Preemptive clarification: This is the start of my internal medicine clerkship. In the medical field it is common to abbreviate internal medicine to IM or just medicine. The latter can be quite confusing. "What are you studying right now?" "Medicine." "Well, obviously, but what field?" "Medicine!" "And who's on second?"
You have been warned.
The past two days have been orientations to the medicine clerkship and the procedures at my hospital, respectively. Yesterday, we also had a couple lectures that were surprisingly interesting (to me, at least). One was a pretty straight forward affair about acid-base dysfunctions as taught by a well-spoken nephrologist (kidney doctor). The other was a two-hour whirlwind tour of the history of translational research. That is the step in medical research where an idea that showed promise in the basic science lab is tested on tissues or animals to see if it does enough to warrant clinical trials.
Today we had a quick orientation before being introduced to our inpatient team. We were all rather anxious at this point because your team can make or break your rotation. Turns out, I didn't get much time at this point to discover the coolness of my team (and the are cool), because we needed to see a patient immediately. She was transferring from another unit and we wanted to interview her to get an idea of what she understood about her situation. As it happened, she didn't know she has a large mass that very well might kill her... soon. It was a rough reminder that medicine doesn't start slow because we need a warm up.
YesterdayIL: Alzheimer's sucks to do research on. Of the two findings from autopsies that have been noticeable for the 100 years since Dr. Alzheimer differentiated this dementia, we have probably been putting all of our efforts into the wrong one. And even if the drugs we make work, we can't find good animal models for Alzheimer's. Then, if you make it to clinical trials, you can't tell if it's working or hurting because the super-sick patients that qualify for early trials are too demented to give you feedback.
TIL: Prescribing iron for a patient with iron deficiency anemia when the patient is on a PPI (proton pump inhibitor (drug that stops stomach acid production (e.g. Prilosec))) doesn't really help because the iron needs acid to be reduced to Fe3+ instead of Fe2+ to be transported into intestinal cells from the GI lumen.
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