She Blinded Me With Science

One of my Microbiology professors did a lecture on controlling microbes in the clinical setting, and she dispensed some really neat historical biographies on a couple of very famous scientists/physicians who had an impact on the world through their discoveries, saving millions of lives in the process. So, I thought it might be neat to share their stories -- I'm a sucker for stuff like this (one of my favorite parts of the recent Body Worlds exhibit, which features "plastinated" human bodies in a very tasteful and artful display, was the historical information on all of the famous early anatomists. For example, did you know that in centuries ago, the church considered it immoral and unethical to dissect the human body, and outlawed it for over 1,000 years? Galen, the famous Greek anatomist, created the foundation of modern anatomy in the second century by working on pigs and monkeys. During the Renaissance period, cultural ideas and social taboos started to shift, but the famous artists like Michaelangelo and his rival scholar Leonardo di Vinci actually had to rob graves in the dead of night in order to perform dissections and further scientific study of the human body). And so, I will now present to you the story of two of the most prominent figures in the field of Microbiology, with a slight twist. I'm going to try my Paul Harvey impression while doing so (this one's for my Grandma). So don't say you've never learned anything by reading my blog!


Hello Americans, I'm Paul Harvey. You know what the news is -- in a minute, you're going to hear... the rest of the story.

In 1846, a Hungarian physician named Ignaz Semmelweis was assigned to the first obstetrical clinic at Vienna General Hospital. He became alarmingly aware of a higher death rate due to puerperal fever among delivering mothers at his clinic, which was staffed by medical students, than at other wards in the area, which were run by midwives. Puerperal fever, also known as childbed fever, can develop into sepsis, a whole body inflammatory state caused by infection that is life-threatening if not treated. Semmelweis did his best to make sure the procedures were being carried out the same at his clinic as they were elsewhere, and still the unusally high mortality at his ward persisted. After a fellow colleague of his died from sepsis following a scalpal cut during an autopsy, Semmelweis then came to realize that the diseases were the same and rationalized that the medical students were somehow infecting the mothers. You see, there were no Universal Precautions back in his day, and when his medical students were between childbirth deliveries, they went to work on cadavers.

Semmelweis then enforced a strict handwashing policy using chlorinated lime and subsequently nearly eliminated death due to puerperal sepsis in his clinic. However, as is often the case when new scientific discoveries are made, his ideas were not readily accepted in the medical community, and his methods were not widely practiced, despite Semmelweis repeating his results in other hospitals and clinics. Later in his life, he became mentally unbalanced and his mind deteriorated, and some speculate that he had contracted syphillis, which was common among obstetricians at the time, and can lead to neurological symptoms such as dementia, mania, psychosis, and depression. In 1865, he was committed to an asylum, and in a case of cruel irony, he died of sepsis following a beating from the guards .


Ignaz Semmelweis (1818-1865)

Around the time of Semmeweis's death, French scientist Louis Pasteur developed the germ theory of disease, which gave a theoretical basis for what Semmelweis had been working towards. Semmelweis is now held in high esteem in the medical and academic world and often referred to as the "Savior of Mothers." However, the story does not end there ...


Louis Pasteur (1822-1895)

Page Two

In the same year that Semmelweis died, Joseph, an English surgeon made his first great success in Glasgow using carbolic acid to sterilize surgical instruments. Back in this time, the prevailing theory of diseases like cholera and the Black Death was the miasma theory, which maintained that diseases were spread thorough a noxious form of polluted air. Joseph was not convinced that wound infections were caused by miasma, and inspired by Pasteur's germ theory, he began to experiment with using carbolic acid, which at the time was used to treat sewage. He eventually came up with a formula that could be used as an antiseptic for treating wounds and handwashing as well as a disinfectant for surgical instruments. His ideas were initally met with skepticism, but were eventually accepted in his lifetime, and he was knighted in 1883. He is now known as the "Father of Antiseptics" and the "Father of Modern Surgery." You may recognize him by his full (knighted) name -- Sir Joseph Lister, and by the product later developed in 1879 and named in honor of him, Listerine.


Sir Joesph Lister (1827-1912)

And know you know ... the rest of the story.
Paul Harvey ... Good day.


Paul Harvey (1918-present)

Takin' Care of Business

Well my winter break starts today, and before I whisk away to a snowy Christmas far away from here, I thought I'd give a round-up of what my quarter looks like. Here are the classes I have:

Clinical Medicine II: This is part 2 of our "bread and butter" medicine class where we study various groups of disorders, their signs/symptoms, pathophysiology, and the current treatments, including medications. We are starting the quarter off with various and sundry cardiac conditions: hyperlipidemia (aka high cholesterol), endocarditis/pericarditis, ischemic heart disease, valvular heart disease, heart failure/pulmonary edema. From there we move to pulmonary conditions: embolisms, deep vein thrombosis, peripheral vascular disease, chronic obstructive pulmonary disease, bronchitis, pneumonia, asthma, tuberculosis, coccidiomycosis (aka Valley Fever), lung cancer, and insterstitial lung disease. Then it's on to kidney disorders: urinary tract infections, pyelonephritis, glomerulonephritis, polycystic kidneys, actute/chronic renal failure, benign prostatic hypertrophy, and incontinence and then wrap up the class with some genitourinary disorders -- prostrate cancer, etc. and finally some endocrine and adrenal hormonal abnormalities. Part of this class included a weekly small-group case session where we follow a hypothetical patient throughout his/her life -- each week represents them coming to see you with a new set of problems, and we have to brainstorm the possible diagnoses and then write up a SOAP note, complete with prescriptions on a "real" prescription pad.

ECG -- this is an entire course designed on being able to analyze and interpret ECG strips. You wouldn't believe how much you can gleam from these. Very detail-oriented stuff -- luckily for me, I have my trusty ECG calipers to help me wade through the intricacies. Even the heart rhythms can be tricky -- not only can heart beats be irregular, but they can be regularly irregularl or irregularly irregular (kind of like how the Detroit Lions are having the perfectly imperfect season -- one more game to go until infamy! Just when you think they've hit rock bottom, they dutifully don the miner's hat and plumb the depths a little further. Here is a pretty good synopsis of the misery that is being a Lions fan: they are 31-95 over the past 8 seasons & have won just 1 post-season game since Henry Ford's grandson purchased the team 44 years ago! The only salve for that kind of pain is that the Pistons have done reasonably well in the last decade, and Detroit is home to the NHL's greatest franchise in the Red Wings, an organization from top-to-bottom that is the complete antithesis of the chronically hapless Lions)

Microbiology -- this is more of a medical-oriented Micro -- no wet lab, though most of us have already had that experience as an undergraduate, which was a great lab -- taking all kinds of swabs and then growing cultures overnight. This class is very practical, and so far we've learned about the various gastrointestinal disorders (in other words -- any of the viruses or bacteria that cause an involuntary fluid loss from both ends, if you catch my drift) and now we're starting to explore various parasitic worms. We also got a good lecture on how the various classes of antiobiotics work -- some attack the cell membrane (penicillin), some disrupt nucleic acid synthesis (rifamycin) , some inhibit protein synthesis (tetracyclines) , and some act as antimetabolites (sulfa drugs). And then there are the antifunglas and the antivirals ...

Physiology II -- part 2 of Physiology -- in this course we are starting off with Renal function and acid/base function, moving into GI function, and finishing with a whirlwind tour of the endocrine system, covering all of the various hormones. Luckily for me, Dr. G gave me really good preparation for this course.

Clincal Laboratory Medicine -- not to be confused with my regular Clincal Medicine class listed above, this class covers all of the various diagnostic tests we will be expected to order and interpret once we start practicing. We started off with the CBC or Compete Blood Count, with differential -- basically studying abnormalities in red blood cells, white blood cells, and platelets. Next is Urinalysis and then the CMP or Complete Metabolic Panel, which includes glucose, electrolytes, and BUN (or Blood Urea Nitrogen). We actually have homework in this class where we receive various lab reports and have to come up with possible diagnoses.

Pharmacology -- this will likely be the hardest class for me. The first section was not really about any drugs in particular, but rather an exploration of pharmacodynamics & pharmacokinetics, which in a nutshell includes how drugs act on the body as well as how the body absorbs, distributes, metabolizes, and excretes them, all in painstakingly great detail. Very heavy on biochemistry, although now I think we are going to move into various classes of drugs which should be a bit easier for me to tackle.

Therapeutic & Diagnostic Skills -- well, each quarter we have a "fun" class, and this one fits the bill this go-round. This is a lab class where we learn various skill-based medical procedures. So far we have had an eye lab where we practiced removing foreign objects, using eye flushes, and using fluoroscein dye to look for corneal scratches and abrasions. The second session involved going to the anatomy lab and learning how to scrub in for surgery. We had an local heart surgeon (Israeli-born who trained in England for 10 years, practiced in Europe, and eventually came here to consult and work) explain the do's/dont's of the OR, and then we actually scubbed in -- did the nail scrub, handwashing, and put on surgical gowns, masks, hats, gloves and got a rundown on surgical instruments. Some of the future sessions include practicing venipuncture and administering shots on eachother, as well as learning sutures and surgical knots (we will be practicing on pig ears!)

Clincal Track -- Independent Study -- this is basically for the Master's component of my degree. While we only meet for a few session over the quarter, there is a project involved that we need to be working on our own, turning in various parts of it over the quarter. We got to choose a topic and then we can either do a 10-page paper or 30-minute presentation on it. I chose the presentation as I have written my share of papers over the years and think getting up in front of my peers and practicing my public speaking will be more beneficial. Thanks to a suggestion from Rachel, I will be doing my presentation on CTCL -- Cutaneous T-Cell Lymphoma -- a very serious disorder which often gets misdiagnoses early on as it resembles more benign skin conditions like eczema or psoriasis. The presentation includes making handouts and developing a Power-Point program.

Interdisciplinary Core -- this is the only class that I have to just show up for. It only meets every other week, and it's meant to just expose us to the various disciplines. Each week a different program is highlighted -- Dental, D.O., P.A., Nurse Anesthesia, Cardiac Perfusion, etc.

In case you weren't counting, that is 9 classes (well, Core class is not really a "class", but attendance is mandatory). I think I counted up 20+ tests alone this quarter, along with my Independent Study presentation, homework for ECG/Clinical Lab, and Clin Med small group write-ups. In other words, I am busier than ever, if that is possible. The program director only half-jokingly said that most students mentally break down in mid-January to early-February, and that we should come to them or see the school counselor when, not if, that happens. I have to say, if I didn't love what I'm doing, it would seem insurmountable.

I'll reward you with some funny for wading through that academic diatribe...

A White Sport Coat ...

...And A Pink Carnation

(Hopefully some of you catch the Marty Robbins reference, or at least the later version by Arizona's own Meat Puppets -- go here if not)

And what am I blathering about now? Well, this Friday the school had its annual White Coat Ceremony. It's a fairly new tradition which originated at Chicago's Pritzker School of Medicine in 1989 but is now observed in over 100 medical schools. It is a formal event in which students are "coated" by their program directors and Dean to symbolize a student's entry into the professional phase of their education.

The event was fairly large, as all of the school programs were included: the College of Osteopathic Medicine, the College of Dental Medicine, the College of Pharmacy, and the College of Health Sciences. By the way, Midwestern is starting a School of Optometry next year, so if anyone has thought about pursuing that field, let me know and I can pass on more information and tell you about the program.

Back to the event -- it was held in the brand spanking new auditorium, which has a half-circle stage and seating for 2,500. Lots of friends and family were in attendance, and the venue was definitely full. The President of the University gave a short speech, and each of the Deans also made some brief remarks. Following the actual "cloaking", we took the following oath:

As I embark upon my course of study, I will:

Enter into a relationship of mutual respect with my teachers and my colleagues to enhance the learning environment and gain the knowledge, skills, and attitudes of a good health provider.

Accept responsibility only for those matters for which I am competent, maintain the trust expected of a health care provider, and never take advantage of the patient-provider relationship.

Respect the patient's right to privacy.

Value the knowledge and wisdom of the health care professionals who have preceded me and endeavor to contribute to their tradition.

Recognize my weaknesses and strengths and strive to develop those qualities that will earn the respect of my patients, my colleagues, my family, and myself.

Continue this learning throughout all the days of my life.

I was still a little under the weather, having caught a cold a few days earlier, but it was a nice ceremony and I did feel proud to be up there with all my fellow students. Here are a few pics of the event:




So does that make me look official or what? Before long I'll be joining the ranks of these famous and esteemed white-coated professionals:

Here I Go Again

Today I start my 3rd quarter of PA school. The last quarter had a few struggles and yet I came out with a 3.45 GPA which was higher than the 1st quarter, so at least I'm hanging in there. According to the teaching staff and former students, this one will be the most challenging -- I'll post more on the course load during the week. I've enjoyed the last 2 weeks of break but am ready to get back to the grindstone -- this may sound preposterous, but I found that I almost don't know what to do between quarters -- it's hard to get out of the "MUST STUDY" mode and relax.

I did complete my "November experiment" again this year -- shut off my air/heat in the apartment for the entire month. That might sound remarkable but it's not really -- the weather here in Phoenix is nearly perfect this time of year -- days are in the high 70's/low 80's and the nights get down to the mid 50's.

So what did I do over my break? Well, for starters, the timing was impeccable as my birthday fell on my break. I did quite a bit of hiking -- didn't get out to Sedona or Mexico this time but there are plenty of good hikes in town. I decided to do a birthday hike on Camelback Mountain. For those not familiar with Phoenix, Camelback Mountain is part of Echo Canyon Park, right in the middle of the Valley, just south of Paradise Valley, just west of Scottsdale, and northeast from Phoenix. It's about a 25-minute ride from my apartment. There are 2 trails leading to the summit, both about 1.5 miles long, with an elevation climb of about 1200 feet, with the summit having an elevation of 2,700 feet. It makes for a good workout and there are a few spots with handrails that are good scrambles. Some people find the desert landscape to be drab and dull, but I think the desert has a beauty of its own, and I much prefer to get out and exercise outside than run on a treadmill in a gym like a hamster on a wheel. Here are some pictures:

















And I also enjoyed a nice Thanksgiving feast courtesy of the Marshall clan, who have taken me in for many a holiday in the years I've been here in Phoenix. 2 of the Seven Deadly Sins were engaged in -- 1st gluttony, and then sloth as ravenous maws were stuffed full like bears getting ready for winter hibernation, leading to bloated bellies and the onset of a food-induced coma. There were 2 birds this year -- an 18 lb roasted and a 22lb deepfried. That is 40 lbs of turkey for 15 people, not to mention flowing wine & all of the usual side dishes including the infamous Marshall family "Slickers" which are succulent homemade noodles and a staple of their holiday meals. My own contribution was the infamous Miller family Olive salad. Here are some pics of the fantastic vittles we gorged on:







Hope everyone else enjoyed their Thanksgiving!