This was my last week of toxicology. We each had to give a 40-minute presentation today. Mine was on alcohol withdrawal. It turned out to be a really good topic, since I had at least one alcoholic patient on my medicine rotation who we thought might be having withdrawal. The problem with hospitalizing alcoholic patients is that since they can't get a drink in the hospital, they can start going through withdrawal a day or two after they get admitted. Alcohol withdrawal is a serious problem, and it can kill the patient. The worst symptoms come with delirium tremens and include seizures, delirium, hallucinations, nervous system dysfunction, and electrolyte disturbances. Of course, fortunately not all patients get delirium tremens. But the ones who do need supportive care.
I also gave a brief presentation yesterday about absinthe, which is a drink made from wormwood extract. It is said that the artist Vincent Van Gogh was under the influence of absinthe when he cut off his ear. There are several alkaloids (chemicals) in wormwood that could cause the symptoms of "absinthism" (seizures, hallucinations, problems walking). But it turns out that the major ingredient in absinthe is alcohol! No wonder these people were stumbling around like drunks and hallucinating. They were alcoholics! It is still not legal to make absinthe in the United States, but they do have it in Europe.
Next on the agenda is preventive medicine, which is an online elective that is really an excuse for me to get out of Cleveland for a couple of weeks.