair. Was just going to leave it down but now I’ll just look retarded. Greaaaat…
