Charlie goes to Medical School

Another writing sample from the old blog:  An example of one of the few times where I tried chasing down an answer from a teacher or a teaching assistant.  Usually, I try not to bother anyone because I don’t want to be one of those students who chase down half points at the expense of the professor’s time.  However, if I research the problem on my own with no results, I then feel that it is okay to go to the professor or TAs out of interest in understanding the subject.

This was one of those times.  The question wasn’t directly out of the material which lead the TAs to misgrade the quiz.  There was no explanation on the regrade, and I genuinely wanted to know.  Then there was a sense of acheivement after holding my own in a conversation about organic functional groups and wet chemistry.

And then the agony of knowing that I’m still an idiot.  Anyway, here’s a repost of the story from the old blog.

Great Moments in Charlie History!: Science Camp Redux

A nice little incident the other day has spawned a new category of posts. I won’t describe what the category is really for, but you’ll see when you finish the story:

After getting back some lab homework in O-Chem, I noticed that I had a problem marked wrong and then the points given back to me. I had said that to tell the difference between a carboxylic acid and an amide was to use a litmus test. One is an acid (obviously) and the other is a base.

When I asked the TAs, they didn’t have an immediate response and then suggest a few wet chemistry tests that organic chemists use to test carbonyl compounds, but none would actually differentiate between the two. At one point, one said that a carboxyl might respond to a Jones test, to which I said that no, a carboxylic acid would already be oxidized and would not respond like an aldehyde. Another suggestion was that 2,4-DNP would react with the ketone in the carboxyl, which caused a bit of confusion until I reminded the TA that ketone and carbonyl were not interchangeable functional groups (a ketone is a carbonyl attached to two sp3 hybridized carbons).

We finally went to ask the professor what the appropriate test would be, and she said that litmus would be the first test she would use. I nod, thank them all for their time, and say that I just wanted to know what to put for the final. I, however, am also a little smug that I had gotten a chance to show some TAs and professor that I think about this stuff, care, and generally know what I’m talking about…with regard to chemistry.

I then walk through the lab, grab my backpack, and try to walk through a locked door.

When it didn’t open, I redoubled my efforts.

Then there was a flash back to a summer science camp that I went to in high school where half the students owned the Far Side shirt with where the kid is trying to enter the school for the gifted by pushing on the pull door. They all thought that was very ironic. I thought that it was cautionary.

I pulled my shoulder off the door, checked the lab to see if anyone was watching me, and then exited through another door.

This doesn’t come close to deserving its own post, but today I worked on getting my transcripts to my future school.  Why?  Because they emailed me about it.  It was just a reminder, but I figured quick action would be prudent.

Transcripts aren’t a huge part of the process, but you will need a copy to fill out the AMCAS and an official copy to send for verification.  They will check against the transcript, so copy it as close as possible if you are filling this out.  The school where I am going has asked for grade updates since the AMCAS application, and also wants official transcripts now to verify that I completed everything that I was taking.

I did notice one new thing about this.  The school where I got my undergraduate degree has now started charging for transcripts.  I had known that my current school did charge after a certain number, but had thought that my old school still gave them out.

I admit that I have made some extraneous use of free transcripts in the past (at one point I had like 2-3 extra sealed copies which however did eventually get used appropriately).  However, having to shell out for college transcripts can be a bit of an inconvenience.

This is especially true for Wife who is now applying for jobs.  Five to ten dollars a transcript isn’t a lot…unless you are applying for 10-15 jobs and each wants a transcript up front.  Sometimes, employers will extend the courtesy of accepting an unofficial copy and waiting until a job has been offered to ask for an official transcript to verify.  However, a lot of employers still want to see these up front.

It seems like what you pay for with this is a certain guarantee that what the interested party sees is official and correct (i.e. not tampered with).  However, these days special printers and paper aren’t that hard to come by.  Plus, you never know when the printer ink you use is susceptible to some kind of solvent or other hack (read Catch Me If You Can).

Really, the official transcripts should be cheap and readily handed out, but verifiable online at a secure site.  That way the cost of applying to multiple jobs or positions does not have to be prohibitive, but the assurance that the information is correct is still there.

For example, you could give out a PDF file of a transcript, then store another copy on the school’s server.  When an employer wants to verify it, they go to the site (which you would want to register with people so you get the verification like you would with a bank…the green bar on firefox to the left of the url) and put the PDF file and a student ID into an online form.  An MD5 check can tell you if the file has been altered.

Oh well.  In any case, I just bought the last transcript that I’ll need for a while.

I’ve got two finals today, so here’s some material to read while I’m busy.

WHO – Pandemic Phases

CDC – Pandemic Phases

This is a description of the phases of a pandemic.  Although this is just a model, there are some things that I’ve noticed at first glance.  First off, these are based on an animal-human species jump.  While animals are a common source of emerging diseases, occasionally there are other sources (e.g. salmonella and fresh produce).  Secondly, the verbiage appears to not account for globalization enough.  The fact of the matter is that with most diseases there is an incubatory period during which there are no symptoms, and for more and more diseases you can now get from anywhere in the world to anywhere in the world before any symptoms show up.

The swine flu has demonstrated a more modern model of dissemination where the disease was identified, the people worldwide start looking for it, and then we start seeing the map fill out.  The effort at that point becomes tracking the localized spread on a worldwide basis, i.e. local public health efforts coordinated through national and international organizations.  However, this is all based on my junior level microbio class.

Anyway, the watchword has been concern, not alarm.  And it still should be.  The map is filling out quickly, but only because we know what to look for.  Enjoy some reading while I venture out into public and breathe a lot while taking my tests.

I’ve got my last two finals as a post-bacc tomorrow.  I was working on a post on immunity, but I need the study time.  Anyway, everyone involved in finals, have good luck.

So, I have just learned my first lesson…put the name of the new flu strain in the post title.

News outlets are already referring to this as a pandemic and rightfully so.  There are reported cases in Canada and New Zealand as well as Ohio now.  I’ve also heard Hong Kong and Spain.  Although these are somewhat isolated cases, this does paint the picture of an emerging infectious disease in the modern age of globalization.

However, this is all off the internet.  I suspect there will be some major announcements made tomorrow when more people are listening.

Here’s a google map aggregation of the reports.  Here’s another one…the RSOE Emergency and Disaster Information Service alert map…but that one has everything.

Edit: Here’s another RSOE site.

New Flu Strain Appears In the US and Mexico (via Slashdot)

Bullet points:

• The Flu is a segmented RNA virus.  This means that it’s genome is broken up into 7 or 8 pieces.
• Bird Flu is particularly virulent, but does not typically spread through respiratory methods because its reservoir is in the GI tract.
• When people are concerned that the Bird Flu could become airborne through mutation, this is not really the case.  The concern is that one organism could undergo concurrent infections and these pieces could shuffle.  The concern is that the virulent strain gets the ability to pass through respiratory methods.
• It is believed that this was the case with the 1918 flu epidemic.
• Swine flu is believed to contain portions of bird, swine and human influenza strains.
• They are referring to this as H1N1 Swine Flu where H1 and N1 refer to the specific type of hemagglutinin and neuraminidase surface proteins on the virus envelope.

…

• It is unlikely that a scenario like 1918 would ever occur again with a virulent flu virus.  Just to show how much our understanding of diseases has grown, at the beginning of the 20th century the germ theory of disease was not taught at every medical school.  Tobacco Mosaic Virus was the first virus to be discovered only 20 years before.  Back then, most people didn’t know what a bacteria or a virus was.
• That being said, this is being considered a public health emergency by the WHO and measures are being taken.  Mexico City is starting to shut down schools and public events and such.  I would expect travel advisories and such.
• For the time being, the concern here has been localized to the US-Mexican border.  However, Kansas has confirmed two cases and New York has eight suspected cases.
• Given the media coverage that the flu gets every year, the general public probably knows what the “flu-like” symptoms are.  If you are running a fever with cough or a runny nose in the areas of concern (TX, CA, etc.) you should contact your health care provider.  Other symptoms are aches, nausea, vomiting and diarrhea.
• The demographics for this outbreak are very different than normal flu outbreaks.  Typically the flu affects the very young or very old.  The majority of people being affected by this outbreak are otherwise healthy adults.
• Based on the numbers in these reports, mortality looks low compared to H5N1 which typically results in death around 60% of the time (from Wikipedia).  But again, these are the numbers in the reports that I’m just looking at (~60 suspected deaths, ~1000 suspected cases…these obviously are not official numbers).  However, if the majority of those affected are otherwise healthy adults, I would expect this ratio to rise once as the disease spreads and other demographics start becoming infected.
• There is human to human spread of this disease, but the main thing that is not known is how easily this is spread.
• There isn’t a vaccine and there won’t be one for a while.  Flu vaccines are slow to produce.
• Preparations for H5N1 have helped prepare for identifying and containing this outbreak.
• Here are some pages with information about the outbreak and prevention: CDC – Swine Flu, WHO – Swine Flu, CDC – Prevention, PandemicFlu.gov
  

Given that this has already crossed the border and that epidemic and outbreak basically mean the same thing (a higher number cases than usual), you could technically call this a pandemic.  However, they typically don’t use terms like epidemic and pandemic during the outbreak to keep down unnecessary panic.  The most annoying question that you will hear in media coverage is going to be “Can we call this a pandemic now?/When can we call this a pandemic?”  Mass media makes a lot of their money on panic.  However, there is reason for concern, and people are working on it.

Anyway, don’t run for the hills.  Stay informed, know what to look for in symptoms and practice good hygiene to protect your self.

Keep in mind that most of the deadliest diseases on this planet are the ones that you never hear about.  You’ll probably hear about this ad nauseum, but there are diseases like Tuberculosis and Malaria which never get reported about.  There is cause for concern which is why there are good people working on this and why you should stay informed.  Just don’t go buying into all the hype that is going to get put out there.

One thing I’ll have to get into here is Insomnia.  There are a lot of triggers that can cause it.  Tonight, I took a migraine nap at 7 after taking a couple of migraine medicines which contain caffeine.  Caffeine consumption later in the day and napping are two key things to cut out if you aren’t falling asleep at night.  More on this later some other sleepless night (or morning).

Among my current courses, I am taking the freshman level Human Anatomy & Physiology course with lab.  The original reason was to work on my memorization of anatomical structures.  And with good reason.  There are a lot of things and stuff in the human body.  Lots.

The unintended consequence was that I also started getting forced to understand not just the basic physiology behind each organ system, but also understand how they interact.  A very basic, but fundamental lesson in medicine.  Especially in light of the fact that most medical schools are now reworking their curriculum to be taught from more of an integrated perspective.

So how do you wrap up the end of the second semester of A&P?  With a case study on something that hits as many systems as possible.  Diabetes was what we got, and rightfully so.  More to the point, type 1 diabetes mellitus and resulting complications.

How does diabetes affect most of the systems of the body?  The usual diagnosis occurs when people start noticing symptoms, weight loss and feeling tired.  However, another key symptom is an increase in the frequency of urination as the kidneys try to get rid of the excess blood glucose and relieve high blood pressure.  Additionally, you will tend to see an increase in water intake as the increase in blood osmolality (from higher amounts of sugar in the blood) will stimulate the brain to create a sensation of thirst.

Where you really start to see the reach of diabetes across the human body is in the complications from periods of hypoglycemia and hyperglycemia over the life of the individual.  What is probably the most damaging is that Diabetics are prone to hypertension which can lead to damage to capillary beds and blood vessels leading to retinopathy, nephropathy and coronary heart disease.  As well, hypertension can cause cataracts and glaucoma.  Additionally, the periods of low blood sugar can cause damage to neural tissue, especially in the outer reaches (the body likes to protect its center), leading to peripheral neuropathy.

During periods of tissue starvation, either hypoglycemia (low blood sugar) or hyperglycemia (no insulin in blood), the body will resort to abnormal metabolism processes.  This results in beta oxidation of fats and transamination of proteins.  The result is the introduction of metabolic intermediates into the blood including ketones and acids.  The nervous system is particularly in jeopardy here as the brain needs glucose (and only glucose) to survive and can only get by (in a very not-okay way) on the ketones.  This condition is known as diabetic ketoacidosis.

There are systems we haven’t mentioned hear.  Obviously digestive has a large role here.  Respiration is affected by blood pH.  Reproduction is affected as pregnancy already puts a large strain on the heart, much more so in a diabetic, and hyperglycemia in the mother can lead to increased birth rate.  We haven’t covered every system, but you also have to consider that the effects of things like hypoglycemia are system wide.

So, there you have it.  Diabetes affects everything.  But then again, that is the case with a lot of conditions.  It’s all connected.  Good job, freshman level Human A&P II with lab.

…

Imagination is an illusion of reality which conceives of reality as an assembly of small pieces of separate entities and selves.  In order to break through, the practitioner meditates on the nature of interdependence or the interrelatedness of phenomena in the processes of creation and destruction.

- Thich Nhat Hanh, The Miracle of Mindfulness

• XBOX 360
• Rock Band
• HDTV…at least 32 inches.
• A Neat-looking Fedora at a Local Habadashery
• Eat at Fago De Choa
• Road Trip
• Fix up the Laptop
• Upgrade one of the home Computers (or a couple of them)
• Sport a Mustache for a Month (that lasted a week)
• iPhone or the Google Phone
• Disneyworld
• Pick a Specialty

Just a quick list for fun.  Waiting to hear from schools was pretty stressful.  One thing that came of this was telling myself or others that I would treat myself to something once I got in.  Of course, when I actually did get accepted, these things sort of fell by the wayside.  The list did get kind of ridiculous.

Plus, I got a lot of distance just out of telling people that I got in.

O Hai.

Admin Cat learns blogging on his first computer...er...pair of fuzzy dice.

Well, we’ve got our new sponsors courtesy Google AdSense.  Okay, not sponsors, but we do have ads based on the blog content.  Thanks to them for a quick and easy ad solution.

We’ve also got the ads set up on the RSS feed which means a new feed through FeedBurner.  New RSS links have been added to the site, so please update them if you would…all one of you out there.  Thanks to FeedBurner for making ads in the feed easy to set up.  Sorry to have to do that to you RSS feed people, but it is a feature that I can appreciate being that there are sites that I never see any off with the exception of their RSS feed.

We aren’t really sure where the blog is going, but while we are figuring that out the ads will help with web hosting fees and keep me, Admin Cat, in nip and litter.  Our goal with the ads is to keep the ads unobtrusive, but at the same to keep them in relevant real estate on the page.  Since this is a pretty topical blog, Google should have a pretty easy time finding relevant ads…unlike some of my gmail conversations.

…seriously, try writing an email about things that smell bad and check out what AdSense thinks is relevant.

Oh, and Thank you, Google, for helping me set up the blog.