Fever of Unknown Origin (FUO) is when a patient has a fever (that’s >99.7F oral, or >101 rectal) on three occasions or three days in the hospital, and nobody can figure out why the heck he or she has it. It’s usually due to an infection, cancer, or autoimmune disease, but I’ve recently recalled from my childhood one major cause that no one at Smartypants Stanford thought of:

Child faking a fever.

I was no expert at this, and having a nurse and physician as parents didn’t help, but on at least one occasion I took the thermometer my mom gave me and stuck it up next to the lightbulb of the lamp next to my bed. Voila, temperature of 106. Unfortunately, lacking the knowledge that I’d probably be dead, or at least look close to it, at 106 degrees, I was forced to go to school.

Also fun to say in the “Eff You” category: 5-FU , a chemotherapy / cancer drug.

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Herpes virus infections (oral, genital herpes, EBV – the virus that causes mono, VZV – the virus that causes chickenpox, and others) can never be cleared; they live in your cells until you die.

So, of course, the associated joke:

Q: What’s the difference between love and herpes?

A: Herpes is forever.

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I almost forgot. I’m the opening line in the latest Stanford Medicine magazine. Always happy to serve as the big, fat Commie Pinko.

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5-10% of alcohol is removed from the body through the breath. This fact, of course, lead a classmate to ask if you can sober-up by hyperventilating. “Theoretically, yes,” said the lecturer.

Seeing as though this’ll be Valentine’s Day #2 without a significant other, I may just have to try it.

Speaking of V-Day, there’s a really nice piece at the end of this week’s This American Life about Johnny Cash, his wife, and the song Ring of Fire . Told by Sarah Jewell, one of my favorite contributors. It starts at about 47 minutes in, and it’s so sweet and romantic that it even made me feel a little less jaded and bitter about the whole thing.

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Aldehyde dehydrogenase is the enzyme in your liver that helps you get rid of alcohol (actually, it’s the second step in the process, but I digress). Some people of Asian decent have less of this enzyme, so when they drink alcohol, they can turn red; in most texts, this is a mutation that decreases alcohol metabolism.

Turns out that everyone else is the mutation. If you look at animals’ versions of aldehyde dehydrogenase, they’re more similar to the Asian version of the enzyme; so somewhere along the way (Germany? Russia? England?), I evolved the ability to drink more. (Disulfram, a drug that can help alcoholics stop drinking, blocks this enzyme, making you flush, and not enjoy the alcohol as much.)

So no, I can’t control the weather, shoot force beams out of my eyes, or read minds… but I can drink more alcohol. Better than nothing, I guess.

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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.

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A number of totally random thoughts, after two days of class (we’re halfway through a week of derm):

• As far as STDs go, I don’t think the joke will ever get old where you automatically assume if someone asks a question about one, they clearly have it. And no, feigning ignorance in some sort of reverse-psychology way (“Do herpes sores hurt?”) is totally overcompensating, and I can see right through you. (I was tempted to ask this question today, as I honestly don’t know, but you probably don’t believe me now that you see the way my mind works its paranoid little magic.)
• Due to the miracles of videotaping and online streaming of classes, I bumped into a classmate on the way back from the gym that I’m pretty sure I didn’t see at all last quarter.
• It is extremely funny when your preceptor asks a generally quiet classmate about the “things you need to be monitoring status post surgery,” and, after having previously talked about the answer in more discrete terms, the classmate blurts out, “well, eating and shitting,” as if the word is standard medical vernacular. (Perhaps he was confused with dumping .)
• The television show, House is strangely intriguing to me, in a kind of this-is-so-fake-and-somewhat-offensive way. The doctor assumes all patients are lying, degrades his colleagues in a paternalistic hot-shot way, and probably freaks people out that they’re going to have Wilson’s disease and go “crazy,” or end up getting African sleeping sickness by having sex. Medical dramas are bad, but not that far-fetched.
• I was a late bloomer. Most kids get Fifth’s disease (erythema infectiosum, caused by Parvovirus B19) by the time they’re 10, but I got it when I was 14, in Mrs. Baxley’s typewriting class. She sent me to the nurse, and I got the day off of school in 8th grade. Sure fooled them; it’s not contagious once the rash appears.
• I keep feeling like I have all this time on my hands. I look at the clock, and it’s only 7:38pm, and I can’t believe it’s so early. And then I remember the difference: it’s the beginning of the quarter, I don’t feel entirely exhausted, and I’m not so tired that my body’s begging to let me take a nap about 7:38pm. What a difference a break makes.
• I just launched ericmah.com about 5 minutes ago. Eric is a good friend and running for City Council in Manhattan Beach, California. Vote early, contribute often. Please, Google gods, make those links help get him on your index list.

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My favorite gift wasn’t the dress shirt or slacks so I can look spiffy in clinics; it wasn’t What’s The Matter With Kansas , or the sour watermelon gummies, or even the underwear. Not the sweaters or calendar of Paris, either.

My favorite gift this holiday was the knowledge that I’m not going bald, as I had been previously thinking for the past couple months, and frantically ranting to my classmate Yana about. No, no, dear readers. I get to keep this lucious mane of hair. My mom has the same hairline forehead V that I have.

Yes, Virginia, there is a Santa Claus.

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From a former babysitter with her own GI stories:

Two doctors opened an office in a small town, and put up a sign reading “Dr. Smith and Dr. Jones, Psychiatry and Proctology.”

The town council was not too happy with the sign, so the doctors changed it to “Hysterias and Posteriors.”

This was not acceptable either, so in an effort to satisfy the council, they changed the sign to “Schizoids and Hemorrhoids.”

No go. Next, they tried “Catatonics and High Colonics.” Thumbs down again.

Then came “Manic Depressives and Anal Retentives.” Still not good.

How about “Minds and Behinds?” Unacceptable again.

So they tried “Lost Souls and A**Holes.” Still no go.

Nor did “Analysis and Anal Cysts,” “Nuts and Butts,” “Freaks and Cheeks,” or “Loons and Moons” work either.

Almost at their wit’s end, the doctors finally came up with a business slogan they thought might be acceptable to the council: “Dr. Smith and Dr. Jones, Odds and Ends.”

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Problem: Inflammatory Bowel Disease is on the rise. It’s a set of GI syndromes-most notably, Crohn’s and Ulcerative Colitis-which are quite nasty: bloody diarrhea, fever, malabsorption of nutrients, indigestion, increased risk of colon cancer, many times requires surgery or lots of immunosuppression.

Solution: Give patients pig whipworms to eat . In a small study, 23 out of 24 people became symptom free by the end–quite a miraculous change. Note, these are not the type of whipworms that give you a prolapsed rectum . That would be human whipworms. Just in case you were wondering.

In other news, I’ll be ingesting a couple tapeworms (Steve and Lou are their names) to help me lose a few pounds before Hawaii. It’s a Paris Hilton secret.

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