Tuesday, November 28, 2006

Long Day But Mostly a Good One

I woke up this morning not feeling very well, so I decided not to go to FCM. I feel kind of bad about having skipped it, because this is the first class I have ever missed since I got here. But I did the reading, and I guess maybe I just needed a little more sleep, because later on I felt better. So I did go to the 10:00 seminar, and it turned out to be really good. It was about how the body provides energy to the heart to use for contraction. You might think that a biochem seminar wouldn't be very interesting, but the seminar leader was really interactive and it was actually kind of fun. He gave us a brief packet of notes to read before we got to class today, and I thought the seminar itself did a good job of integrating a lot of the things we've been learning during this entire block.

After class, I went to a really awesome talk about facial transplants. I don't know if you've ever heard of this, but it's pretty incredible. Basically it is for people who have really severe disfigurement, like if they get most of their face burned away in an accident. They would be given a donor face (skin, nerves, blood vessels, etc.) from a cadaver. CCF is the first institution anywhere in the entire world to have an IRB approve a clinical trial to do facial transplants. They haven't done one yet on a human for various reasons, but they've been doing them successfully on rats for several years. The biggest issue is how to prevent the recipient's immune system from rejecting the transplant. You might already know that people who get organ transplants have to take immunosuppressant drugs to prevent their bodies from rejecting the donor organ, and the facial transplant researchers are hoping to avoid that problem. Apparently, if some of the deeper tissues like bones are transplanted along with the overlying skin, it helps prevent rejection. But this issue of immune system rejection is a much more complex problem with a facial transplant than it is with an organ transplant because there are so many different kinds of organs that are part of a person's face!

Right after the talk, I had clinic. Today is not my normal clinic day, but I missed clinic last week because of my preceptor being out of town for Thanksgiving. It was a really hectic day, and I was there until 6:00 because we were just so busy. Even then, we didn't get a chance to go over my patient logs, so we're going to have to do that next week. I saw four patients and did the chest and lung exams on them. A couple of my patients had some really sad personal issues they were dealing with. One actually started crying in the office, and basically all I could do was offer a tissue. I was warned before I started working in the clinic that patients will often tell students personal things like this, and it's definitely true. Anyway, it was a really tiring and trying day, but it was a good learning experience, too. You just never know what you're going to run into when you're dealing with patients.

Tomorrow is a long day for me too because we have clinical skills class. So I need to go to bed now.

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