sanguinemare

March 24, 2012

Updates and onto GI (Gastrointestinal module, aka the gut)

Filed under: "Me" updates,Med School and the MSTP — sanguinemare @ 4:55 pm
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Terribly sorry to have been so MIA – this spring semester we have started our organ modules, on top of which we had our medical school’s annual skit night to prepare for, so as such I have been a bit out of touch.  That, and… I still don’t have internet at my place.  Frustration.

Anyhoos, we have flown through the cardiac (heart) and pulmonary (lung) modules through the first two and a half months after getting back on Jan 2 (our winter break was a very short 2 weeks sadly).  Each of those modules was 5 weeks long, and this one will be as well.  Apparently, pulmonary is the easiest module we’ll ever have in our med school career, so it only gets harder from here.  Especially GI (stomach/gut) and renal (kidney), which are our next two modules. GI is tough partly because it’s one of the first modules to test us completely in Step 1 USMLE style questions, and also partly because there are so many organs covered in the same space of time as the single organs in cardio/pulmonary (7 total: salivary glands, esophagus, stomach, small/large intestine, liver, gallbladder, and pancreas).

In terms of MSTP stuff, I’ve also been trying to find a lab to work in for the summer, which has been quite difficult, mainly because I’m one of those people who are interested in almost anything, so my searches are very broad.  I’ve looked through all the faculty (sometimes up to 30 or so) in at least 5-6 different Centers at the school to narrow down the list, and have met with maybe 10 or so.  Scheduling meetings with professors is tougher than it looks, because sometimes they are out of town because of conferences etc, sometimes they can do a certain time in a week but I’ll have class, etc. so it’s been a long process.  Most of my MSTP colleagues in my class (if not all) have already found their lab mentors for the summer, and one of them has already started going to lab meetings!  So I’m feeling a bit behind, but hopefully, I’ll be done a couple weeks and figure that out. 

Housing is another thing I’ll need to worry about – definitely need to move out from my place – it smells of smoke (from a past tenant I guess), the trash can collector sometimes comes at odd hours, there are sketchy people outside the alley sometimes behind my place because it’s behind a bar which sometimes plays music until 1-2am, even on weekdays occasionally… so yeah.  Definitely need to move out.

Anyway, to give a few interesting tidbits about the GI tract so far, here is (according to our lecturer’s slides) the reason the study of GI is important:

  • ~70 mill people in the US visit their physician for a GI-related complaint every year.  5% of the US suffers from chronic digestive disorders.
  • “Abdominal pain” and “diarrhea” are among the top 7 reasons for doctor visits, and there are 0.9 million hospitalization for diarrhea alone in the US
  • ~4 million people have ulcers, 11 million have hemorrhoids, and 5 million have constipation.
  • In 2010, the top selling drug was Nexium, which is a proton pump inhibitor used for ulcer treatments ($5.28 billion).
  • Estimated direct costs in the US per year: $87 billion ($20 billion indirect, like from loss of work days, etc).  

To give you some perspective, the US has about 300 million people (311,591,917 according to the 2011 US Census Bureau).   So percentage-wise, things like ulcers and constipation aren’t that major, but of course are still of concern.  70 million people having a GI-related complaint is pretty significant though.

I do enjoy the interesting stories we’ve been told in GI by our module director so far.  On the very first day, we were treated to a story about how Holy Roman Emperor Frederick II of the 13th century learned how to best digest his food.  Basically, he fed 2 men a large, delicious meal, and sent one of them to hunt and one to rest.  He later had both of them executed and removed their bowels to see who digested the food better.  Lovely, isn’t it?  For those who don’t know, the one who rested had better digestion, since more of his blood flow was able to be directed to his stomach, rather than to his muscles (like the hunter’s).

Another story we were regaled with two days ago was on the pairing of William Beaumont, a local army surgeon with no medical degree, and Alex St. Martin, a French-Canadian fur trapper who had the misfortune of being such a jester that a fellow fur trapper accidentally shot him in the stomach after laughing too hard at his joke and dropping his loaded shotgun.  The moral there is to not be too good a comedian, I suppose.  Or to make sure your friends don’t carry loaded guns.  Anyway, the year was 1822 and Beaumont did his best to heal the wound.  By the 5th week, healing had begun, and a year later, everything was scarred over and healed except for a small hole in the stomach that provided a window of sorts to the outside (he had had a fistula – an abnormal connection of tissue – between his somach wall and abdominal wall)

Beaumont then started experiments with St. Martin including dropping food on a string into the stomach opening for a while, then pulling it out and seeing how much it was digested.  Thus, was born the first physiological experiments on the stomach.  He paid St. Martin ~$160/year to do this, and despite disagreements sometimes (such as those culminating in St. Martin storming from the room in exasperation and only agreeing to come back after Beaumont agreed to pay him more), they did this for quite a good while.  (Wikipedia says that St. Martin actually didn’t do this to thank Beaumont for keeping him alive, but actually because Beaumont made him sign a contract to be a servant (St. Martin was illiterate).  That’s pretty terrible, even without IRB approvals and such…)  St. Martin ended up outliving Beaumont, and lived until 1884 (or 1880 according to Wiki).  So there you have it – you can have hole in your stomach and apparently still live to be quite old.

Anyway, it is about time for me to restart (aka begin) studying, since I’m taking my midterm early on Wednesday so I can leave for a conference.  Hope you enjoyed the stories, and may you all stay well and healthy until next time!

Oh, and just in case you’re curious, here’s an overview of what we have in our 5 weeks of GI:

  • 56 lectures
  • 10 lab sessions (5 anatomy, 2 histology (although I only see one in our schedule…), 2 pathology, and 1 microbiology)
  • 2 small group sessions (Ulcer/GERD (aka acid reflux/heartburn), Liver)
  • 2 large group sessions (Radiology I and II)
  • 2 patient presentations (Hepatitis/Cirrhosis and Congenital abnormalities) – these are where patients are brought into the class and we first get a mini-lecture to learn about their diseases/mechanisms of disease, and then have a Q and A session with them about their lives and what it’s like living with the disease.
  • 3 optional review sessions (including 1 2-hour anatomy lab review that I will unfortunately have to miss because I’ll be taking my midterm at the same time.)
  • 70% attendance required (yes, we have started an attendance policy at our school as of a year or two ago so that lecturers don’t feel odd giving lectures to an empty room.  Generally the attendance policy is 80%).

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