Friday, March 16, 2007

Lipid Seminar, PBL, POD, and CHI

Today was a really long day, but it was a good one. Our seminar this morning had three parts. The first part was an intro to lipid digestion and absorption. Dr. Chisolm, who ran our Journal Club course last summer, was leading it. He's very interactive. I think if he knows that you might not be paying attention, he'll call on you. So my philosophy is that it's best to volunteer to answer questions rather than let him call you on something that you might not know. Afterward, we broke into two groups to discuss the two articles that we had been assigned to read for homework. This time I finally got to be in the group that stayed in the library! Dr. Chisholm went over the first article with us, and then a physician went over the second one. I think I got quite a bit out of the seminar, and it was fun.

We are finished now with our PBL case about the sick doctor. We didn't have as many learning objectives today, so we spent some more time discussing what the responsibility of the patient-doctor's physician was toward the patient's twin brother, and how he could fulfill that responsibility without violating his own patient's privacy. One thing that annoyed me is that we still don't know what kind of twins the two of them are. It makes a difference, because if they are fraternal (dizygotic) twins, then they don't have any more genetic similarities than any other pair of siblings would. Obviously if they were identical twins, then that's a different story. Hopefully they'll give an answer to that question in the case next year.

Our POD seminar today was FANTASTIC. It's easily one of the best we've had all year. The speaker was the same pathologist who had been doing our GI histo seminars earlier in the block. She studies Crohn's Disease and inflammatory bowel disease (IBD). Something really good that she did is that she just sat and talked with us instead of showing us endless slides of data, which made the talk very interactive and informal. People asked a lot of questions. One of the most interesting things she told us is that she got involved in this type of research because of her personal experience with someone close to her who has one of these diseases. Also, she convinced the gastroenterologists at CCF to take more biopsies of patients with IBD during their colonoscopies by writing in her path reports that she had received inadequate numbers of samples. It turns out that people with IBD are more prone to getting colon cancer, and the number of biopsies being taken were not in accordance with published literature guidelines for catching most of these cancers. Now it is standard practice at CCF to take enough biopsies, and she said sometimes she even gets more than the number needed. She was rightly proud of having instigated a change here that could literally save people's lives.

In the afternoon, I volunteered at CHI. The weather was kind of cold and gray, but we had a lot of people come anyway. I was doing the glucose and cholesterol tests again--I've gotten pretty good at getting blood by now, even from the people who aren't "bleeders." We started offering HIV tests today, and the nurse who was administering them was sitting at the next table from where I was. So I was able to watch her a little bit when things were slow at my table. It's apparently some kind of DNA test that uses swabs, not a blood test. I haven't done the HIV training yet, but hopefully there will be another session soon so that I can learn how to do it. I figure they'll probably do it this summer so that the new M1s can get involved too. We also had a patient with a positive pregnancy test today, so some of my classmates were able to help her with getting prenatal care. I was talking about it afterward with one of my classmates who does the social work for the CHI patients. It's kind of scary in a sense because there are so many things that a pregnant woman with no health insurance needs. But at the same time, it's a significant opportunity to hopefully make a difference in someone's life, even though we're still only first and second year students.


Alex Pine said...

There is a nice news-of-the-week post in March 30th issue of Science. It talks about Dr. Watson's (of the DNA fame) DNA and some ethical concerns associated with it. He agreed to make it public, but requested that his ApoE gene status be blanked out. Also, what about those loci that now are considered innocuous, but might be associated with some disease in the future. Should his children have a say in what's published and what loci are blocked?

CCLCM Student said...

I have to assume this question is rhetorical, because I'd need to start a whole new blog to answer it. ;-)