Thought Train – What does it really mean to settle down?

27 08 2014

Source – lorenzaccio on flickr

I used to think that to be truly settled down in a place, you need to be comfortable taking the bus. Looking back at my stay in Bangkok where I took a bus to work in an
absolute foreign country and then rented a place where I would start my day with a delightful boat ride to work, I suppose there is some truth to the naivete. Though I
wonder if planning a trip by public transport to a new place is more of a step in growing up rather than settling down per se. When I was much younger, my benchmark for
having grown up, and being able to take care of myself, meant being able to take a bus or train independently in Mumbai.

Taking the train in Mumbai seems like such a struggle in contrast to the ease of movement back at home. 





Thought Train: On going home

26 08 2014

I wonder if home means something else to people who travel a lot. Is it something more special because they have limited access to it? Do they find it easier to make a place their home or harder? I sometimes find it easy to be at home almost anywhere, but I wonder if it has got to do with having stayed in a single spot for many years and it feels like you can relax and make yourself comfortable anywhere because on some instinctual level you know that abode is only temporary.

Which begs the question.

What does it really mean to settle down?




Books! Emperor of All Maladies

3 08 2014

Cover

I’m paying a bomb in overdue fines for this book, but it’s worth it. The book has been on my radar from a few years ago after a close friend recommended it, but it wasn’t available on the library’s otherwise fantastic e-book portal so it took a bit of a coincidence to finally get my hands on it.

i started reading it way back in June when I started my surgical oncology rotation. As I was doing a takeover of the patients before starting, one of my colleagues jokingly spoke of the field as being almost Halstedian (a reference that is easy to misconstrue). Halsted is famous for proposing the radical mastectomy, a major, disfiguring surgical procedure involving removal of the breast, the pecs, and lymph nodes in the arm pits. Surgeons of that era noticed a trend of breast cancer recurring in the margins of the previous surgery and this drove them into a frenzy of more and more invasive surgery (including removing lymph nodes around the collarbone, the chest and so on). This turned out to be a bad idea and looking at the data, it didn’t seem to improve life expectancy, yet the story goes that Halsted dogmatically persisted with aggressive surgery against consensus. Despite that Halsted is famous for a number of this as his wikipedia entry attests to.

Siddhartha Mukherjee really paints a lively, colourful picture of cancer’s history, and it looks like the secret to doing that well is to really flesh out the people who made that history. Mukherjee goes a step further to make the science accessible. Now I am clearly biased and I am reading this book as a medical professional and as the title of my blog suggests, always a student at heart. This paragraph, truly embodies how medicine should be taught. not as a bunch of dry facts but as a logical though process, with the appropriate historical context adding colour to the story.

“In 1982, a post doctoral scientist from Bombay, Lakshmi Charon Padhy, reported isolation of yet another such oncogene from a rat tumour called a neuroblastoma. Weinberg christened the gene neu, naming it after the type of cancer harbouring this gene.

The product of the neu gene in contrast, was a novel protein, not hidden deep inside the cell, but tethered to the cell membrane with a large fragment that hung outside, freely accessible to any drug. Lakshmi Charon Padhy even had a “drug” to test. In 1981, while isolating his gene, he hass created an antibody against the neu protein.

Weinberg had an oncogene and possibly an oncogene blocking drug but the twain had never met (in human cells or bodies). In the neuroblastoma cells dividing in his incubators, neu rampaged on monomaniacally, single mindedly, seemingly invincible. Yet its molecular foot still waved just outisde the surface of the plasma membrane, exposed and vulnerable, like Achilles’ famous heel”

I never imagined, during my cancer biology lectures back in med school that Cancer, something that we often see as depressing, morbid and sometimes hopeless, could have a story behind it that’s hopeful, inspiring and quite a scientific adventure.

It’s made me appreciate the training I’ve had and the value of good teachers.





My favourite passage from a Science book

24 03 2014

This passage stuck in my mind after attending the Darwin Day 2014 celebrations and I kept thinking about it when I was sitting at the pond.

“It is interesting to contemplate an entangled bank, clothed with many plants of many kinds, with birds singing on the bushes, with various insects flitting about, and with worms crawling through the damp earth, and to reflect that these elaborately constructed forms, so different from each other, and dependent on each other in so complex a manner, have all been produced by laws acting around us. These laws, taken in the largest sense, being Growth with Reproduction; Inheritance which is almost implied by reproduction; Variability from the indirect and direct action of the external conditions of life, and from use and disuse; a Ratio of Increase so high as to lead to a Struggle for Life, and as a consequence to Natural Selection, entailing Divergence of Character and the Extinction of less-improved forms. Thus, from the war of nature, from famine and death, the most exalted object which we are capable of conceiving, namely, the production of the higher animals, directly follows. There is grandeur in this view of life, with its several powers, having been originally breathed into a few forms or into one; and that, whilst this planet has gone cycling on according to the fixed law of gravity, from so simple a beginning endless forms most beautiful and most wonderful have been, and are being, evolved.” ~ Charles Darwin, The Origin of Species 1859 Edition

Source





I found the tenses on this govt FAQ a little odd

18 02 2014

I was taking a break from studying by browsing the FAQs for MediSave which is a fund set up by the government where you contribute a bit of your salary to so as to help cover medical bills. Here’s what I saw.

medisave tenses

 

Read the rest of the FAQ  here.





“I wish I could go to bed”

14 02 2014

This came in via Medscape, which a Medical Education/Newsportal most of us subscribe to. It’s a compilation of reflections from the Medscape panel on “Why we practice Medicine”

If you have a subscription, you can see the rest of the slides here.





Med school has ended

7 02 2014

That is an ironic thing to say considering how the title of this blog is medschneverends. Yet, today, I just finished my final end of rotation test and hung out with my group mates for a final post-test outing. I’m a very nostalgic kind of guy and thought about how I went from my first day with a stethoscope where I was convinced that all the heart sounds heard from a stethoscope were make believe to the stage where you listen to a patients chest and start making some inferences as to why the heart sounds the way it does and what treatment you can offer the patient.

It’s a long hard journey that would not have been possible without some lovely friends, patient mentors, my parents who have been very enabling and multitudes of willing patients who were kind enough to let me listen to their chest multiple times without complaining. This goes for the entire spectrum of clinical skills I’ve started acquiring and refining over the past three years.

It’s time to settle down and prep for the finals and on the bright side, it would mean some time to really digest all those years of learning and just maybe, I’ll be able to a bit of writing on the side too.

Cheers to many years of learning ahead!








Follow

Get every new post delivered to your Inbox.

Join 1,736 other followers