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
Watching the announcement of the new pope on TV with an irreverent Catholic (Anna) makes for hilarity. Some commentary:
“Fifty thousand people standing out in the rain for what?!? Is that normal?!”
Me: He’s rather old…
A: No ‘rather’ – he’s old, period.
“Finally, we can sleep well in our beds tonight!”
One thing’s true – we will sleep well, though not necessarily because of the news in Vatican City. Tonight, I’m finishing some other loose study ends, not setting any alarm, and looking forward to a long weekend in my pajamas. We have the next two days off for a national holiday. I am so grateful for this extra time to catch up (read: start) on the GI system. I don’t know if I have the guts to stomach all the lecture material =/ We started with the oral cavity a few weeks ago and have covered all the way down to the intestines by now, so I’m quite behind. The gall!
Our Medical Professions lecture was given by a psychiatrist today! I had been looking forward to hearing what he had to say, and though he was quite soft-spoken and didn’t offer any startling insights, it was still a nice reminder of what I one day hope to do (I think). It would’ve been nice if he could have spoken about his day-to-day duties more, but I’ve noticed that psychiatrists are usually extremely reticent or evasive when it comes to discussing the details of their work (and boy have I spent lots of time trying to figure that out!). Confidentiality is a particularly sensitive issue in psychiatry (why that is reflects the taboos of mental health still so deeply rooted in society), to the point that it makes it hard to know exactly what it is that a psychiatrist does. I think clarifying that would improve the image of mental health professionals and their role in medicine.
In the middle of his presentation was a figure from an article about a polymorphism in the serotonin transporter gene (5-HTTLPR) … citing none other than one of my former Duke professors!! This was particularly startling because I did not enjoy his “Inside the Disordered Brain” course at all despite its promising name, but apparently he is a pretty big deal?! Go figure. My best memory from that class is making up wacky mnemonics with Kate.
I met another Dukie, in the anatomy dissection room, of all places! As it turns out, one of our TAs spent a year as a Blue Devil! We were always told that Duke connections could find us in random corners all over the globe, but now I’ve experienced it 🙂
I tend towards ambivalence about my time there. However, the more distance arises, the more I realize what my time at Duke did (and didn’t) do for me. One thing I’ve taken with me to medical school is being primed for failure. In a good way! It sounds terrible, and at times, it was a hard lesson, but at Duke, I got so used to underachieving compared to my goals, that it became normal. That allowed me to separate success from my sense of self worth, something I’m still working on, but that has served me well so far this semester. I find myself less stressed – perhaps to a fault, considering the exam crunch – and more easygoing. I still want to do well and I do still aim high, but I don’t take the fall so personally or permanently.
Happy birthday, my joyous, linguaphilic friend. I hope you’re having a wonderful time at Homecoming!
Today is the end of a long 2nd week of school here. Cause for celebration all around!