Today, I feel like a medical detective.

A 67-year-old man, a heavy smoker goes to the hospital to investigate the origin of his chest pain. The lab parameters and blood gas values are: Na+: 138 mmol/L, K+: 4.8 mmol/L, glucose: 5.2 mmol/L, creatinine: 98 mmol/L, pCO2: 55 mmHg, pH: 7.32, actual HCO3-: 40 mmHg, BE: 4.2 mmol/L. What kind of acid-base disorder do you suppose? What could be the cause of the disorder?

Our physiology lab manual posed this and some related questions to prepare us for our acid-base balance experiment. The topic itself has been dense to study and wrap my brain around, so it was nice to see the knowledge applied in this direct, clinical way.

My diagnosis: compensated respiratory acidosis due to COPD.

Today’s a big day in college basketball! Duke is playing UNC in enemy territory. In the name of all the -arkies, GTHC, GTH!

Inside Cameron! 2010

Today, I still feel at home in Vienna.

For those who are lost, there will always be cities that feel like home.
– Simon van Booy

Last weekend, Megan and I met for a semi-spontaneous trip to Vienna! It’s about a 3 hour train ride from BP, and a slightly longer plane ride from Madrid. She doesn’t have class on Fridays or Mondays, and school’s about to start for me again, so it worked out really well!
My memories of the city are tinged by nostalgia and the summer heat: ice cream every day, walks in the park, strangers who took to me, the girl traveling without her parents. I was prepared for the possibility that the city wouldn’t have the charm and luster that lives in my memory, especially in the winter and with the changes that more than a decade inevitably bring to a person and a place.

Stefansdom then …

… and now.

Anna and I arrived on Friday around noon, and took a subway straight to the hotel. One great thing about Vienna is that public transportation there is extremely accessible: every subway stop has an elevator, for example, which makes life there A LOT EASIER when trying to get around in a wheelchair.

Megan arrived shortly after, well-fed by the airline snacks on Air Italia 🙂 We walked around the city center, including a visit to Stefansdom and Peter’s Church. Afterwards, Megan and I saw more of the city by ourselves. We tried to go to one of the cafés that her father recommended, but all of those had a least a step precluding my entrance. Accessibility issues still abound! However, it worked out for the best because we stumbled across a delicious Italian restaurant called Ristorante Sole. The staff there was so considerate, even taking pity on our indecisiveness and portioning our two entrees so that we could each have half. For dessert, we split strawberries with creamy mascarpone.

Well-fed and ready to see the city by night!

That’s when the excitement really started, though, because as we walked around, we found ourselves on the outskirts of a riot protesting a ball in the Hofburg. Megan and I tend to gravitate towards home before the night owls even take flight. It so happened that the entrance to our hotel was RIGHT in the middle of a crowd of protestors. Fortunately, the policemen deemed us harmless and allowed us to pass through the barriers.

On Saturday, we took a subway to Schönbrunn, the Hapsburg’s summer residence, painted Maria Theresa’s favorite color, ochre yellow.

We toured 40 rooms on the first floor!

The palace itself is only half the fun of Schönbrunn; its vast grounds include a zoo (with pandas!), rose garden, and paths for meandering.  We walked to the top of a small hill to see this view:

I didn’t realize we were so far up until we got there! It was worth the cold ascent.

After warming up in our room, Megan and I ventured out again for dinner at Café Landtmann and explorations around the city hall. The city hall is a gorgeous building, reminiscent of the gothic style of Duke Chapel.

There were at least 3 ice skating rinks set up in front of the city hall, and people were out en masse to skate and enjoy mulled wine and hot food.

Temperatures were frigid at this point, so we called it an early night again and relaxed in our room.

On Sunday, we went to the Albertina to see the newly acquired collection of Impressionist, Expressionist, and Surrealist art, entitled “Monet to Picasso”.

This Chagall painting was one of my favorites.

Per Anna’s request, we had to to have Wiener Schnitzel (when in Wien …), so that was our mission in the afternoon. That was when the snow started to fall! It was enough to be pretty without becoming an inconvenience like the Snowpocalypse and Polar Vortex of the East Coast.
In the evening, Megan and I went to visit Stephi, an old friend of mine, at her home. It was really nice to see her again and meet her family. I had not spoken to her in quite a while, though she sends me Advent calendars every December! Moreover, Megan and I had just become friends in middle school before I met Stephi, so it was sweetly bizarre to introduce these two people who have been in my life so long.

Stephi suggested we go to Sunday Swing at the Leopold Museum Café, so that was our next destination, since the night was still young, even for us. At this point, there was an inch layer of snow coating the streets, making for a charming winter wonderland as we trudged out. The Sunday Swing was in full … swing… when we got there. I felt transported to the ’20s! The only downside was the thick smoke hanging in the air from all the cigarettes, but perhaps that contributed to the authenticity of the experience.

Monday was our last morning, so we went to see Karl’s church and a peak of Belvedere, but it was too cold and snowy, so we ended up getting hot chocolate and coffee in a bakery underground. 🙂 Warmth and a friend – not a bad way to end the trip, after all.

from a temporary exhibit by the Austrian artist Sonja Gangl at the Albertina. Adieu, Vienna! Auf Wiedersehen!

Vienna wasn’t quite as I remembered it, but that ended up being okay. After all, I’ve changed a lot, too. Time has worn down parts of us, circumstances have enriched us, but we are still recognizable.

Today, I’ve been a long time gone

(What beautiful harmonizing and an unexpected pairing from these two musicians!)

After 4 weeks, 3 exams, 2 decidedly unfestive holidays, and 1 lovely visit from my mom, I can finally say that the fall 2013 semester is in the books. I’m already dreading doing it again in May, but I’ll try to just live in the moment for a bit. It’s an odd feeling to be so free – kind of like when I stopped piano lessons after many years, and couldn’t shake that feel of “what am I forgetting?!” when I didn’t practice.

Now, I’m on a full-out media binge (TV shows, books, magazines, music I’ve neglected since October) and making plans for the next 2 weeks of break. Any recommendations to add to the list?

Today, I operated on a rat.

Physiology labs at the beginning of the semester started off on the boring side of interesting because many of them were conducted with computer simulation software (we had SimNeuron, SimMuscle, … you get the gist) that generated the data for us. Some time in the last few weeks, though, the labs have gotten interactive and fun! It started off when we measured the effects of certain vasodilators and vasoconstrictors on a biopsied rat aorta. We’ve also done ECGs one one another, taken blood pressure in various physical states, and listened to heart sounds to complement our cardiovascular unit. Today’s lab was probably the pinnacle of the semester: each lab group operated on a live, anesthetized rat to study the effect of vagus stimulation! Even our professor had been looking forward to it for a while. At the last class, he reminded us enthusiastically that it was “VAGUS, BABY!” coming up 🙂

Lest the word “operate” gives the wrong impression I will preface by saying that each rat was sacrificed after the experiment with a high dose of KCl injected into the heart, while still under anesthesia. I think and hope it did not suffer at all.

Our standard white lab rat came to us fully sedated by the lab technician. We picked it up and laid it out on a glass stretcher. The first task was to cut open the chest and find the trachea for intubation. Strictly speaking, this was not necessary for the vagus investigation, but it was a good experience for us to have. This required “atraumatically” tearing through some layers of muscle and making a “T”-shaped incision in the trachea through which a cannula was inserted, all of which Rina did expertly!

Then, we located the carotid artery, which is relatively large and easy to identify because of its pulsation. The vagus nerve, in contrast, is a minuscule strip on the underside of the artery. Priyanka and a Hungarian student joining us for the day separated the nerve, and placed an electrical insulator under it. For the next part of the experiment, we inserted subcutaneous ECG leads, placed an electrode on the nerve, and measured the heart rate. (Because of the nerve’ parasympathetic function, stimulation of the nerve led to a reduction in heart rate. Administering atropine, a parasympathetic antagonist, reversed the effect.)

Afterwards, the official experiment was over, but we dissected the rest of the rat to see its internal organs, all so similar to humans’ viscera. The set-up looked something like by then: this [warning! not for the squeamish]. We also cut into the head and removed the brain. Although some found this extra dissection a bit gruesome, I felt better knowing that we got the most out of the sacrificed life.

Initially, I was actually bit skeptical that the lab experiment was worth the life. Couldn’t this be one of the simulated ones? In retrospect, though, it was about more than the physiology of the vagus nerve. It was the first time I had ever cut into something living, and also the first time I killed a mammal (not that I kill other classes of animals on the regular or anything, but I have no mercy when it comes to bugs!). It’s a different facet of medicine from all the theory stuffed into our heads these years, and one necessitating a prepared emotional response. This was “just a lab rat”, but soon, it won’t be!

Today, I share Megan’s photos!

Megan captured some beautiful photos of Budapest and our non-costumed Halloween weekend together in her latest blog post. 🙂 I was WOWed — the riverbanks have never looked more lovely.

Gotta run, anatomy midterm tomorrow. Second year continues to be a nonstop funfest.