You are currently browsing the tag archive for the ‘life’ tag.

 

    Di at Doctor and Covenants pointed me to this story, where a brain surgeon was operating to remove a mass from a patient and and ended up finding a foot.  The story states that this is either a rare type of tumor called a teratoma or is it a rare case of a twin that remained attached to the patients and was totally enveloped into the skull, a condition called fetus in fetu.

         The image is striking, and gives a certain visceral reaction, which is largely why pictures like this make their rounds on the internet.  Read the rest of this entry »

   Neurology has traditionally been a rather laid back specialty.  The delight of it for me is the chance to ponder the inner workings of the brain as it affects the nervous system in a systematic and reflective manner.  We don’t usually go into for the thrill of racing to save someone in a life and death situation.  In fact, at least for me, this is when my brain functions at its worst.  Thoughts begin to race, focus is scattered, and things become less clear.  However, times have rapidly changed with the advent of thrombolytic therapy for stroke. Read the rest of this entry »

     Whether its Moses parting the Red Sea, Jesus rising from the dead, Mohammed riding a winged horse of fire up into heaven, or the Angel Moroni appearing to Joseph Smith to lead him to an ancient record written by his own hand on gold plates, all the World’s great religions are founded upon miracles. They are fantastic and dramatic, and awe inspiring. They are also generally ridiculed and looked down upon in today’s “evidence based” world. To believe in miracles is to be gullible. In today’s world there must always be an explanation.

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The long awaited end to the hiatus is here, at least temporarily.  I break it in the way you may have come to expect, by sharing all the stuff I would have written myself, if only I were bright and talented enough with lots more free time.  So I present, especially for my faithful readers, both of you, the very best of the internet I could find over the past while or so Read the rest of this entry »

Every man can, if he so desires, become the sculptor his own brain“.
             Santiago Ramon y Cajal (1852-1934)
                             Spanish Neuroscientist

  Life is distinguished from the inanimate by its ability to recreate itself and hold a pattern.  Throughout our lives, The very material we are made up of is recycled or regenerated.  Every few weeks we completely change out the cells that compose our skin.   The body is constantly in a state of regenerating itself.  Even the bones are borrowing or depositing calcium throughout our lives.  The machinery of our cells are constantly disposing of waste, replacing damaged portions, killing cells that are old or dysfunctional and making new ones.  All this processes are kept in order by our genetic information.  In essence the only thing that holds our form and keeps it from weathering away and degenerating is our DNA.  This is the master set of instructions that our cells use to replace, rebuild, and develop us into the body we now have.  It is the ultimate difference between the collection of elements that is us, and a rock.

     However, there is much more to what we are than just the DNA blueprints.  I remember a moment at the beginning of my very first year of medical school that really brought this home to me.  In anatomy we had to memorize every crater, every bump, every nodule, line and crevice in every bone in the body.  As we learned about these landmarks, we learned that they form not as part of some genetic program, but as a reaction to stress forces from pulling tendons and ligaments, triggering a reaction that caused the cells in that part of the bone to duplicate and reinforce the bone as needed.  In other words, our actions determine the shape of our bones every bit as much as our genes.

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    I am continuing my review of the best blogs mind, body, and soul at least from my perspective.  Doctor blogs have been the subject of controversy with the AMA lately.  There are privacy concerns and concerns about the professionalism of ranting about colleagues or patients in such a public forum.  While these concerns may be valid, this isn’t what I generally see in the blogs, at least not the ones I end up following anyway.  Many, many blogs focus on healthcare and its shortcomings and problems with the system.  These have their place, but for me the very best blogs share the highs and the lows of medicine.  I think the blog format is ideal for sharing the unique experience and point of view that we physicians have.  I think the best blogs humanize the doctor, the patients and in so doing feed the soul.  Here are a few of my favorites- Read the rest of this entry »

Few things in medicine are harder than trying to explain to a patient that you don’t understand what is going on.  As is common, I recently had an adolescent patient that had either psychosomatic stroke symptoms or actual acute resolving weakness exaggerated by anxiety.   As we very gently let him down, we explained that we could not find a physiologic reason for his weakness, now better, and that we would likely never know what caused it.  All the patient often hears in these conversations is a booming, “It’s all in your head.”  So it was under these conditions that the patient caught me off balance.  “How can you not know, you have been studying this stuff for your entire life?!” 

Avicenna, Islamic physician and philosopher

Avicenna, legendary Islamic physician and philosopher

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Choosing on a medical specialty involves learning your own answers to a series of questions?

-Do I enjoy patient interaction or not?

If no, consider Pathology or Radiology

-Do I like surgery and procedures more, or medicine and clinical reasoning, or both?

note- Anesthesia is a procedure and OR specialty, sort of surgery-lite.

Both- Ophthalmology, Orthopedic Surgery (well peds ortho anyway), ENT, Ob-Gyn, and Emergency medicine for procedures

-Do I prefer general, broad knowledge or limiting to one area or system, Primary care or specialist?

This is often a question of knowing a little about a lot, or a lot about a little.  However, It also involves whether you prefer relatively healthy patients or relatively sick.

-Do I do I prefer to see kids, adults, or both? (remember you can do almost anything for kids that you can for adults.)

The last question was easy for me.  From my point of view, pediatric care is superior to adult medicine in so many ways. Read the rest of this entry »

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