I was tempted to post this image of a newspaper clipping under “Humor,” but more than anything, it’s just really sad. Smoking will do more harm than jackhammers ever will, Ms. Williamson.
Smoking during pregnancy has a number of risk factors for the mother and the fetus. Please, for the health of your child, don’t do it.
We talked about diagnostic testing in our biostatistics/epi class yesterday, and I really think it was the first time that I realized how important statistics can be. It was probably the first time that I really saw how statistics affect patients–individuals–not big masses of people.
We talked about prevalence, pre- and post-test probabilities, predictive values, and likelihood ratios. Reading it now, it sounds pretty dry and boring, but it absolutely affects how likely a patient is to have a certain disease. It’s these kind of decisions and analyses that are absolutely vital to medical decision-making, and vital to being able to provide the most information and the best information to a patient; they also say a lot about how efficiently we spend health dollars in the US.
The big boom in “spiral CTs” or “whole body scans” can be pretty worthless if there’s no clinical suspicion of illness. Even a test that’s sensitive and specific 95% of the time will be a worthless test if the prevalence of a disease is extremely rare; one may increase their risk of some disease from 1% to 2%, but 98 times out of 100 you won’t have the disease, and you’ve just spent $6,000 to tell you that.
We had our first lecture on psychiatry yesterday, and learned the basics of the DSM IV–the big thick tome-of-a-book that helps mental health folks to diagnose mental illnesses. Recently I’d been talking with a friend about his possible depression, and encouraged him to at least talk to someone at CAPS about his concerns, and I really hope he starts to feel more like himself again soon. Sometimes I wish these were things I could just do for people, but in mental health especially, I think it requires a certain amount of personal motivation. The individual has to want to change.
I guess all one can do sometimes is try to be encouraging and supportive, and to lend an ear. Unfortunately, sometimes even that can get complicated by one’s own feelings.
I went to a dinner party on Monday night, and I was incredibly surprised and excited to learn that a classmate is pregnant! 13 weeks! This is very strange for several reasons, but mostly because it reinforced the fact that I am an adult, and that my friends are adults.
We were talking about genetic testing, amniocentesis , and chorionic villus sampling , and what should be tested, and what should be left up to fate. (The classmate is an Ashkenazi Jew , so there’s an increased risk of a number congenital diseases. Note: most Jews in the US are Ashkenazi. I didn’t know this until last year; I thought Ashkenazi was some rare group of Jews. Not true.) If some serious genetic diseases were detected, they would probably terminate the pregnancy.
Anyway, I joked that they should also check for the gay gene (see, that’s funny, because there isn’t one), and somehow it came up that if the gay gene was positive, they’d have to think if they wanted to continue the pregnancy, as if being gay was along the lines of Tay-Sachs or something. I couldn’t help but identify with the fetus, and felt a little offended (I’m sure the friend didn’t mean to offend). I was just surprised at how different a perspective I must have. I guess I can see my classmate’s perspective-you wouldn’t want your child to have any extra hardships in his or her life-but I just have a hard time thinking of the notion of me not being here because my parents learned something about me. (This probably stems from my human egotism of existance, but let’s ignore that part of it for a minute.)
If you haven’t noticed, yes, it’s not necessarily the best fate to be the lucky person chosen by the Universal Order to play the gay for this lifetime, but I’ll be damned if I’m not a much better person for it. I understand compassion, kindness, struggle, injustice, stereotyping, ignorance, and unconditional love and blind hate better than many people that have grown up in similar, heterosexual shoes.
It’s part of me, not the most important part, but part of me, nonetheless. I’m pretty happy with how I’ve turned out, and I wouldn’t change any of it, even if I had the chance. (Well, okay, maybe a little less neuroticism, and maybe a nosejob. And maybe showering more in the 7th grade would have helped.) But I’m me; I’m not diseased, I’m not sick. Within the normal limits. Or just outside them. But anyway, who wants to be normal? Normal’s boring, if you ask me.
I’m curious how much of health is related to a person’s happiness. That is, how much of one’s mental health and health behaviors are related to a person’s happiness, sadness, loneliness, misery.
If people were happier, would they do fewer destructive things to their bodies? Overeat? Undereat? Exercise more? Smoke less? Drink less? Do fewer drugs? Have fewer negative or harmful thoughts?
How much of one’s health is related to self-image? If we had tighter communities, more social supports, more love and kindness in our lives, would we be healthier? I’m tempted to say yes.
IM conversation taken out of context:
On that lovely note, I’ve gotta shower and study my STD’s.
The STD’s. Not mine. I’ve got to stop saying that.
A number of totally random thoughts, after two days of class (we’re halfway through a week of derm):
After a red-eye and 3 hours of sleep, I’m back from Oahu. Had an incredible time. Just what I needed. So far removed from medicine that I came back to school today and was reminded of what med school’s like. Namely, being talked at by strange specialist professors who use way too many terms that you have no idea what they mean.
Also new: some photos from Hawaii .
I’m deeply fascinated recently with the idea that life comes from life-or more realistically, life comes from death. And more personally, where did I come from? And more spiritually, have I been a cow, an insect, or a bacterium in a previous life?
If women are born with all the ova they’ll ever have, that means that half of me came from something of my grandmother’s, that she then passed on to my mother in the womb. Am I a piece of chicken? Or maybe a bean? Or a sloughed-off cell from the inside of her cheek? Or a bacterium?
And if it takes men about 74 days to mature their spermatozoa, what a fascinatingly microscopic idea that some little bit or speck that he ate was to become me . I picture a cheeseburger, or maybe some roast beef. Maybe a bit of bacon from his mother’s incredibly delicious green beans.
I realize this edges frighteningly close to the idea that I was not, in fact, delivered by stork or simple budding , but it’s somehow mind-boggling to consider all the forces and interactions and molecules and sequences that had to occur just to make me. Call it egotism or what you will, but some part of me-no, all parts of me-existed before I ever existed. Before even the concept or the thought of a me existed. In one form or another, at least. Everything’s connected to everything else.
