post

Picking Apart My Brain

I was one of the first into lab from my group of eight. On the table was a clear plastic container filled with a solution of 10% formaldehyde. The container sat on a tray — a tray that you might find in a cafeteria.

I slipped the tray out from underneath the container and carefully opened the container. The smell was strong. The liquid looked a little brownish. I reached in, my gloves on, and pulled out a human brain. Well, at least half of a human brain. It had already been cut down the middle — a clean cut separating the left and the right brain.

The day’s lab only required examining one hemisphere. Already having arbitrarily chosen one side, I placed my half-brain onto the tray and went to the special sink to rinse off the formaldehyde solution.

In line I looked around. It was a weird scene. Students waiting in line. All holding cafeteria trays that carried a human brain.

After finding and identifying all the structures on our checklist, it was time to leave the lab. The brain slices were returned to their smelly solution. Most of our nostrils burned. Someone’s eyes were teary.

Neuro lab was a little strange. Gross examination wasn’t that bad. I mean, I’d seen plenty of brains in pictures. It was the slicing that I felt weird about. It cut so easily. Almost like a kiwi, without the skin. Or maybe think JELL-O, the kind with fruit inside.

But, I think the best example, if you’re familiar with it, would be tofu. The hard kind. Not the soft tofu used for soup. It’s actually how Katrina Firlik, MD (a neurosurgeon) described the consistency of brain in her book Another Day in the Frontal Lobe, which, by the way, as an awesome book.

A classmate commented that its so strange watching it. We are cutting up someone’s brain. At one time, the cells in this brain we were now cutting up, fired off electrical impulses. It commanded muscle groups and regulated complex functions. It held someone’s memories.

Occasionally I get these moments in medical school. Moments in which I stand in awe. I am amazed at what I am holding, or touching, or seeing. I like those moments. I’d like more of them, too. I think they help me push on through the drudgery of having to study all the time.

And now, its late and I’m sleepy. So I’ll end this post here.

post

Medical Humor – Nurses’ ER Rap

All of the videos I’ve shared on this site have been medical school related videos. This was created by nurses for a National Nurses’ Week Contest. Check it out, and enjoy.

post

Medical Humor – Playing Doctor

The seven-year old girl told her mom, “A boy in my class asked me to play doctor.”

“Oh, dear,” the mother nervously sighed. “What happened, honey?”

“Nothing. He made me wait 45 minutes and then double-billed the insurance company.”

post

Medical Humor – Things You Don’t Want to Hear a Surgeon Say

Things You Don’t Want to Hear a Surgeon Say in the Operating Room

  • Oops!
  • Has anyone seen my watch?
  • Come back with that! Bad Dog!
  • Wait a minute, if this is his spleen, then what’s that?
  • Hand me that…uh…that uh…..thingy
  • What do you mean he wasn’t in for a sex change!
  • Damn, there go the lights again…
  • Everybody stand back! I lost my contact lens!
  • Well folks, this will be an experiment for all of us.
  • What do you mean, he’s not insured?
  • Let’s hurry, I don’t want to miss “American Idol”
  • What do you mean “You want a divorce”!
  • FIRE! FIRE! Everyone get out!
post

Dr. Phil, have you heard of… HIPAA?

Related Posts: Britney Spears Now In Doctors’ Hands

Dr. Phil & Britney
Copyright 2008 Brad Barket / Robyn Beck / Getty Images

News on the street, and by street I mean Internet, is that Dr. Phil paid a little visit to a certain celebrity (whom I’ll refer to as Ms. S) on Saturday (January 5) at Cedars-Sinai Hospital. She had been there since Thursday after her standoff with police.

Well after his meeting with Ms. S, Dr. Phil released this statement to Entertainment Tonight:

My meeting with Britney and some of her family members this morning in her room at Cedars leaves me convinced more than ever that she is in dire need of both medical and psychological intervention. She was released moments before my arrival and was packing when I entered the room. We visited for about an hour before I walked with her to her car. I am very concerned for her.

I am HIPAA Hipponeither a doctor, nor a HIPAA expert, but I did sign the form and take a little class about it. Isn’t this situation a breach of doctor-patient confidentiality? Dr. Phil, shame on you!

I suppose he might claim that he is not her doctor and she isn’t his patient. So in that case, he is not bound by doctor-patient confidentiality.

According to one article by TMZ, Ms. S was totally “blindsided” by the visit:

People on the 7th floor at Cedars-Sinai Medical Center say the doctor arrived about 7:30 AM Saturday. We’re told [she] did not invite him in; she didn’t even know he was coming. Sources say it was [her] parents who told Dr. Phil to go to the hospital. When he walked into her room, we’re told, a blindsided Britney walked out — and eventually came back.

Maybe Dr. Phil’s defense can be that he was an invited family guest? I don’t think so. Further reading of that article reveals that Dr. Phil would like to do a television intervention of the pop-star anonymous celebrity patient.

Hmm.. so Dr. Phil comes in at the request of the patient’s parent. And then he decides to use this opportunity to generate some publicity for his television show?!? Who in the world got him on the air?? Oh, wait.. Oprah! Oprah needs to pull him in for a little sit-down.

I’m glad to see that I’m not the only one thinking that this was inappropriate. Another article at TMZ reports that many psychiatrists have criticized both Dr. Phil and Cedars-Sinai.

the hospital should not allow any doctor who does not have in-patient privileges into a patient’s room, unless that patient has given prior consent. TMZ has learned Britney had no idea Dr. Phil was coming to her room and indeed when he walked in she became agitated and walked out.

The psychiatrists were pretty much unified in their opinions. One claimed to be “outraged and disgusted” about the whole situation. Another called Dr. Phil’s actions “intrusive and inappropriate.” Yet another criticized the Cedars for allowing Dr. Phil, who doesn’t have practicing privileges there, to see one of their patients without her knowledge or consent.

Out of line. The whole situation was absurd from a patient confidentiality standpoint. When dealing with any patient, their privacy is so important. Which is why every single medical blog (at least that I know of) has a very clear privacy statement. No patient identities are to be compromised. Doctors, in order to do their job well, must be able to get the complete story from their patients. And patients, in order to open up, must feel confident that what they share to their doctor will stay between them. Its a simple ethical issue, and a legal one as well.

*****

Update (January 7, 2008): Today (January 7) MSNBC.com is reporting that Dr. Phil has decided to pull his special on Ms. S. He said that the situation is “too intense” for him proceed.

Dr. Phil’s statements and actions have sparked a lot of criticism in the media. He defends his actions by saying he was not acting in a professional capacity when visiting Ms. S. You can check out the article at E! Online – Dr. Phil Defends Britney Visit, Calls Off Special.

Update (January 12, 2008): A complaint against Dr. Phil has been filed with the California Board of Psychology. The complaint, filed by another psychologist, claims that in going to counsel the pop-star, Dr. Phil was practicing psychology without a license. This is a serious charge, and one the board might hand over to the District Attorney for review because practicing psychology without a licenses in California is a felony.

Dr. Phil has never been licensed to practice psychology in California and retired his Texas license in 2006.

The complaint also says that a petition to remove Dr. Phil from the air is going around.

More can be found at TMZ.com: Psychology Board Investigates Dr. Phil.

Update (January 18, 2008): USA Today is reporting that Dr Phil still believes his meeting with Ms. Spears was appropriate. However, Dr. Phil says, that he regrets making a statement about it afterwords. Quoting from the article:

“Was it helpful to the situation? Regrettably, no. It was not, and I have to acknowledge that and I do,” the talk show host told his audience Thursday during taping of a Dr. Phil episode that will run Monday.

“I definitely think if I had it to do over again, I probably wouldn’t make any statement at all. Period.”

More can be found at USA Today – Dr. Phil says he regrets statement on Britney.

Sources: TMZ.com: Brit Blindsided by Phil — Hospital Acts Curiously, TMZ.com: Psychiatrists Slam Phil, Cedars, Entertainment Tonight, E! Online – Dr. Phil Defends Britney Visit, Calls Off Special, TMZ.com: Psychology Board Investigates Dr. Phil, USA Today – Dr. Phil says he regrets statement on Britney.

post

Medical School is like… Pancakes?

Recently found a post over at Rumors Were True titled Pancakes Everyday. The author of that blog is also a medical student. Apparently, a while back, he wrote a post in which he likened medical school to eating pancakes everyday. Its an interesting post. You can check it out at the link above.

Anyways, I guess a friend of his read the post and decided to make a video based on the post. I think it gets the point across.

Enjoy.

post

Prescription Placebos

Source: MSNBC.com – Doctors often dole out placebos to patients

In a recent MSNBC.com article, I discovered that many physicians prescribe placebos. The researchers claim that half of the doctors surveyed admitted to prescribing a placebo to a patient at one point.

One of the authors of the study, Rachel Sherman (a medical student), said that this “illustrates that doctors believe expectation and belief have therapeutic potential.”

One part of the article made me wonder… It said that some doctors tell their patients that they are prescribing a placebo (4 percent of doctors surveyed). Doesn’t that defeat the purpose of prescribing a placebo? Maybe these doctors missed that lecture in medical school. Wait, no.. we learn about placebos as early as high school! Why in the world would you tell your patient, “It’s a placebo”?!?

I just find it amusing that doctors prescribe placebo. I suspect that a number of these cases would be for patients, or their parents, who insist on getting some sort of medication even though their physician says they have nothing to worry about.

It makes me wonder if I’ve ever been prescribed a placebo. Although I’ve never insisted on taking something. I don’t think my mom has ever insisted to the doctor that I be prescribed something either.

Personally, I think that the only time I’d be tempted to prescribe a placebo is for an insistent patient. I realize that there are ethical objections to the practice, though.

In a perfect world, maybe there would be no need for informed consent. The patient would have complete trust in the doctor and the doctor would be perfectly competent. Of course, in a perfect world, there would be no need for doctors…