Congratulations to all my friends and classmates who are graduating today. I’m going to miss all of you immensely, even if you’re still sticking around at Stanford. You’ve helped make a difficult 4 years enjoyable. To those of you moving far away, expect a call from me when I’m looking for housing when I interview. No, really.

Congrats!

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I would think that a policy wonk for a conservative think tank would be above taking cheap shots at a tragedy, especially when said tragedy is anecdotal and proves nothing, but I guess not. David Hogberg somehow equates the latest controversy at Drew/Harbor hopsital with that scary world of socialized medicine , so I’m happy to fire back with anecdotes myself.

One hospital in California did unnecessary heart surgeries.

Another hospital was fined more than $700 MILLION for defrauding Medicare (and by relation, US taxpayers.

One private psychiatric hospital locked up patients and held them against their will until their insurance ran out. (No, I’m not making that one up.)

Where did this happen? Canada, the UK, Japan? No, it’s right here in the US. The first was a hospital owned by Tenet, the second HCA, the largest private hospital chain the country, and the third was National Medical Enterprises, now known as… Tenet.

And all three of these are privately owned hospital chains. That what you want from your health care system? One that puts profits over patient safety and proper treatment and diagnosis?

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Anonymous doctors talk about practicing medicine and The 50 Doctor Poll . Favorite bit:

Do doctors have God complexes?
Yes…. 28
No…. 22

Do you have a God complex?
Yes….2
No…. 48

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On a 2-week rotation of Anesthesia recently, hence the not posting. I find myself using my eyes to pretty much express every emotion, since the rest of my face is masked. (This happened while I was on surgery, as the surgeons do it too, but I’ve become quite skilled at it recently, since the nurses and attending and I will often try communicate silently in the OR, since that whole “people with scalpels and needles should probably be able to concentrate if they want” mentality is quite popular around these parts.)

Figured I’d give my little rundown of expressions that I use through the power of the YouTubes .

Video is below. If you’re viewing the feed or get the email and want to see the video, just click on my page or the Youtube link.

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He died today at his home after quite a struggle with multiple myeloma. Always had great memories of watching his show on Nickelodeon early in the morning. I remember a kid eating an apple upside down and still being able to swallow it. My first introduction to peristalsis and GI physiology.

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Okay medical blogosphere, let’s figure this one out (comments are open!). Is there a physiologic mechanism to “breaking the seal,” or is it just a drinking myth? ( Breaking the seal, if you’re not familiar with the term, refers to the idea that if you’re out drinking, once you start peeing, then you’re going to have to go urinate every 10-20 minutes after that. “Don’t break the seal!” means don’t start peeing, ’cause then you’ll never stop! )

From Goodman and Gillman’s Pharmacology:

Alcohol inhibits the release of vasopressin (antidiuretic hormone; see Chapter 29) from the posterior pituitary gland, resulting in enhanced diuresis (Leppaluoto et al., 1992). The volume loading that accompanies imbibing complements the diuresis that occurs as a result of reduced vasopressin secretion. Alcoholics have less urine output than do control subjects in response to a challenge dose with ethanol, suggesting that tolerance develops to the diuretic effects of ethanol (Collins et al., 1992). Alcoholics withdrawing from alcohol exhibit increased vasopressin release and a consequent retention of water, as well as dilutional hyponatremia.

Vasopressin (ADH, antidiuretic hormone) causes your kidneys to reabsorb free water molecules, to maintain your sodium osmolality, so knock that out and you’re going to be peeing lots of dilute urine, making you hypernatremic. Combine that with ethanol’s peripheral vasodilation, making your kidneys think you’re hypovolemic (even though you’ve been drinking lots of fluid), and they’re going to try to clamp down to reabsorb all the possible sodium they can… aaand that’s all I’ve got. Maybe it’s just a feed-forward positive feedback relationship with the continued filtering of the kidneys, since they don’t realize ADH isn’t being released? I don’t think it really matters if you stop drinking or not.

I swear I experience this all the time, but maybe it’s just the drunkness and rapid passage of time. I’m stumped.

(Excuse: Was reviewing phys today for Anesthesia which starts on Monday, and boy can my mind wander.)

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Funny rant about the instant message generation and the sad state of American grammar: Med School Does Not A Genius Make :

I’d like to take a moment to voice my complete and utter hatred of USMLE forums. I invariably stumble across these when Googling anything Boards related, and I swear half the people type like they’re 13:

OMG I h8 studyin soooo much,,,,, jusst wannaa go watch a movie! What do u all think the bets movies r ??? LOL I wanna see JoNnY DePp in Pirates.

PS whuts the gene defect in Von Recklinghausen’s?

Sadly, I think I abbreviate just as much in my notes, they’re just more medically accepted terms:

58M c/o SOB, CP 10/10 x3d, – N/V/D +diaphoresis -radiating -exertional, No PMH, no PMD, no meds, no cardiac FHx.

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In two parts.

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