January 29, 2010

opposites

Studying can get more than a little bit monotonous, especially when reviewing and having no old tests to go off of, so I try to spice it up by studying in different locales, trying different techniques, etc. For instance, I typed up some tables and such and then had my wife quiz me over them. "Oh, I don't know. I'm not as smart as you doctors. I might not do it right," my wife sardonically replied. She thinks it's funny to constantly make fun of how smart we med students are knowing full well my opinion on how many stupid smart people there are. If you set out to design polar opposites, you couldn't do a better job of me and my wife. We're as far apart as up from down. I'm linear and analytical. She's spontaneous. She'll pull questions that aren't even out of left field. Hell, they're not even in the ballpark. They're more from the bar three blocks down from left field. But I've learned that if I can explain something medical to her, then I must know it pretty well. The opposite is true, too. If she pulls a question from said bar three blocks down and I can't answer it, well, I need to expand my knowledge. Life is funny in the timing. Last night, she's helping me review and we get to the GABA pathway. I explain to her that drugs that mellow people out like valium or the infamous date-rape drug rohypnol, work by accentuating the effects of GABA. GABA is a signal that blocks stimulation. Everything mellows out. That's why they're used to treat anxiety. They're inhibiting those stimulus signals that are driving the anxiety. And out of the blue, she asks, "So is this what alcohol does? (without giving me time to even answer, this is how her brain works) So you could give this to an epileptic to stop their seizures?" "No idea. I suppose it might work." I'm not kidding. The VERY FIRST question on the written portion of the neuro exam: Patient presents to the ER with acute seizure. What might be a good treatment option in an acute event? A) don't remember B) GABA agonist like benzodiazepines I had to bite my lip to keep from laughing myself out of the chair right then and there. So I google it when I get home (again, how did med students learn before google?) and sure enough, benzos while not a first line option for chronic management of seizures because they tend to become less effective over time, ARE often used for prolonged seizures. Too funny. There's a piece of clinical information I won't soon forget, just because of my wife. The magnetic force of polar opposites ain't a bad thing.

2 comments:

Steve Parker, M.D. said...

Five years ago I asked a medical student doing a clinical rotation with me where she found a particular bit of medical information. She said she "googled" it. I was skeptical and, frankly, disappointed.

Now, I do it myself all the time.

Just gotta take it with a grain of salt and consider the source.

-Steve

Isaac said...

If it's something important, I always confirm it up with a more reliable source. It's just too powerful a tool to pass up, though. Like in this case, I used webmd as the initial piece but then confirmed it with a review article in the journal Epilepsia and NYU Med School's page on treating epilepsy.