This is turning into a pretty busy week so far. We had our last FCM session today, but it was just to present the projects we were supposed to be working on. I hadn't really done much of anything toward my group's project and I needed to finish the reading for seminar anyway, so I didn't go this time.
Our seminar was a workshop to go over how special antigen presenting cells (APCs) in the body can activate T cells. T cells are a very important component of the specific immune response. Some T cells can kill infected body cells, and others activate B cells to get them to make antibodies. The APCs present antigens to the T cells using special proteins called the major histocompatibility complex. These proteins are the ones that have to be matched if you want to try giving someone an organ transplant. Your T cells recognize MHC proteins from someone else as being foreign if their MHCs are different than yours. If someone gets an organ that doesn't match their MHCs, then their T cells will attack the new organ and kill it. This makes sense in terms of evolution, because we weren't made to get organs from other people transplanted into us. Of course, for people who need transplants to stay alive, this means that the logistics of transplantation are very difficult. Even when the MHCs of the transplanted organs and the recipients match each other perfectly, the recipients still have to take immunosuppressive drugs for the rest of their lives so that they don't reject the organ.
I wasn't supposed to have clinic today, but I had to make up the one that I missed last week. My regular preceptor is out of town, so I'm working with a substitute this month. My first patient today had a major complaint of being constipated. Since my second patient cancelled, I spent about an hour reading about the etiology and treatment of constipation. It is both disgusting and also kind of fascinating in that can't-look-away-from-the-train-wreck way. Basically, if the stool is hard enough and can't be softened, the doctor has to manually remove it. The only other somewhat exciting thing I did today was to perform a breast exam on a woman. Again, we aren't supposed to do this until next year, but I watched the doctor perform one, and then she told me in front of the patient to go ahead and repeat what she had done. You might be thinking that this would feel totally awkward to me, and you would be thinking right. I tried to just copy what the doctor had done and hoped hard that the patient didn't feel like I was groping her.
The more I learn about the fun in store for me over the next few years, the more I realize that it's a good thing I didn't totally know what I was getting myself into before I applied to medical school. I can tell you for sure though that I have zero interest in being a gynecologist.