Friday, January 23, 2009

The Best of Toxicology

I am now halfway through this toxicology rotation, and I really love it. It's mostly didactics and not very much clinical stuff, but the subject is really interesting, and the attending has all kinds of cool stories to tell. For example, he testified for a criminal trial where someone poisoned the defendant. That was definitely cool. He also gets to travel around a lot. Monday he'll be doing consults, so we're going to go with him. I'm looking forward to that. We're also each going to do a presentation at the end on some kind of tox topic. Mine will be on alcohol withdrawal.

We spent Monday morning in the attending's lead clinic. This is an outpatient clinic where he sees kids who have lead poisoning, usually due to ingesting or inhaling lead-based paints. If their lead levels are high enough, he chelates them. (Chelators are chemicals that bind to lead so that the body can excrete it.) Since a lot of the buildings in Cleveland are relatively old, especially in the poorer areas of town, there is still a lot of lead-based paint here. One family had three little girls, all with almost the same names. The nurse practitioner was having trouble remembering which one was which, but the funniest thing was that the girls' mother was having the same problem.

Today's afternoon seminar was on the art of physical diagnosis, or rather, how this art is being lost because of the dependence on technology. We didn't actually practice any physical diagnosis, mind you, just talked about how we don't really learn it. Again, it's an important topic to think about, but three hours of it is really not necessary.

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