tag:blogger.com,1999:blog-3123819319548998095.post6533340317394890640..comments2023-11-29T02:27:42.928-06:00Comments on The Masks We Wear: To: Anonymous (Doctor)Aekhttp://www.blogger.com/profile/12183623849361560922noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-3123819319548998095.post-38184009938269035932009-08-22T20:49:20.156-05:002009-08-22T20:49:20.156-05:00Or even 90%. If you say 90% are environmental or ...Or even 90%. If you say 90% are environmental or environmental-genetic, you're probably close to being right.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-33538297725084540452009-08-22T19:24:46.900-05:002009-08-22T19:24:46.900-05:00Actually, current thinking is that most psychiatri...Actually, current thinking is that most psychiatric diseases are environmental (personal habits as well as physical environment) in origin, with some genetic factors entering into the mix. They are most certainly not all genetic.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-51275513575047879222009-08-22T18:59:00.171-05:002009-08-22T18:59:00.171-05:00Dave83201: I can't wait to read about it on y...Dave83201: I can't wait to read about it on your blog. :) Hmm, perhaps that sounds a bit too positive. >.><br /><br />Anonymous (AD): Glad to see you comment again. ^_^ Your insights are quite interesting to me, and I agree with much of what you said. I will post an edit to the bottom of this post in response (because to do so in a comment here would probably be too long).<br /><br />Anonymous (b): I'm not sure if we're using Robbin's or Rubin's. I don't have pathology until next year, though I've heard both texts referred to as the "Bible" of pathology.<br /><br />J: I don't know the answer to your question. Many diseases are at least in part genetic, but to say that 90% of psychiatric illnesses are genetic in origin seems a bit of a stretch to me. Certainly I don't doubt that there is a genetic component, but how large that component is (in comparison to environment) I do not know.<br /><br />But yes, pharmacology is now quite important to their treatment, at least as far as I'm aware (I'm sure I'll learn more).Aekhttps://www.blogger.com/profile/12183623849361560922noreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-6515669489039700962009-08-22T17:00:12.748-05:002009-08-22T17:00:12.748-05:00Aren't about 90 per cent of psychiatric illnes...Aren't about 90 per cent of psychiatric illnesses genetic in origin, and isn't pharmacology a very important part of their treatment? As late as 50 years ago Freud was everything.Jnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-80976348093183350742009-08-22T16:26:06.878-05:002009-08-22T16:26:06.878-05:00I'm not sure if you know, but are you going to...I'm not sure if you know, but are you going to use Robbins for pathology? Or did your school go with Rubin's?<br /><br />-bAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-41014450888271650602009-08-22T16:16:53.024-05:002009-08-22T16:16:53.024-05:00Bottom line: have fun with this year (and read Th...Bottom line: have fun with this year (and read The House of God when you can). It’s really easy to let it overwhelm you. There’s a lot of tension, and classes tend to get really close (and intimate) in dealing with that tension. I recall there were 4 guys in my class who were clearly in the closet; it was only at our end of second year party, which was part orgy and part ode to Bacchus, that they realized everyone else in the class knew they were gay and didn’t care (except for the Catholic fellow who dropped out a week later and went into the priesthood).Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-25682882880724022092009-08-22T16:16:28.767-05:002009-08-22T16:16:28.767-05:00As for not having that much time, the day I don’t ...As for not having that much time, the day I don’t have time for a medical student, with all the kindness shown towards me by physicians when I was a med student, is the day I hang up my shingle. Never, ever be concerned about asking a physician about anything, and never be afraid to say “I don’t know”, because that’s the start of the process of finding out and learning—knowledge likely useful at some time in the future. The most dangerous thing a physician can do is to say “I know” why they don’t. That’s how patients get injured, and that’s unforgivable conduct.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-45469922951816629602009-08-22T16:16:05.119-05:002009-08-22T16:16:05.119-05:00As for not having that much time, the day I don’t ...As for not having that much time, the day I don’t have time for a medical student, with all the kindness shown towards me by physicians when I was a med student, is the day I hang up my shingle. Never, ever be concerned about asking a physician about anything, and never be afraid to say “I don’t know”, because that’s the start of the process of finding out and learning—knowledge likely useful at some time in the future. The most dangerous thing a physician can do is to say “I know” why they don’t. That’s how patients get injured, and that’s unforgivable conduct.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-86634756532920134072009-08-22T16:15:05.043-05:002009-08-22T16:15:05.043-05:00Gross is important, but so is histology and embryo...Gross is important, but so is histology and embryology. (If you think gross is a dying art, try finding a competent embryologist sometime!) I liked histo much more than gross, though it didn’t help much in the OR. On the other hand, histo was critical in understanding pathology. I’m sorry if I sounded a bit down on Pharmacology. The course is actually a key one, and you will go through the different classes of drugs etc. Pharmacists are often helpful, though I wish they spent more time on clinical matters during their training. I’d feel much more comfortable in deferring to them if they did. I’ve found my pharmacists train for the drug store rather than the hospital, which is a real waste of their expertise. Pharm was the place where I finally came to understand what the sympathetic and parasympathetic systems were all about, where drug-drug interactions started to make sense, and where dosing schemes began to make sense. Remember, though, that the goal is to learn the terminology, and there’s a lot of that to learn.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-31344009981639569642009-08-22T16:14:44.095-05:002009-08-22T16:14:44.095-05:00Woe to the patient treated six times in the last t...Woe to the patient treated six times in the last three months for STDs who comes in jaundiced and doesn’t see fit to mention anything about the 6 z-packs they’ve had during those three months. (Or erythromycin, if you want to be dramatic about it.) Or the arthritic in renal failure who doesn’t do anything for their arthritis (except for the gram of naproxen taken each day for the last four years, again not mentioned). People are people. And all they’re asking for is to be treated with respect. Now, when someone comes to the trauma unit with multi-organ damage, the last thing I’m going to start worrying about is what’s going on with their home situation—let’s get them through the acute phase and then we can deal with disposition issues, as well as anything related to why they appeared in the trauma unit in the first place (guns in the home, alcohol abuse, combination alcohol and drugs, etc). It’s a question of immediate priorities.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-41054254277135255942009-08-22T16:14:20.474-05:002009-08-22T16:14:20.474-05:00The temptation during gross lab is to look at the ...The temptation during gross lab is to look at the cadaver as something other than what was once a living person. Either that, or one becomes overly connected to it, as one of the groups in my class did. Two members of that group dropped out of medical school, one repeated the course, and one passed, albeit barely. Master the specifics of the cadaver—there will be time to assemble it together before med school is finished. As for the patients’ desire to be looked at whole—it depends on the circumstance. In the clinic, of course, everyone wants to be considered as a whole human being, and they have every such right. After all, medicine is the only field in which you can go into a room, close the door, tell someone to strip, and not have they screaming for the police. In return, they ask, quite reasonably, to be treated with respect. That’s the pact between physician and patient. They’re there for our assistance, and we ask for honesty from them in order to provide understanding and treatment for them.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-70176669951660237112009-08-22T16:13:32.210-05:002009-08-22T16:13:32.210-05:00The biochemistry is quite important, since that’s ...The biochemistry is quite important, since that’s the means by which therapeutic interventions will likely be administered, and not knowing the biochem, it’s going to be hard to understand the therapies. So I’m not willing to accept your criticism of the course just yet, and not knowing your medical school, I’m not in a position to comment on how the course integrates with the rest of the curriculum. However, I wouldn’t be concerned that you will not get the needed education in medical genetics—just that there’s only 4 years available. Medical school is about learning the terminology. Internship and residency is about how to practice medicine. There’s a lot of terminology to be mastered.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-45471861218975789992009-08-22T16:13:04.553-05:002009-08-22T16:13:04.553-05:00I'm not suggesting I'm the last word on me...I'm not suggesting I'm the last word on medical education, but I think you need to keep in mind there are only four years of medical school, and there's a lot of educating taking place during internship and residency. As for learning medical genetics, this may indeed be the last course you take titled “Medical Genetics”. However, you may rest assured it is not the last time you will take a medical genetics course. Pediatrics increasingly deals with medical genetics, and many clerkships have a solid week on the subject (remember, it’s only a 6 week clerkship, so one week is a lot of time on the topic). Ditto for internal medicine.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3123819319548998095.post-90805544372896698802009-08-22T14:06:19.961-05:002009-08-22T14:06:19.961-05:00Fascinating! I'm not sure what percentage I un...Fascinating! I'm not sure what percentage I understood, but fascinating!<br /><br />Oh and I'm writing a post right now about my health issues. I have strong feelings about some aspects of my medical care, and not all of it is positive. While the post will reflect my true feelings, I just don't want you to take any of it personally. It is a mere rant meant to make me feel better more than to change anythingDave83201https://www.blogger.com/profile/17517932528630339811noreply@blogger.com