Tuesday, October 17, 2006

FCM, Tilt Table Test, Anatomy, and Obesity Talk

Today was a rough day as far as classes go. The FCM class was supposed to be about the Tuskegee Syphilis Experiment, at least based upon what the portal said and the reading we were assigned. Instead, we started out by having a person from the Cleveland Department of Public Health tell us about all of the subdepartments in the department for a full hour. There are a ton of subdepartments, and as you can imagine, this got kind of monotonous after a while. We broke up into our small groups to talk about the Tuskegee experiment afterward, and again this was kind of frustrating because the facilitators were talking more than the students were in many of the groups. I would prefer to have the FCM facilitators be more like the PBL facilitators, where they basically let the students do most of the talking unless the students are going completely off track. FCM has just not been the highlight of my CCLCM experience in general. I think that the issues covered are important, but the course is really not as interactive as it could and should be.

Afterward, the class split up. Half of us went to the CCF hospital for a clinical lab, and the other half had a science lab at the LRI. I was in the first group. We were supposed to be seeing some demonstrations of clinical tests (of which the tilt table test is one) that are used to determine how the patient's circulatory system responds to normal changes such as standing up. The tilt table test has the patient strapped to a board for up to 45 minutes at a seventy degree angle to see if their blood pressure will rise to compensate for the change in position. Anyway, it could have been very interesting, but again we wound up beginning by sitting through an hour of power point lectures in a small, hot room. At the end of the second power point, we asked if we could go see the clinical tests, but unfortunately it was kind of rushed and we didn't really get a full demonstration of how they worked. Afterward, we went back to the small, hot room and answered fill-in-the-blank questions, which was actually pretty helpful.

Things got a lot better after lunch. First, I worked on my PBL objective for tomorrow, and then I went to anatomy office hours. Again, it was fantastic, and I felt like I really got a lot out of it. I went with one other student, and we were the only two people in the whole lab. So the anatomy assistant was going over each cadaver with just the two of us, and it was like a private lesson. I really like the anatomy office hours, particularly because sometimes it is hard to see everything when there are seven or eight people all crowded around one cadaver during the Monday labs. I plan to keep going all year.

In the evening, a few of us went to the Page Lecture, which is an award lecture given by a scientist who is chosen each year for his or her work in medical research. This year's winner was Jeffrey Friedman from Rockefeller University, who was one of the discoverers of the hormone leptin. Leptin is produced by fat cells, and normally high levels of leptin should signal your brain that you need to stop eating. However, in people with leptin deficiencies or who are leptin resistant, the signal doesn't get through, and they keep eating. It's a really interesting topic. I learned two things that were especially interesting. One is that part of the reason why obesity and overweight is more prevalent in developed countries is because of our aging population. People naturally tend to gain a little weight as they get older, and since we are getting older as a society, naturally we are also getting heavier. In addition, there are two types of leptin problems, which you can equate with the two types of insulin problems that a diabetic has. Type I problems are in people who don't produce the hormone, and they tend to be less common. Type II problems are in people who are resistant to the hormone. It is not yet known how many obese people are obese because of leptin resistance, but most obese people are known to not be Type I (i.e., leptin deficient).

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