1. List 10 indications for ordering imaging.
trauma, unexplained wt loss, night pain, neuromotor deficit, RA, hx of malignancy, FUO, abn blood finding, deformity, failure to respond to therapy, medicolegal
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Today was the third time that I took blood from a classmate's arm during class. It was the first time that I felt calm and methodical about it. Nailed the vein, plugged in the tube, changed tubes, pulled the tourniquette, removed the needle....I didn't sweat or shake at all. Phew. I know I'll be proficient at this, but the first two times I was shaken by it. In retrospect I think it was the TA who shook me up. She was all over me, telling me how confident I was (when I wasn't) and telling me what to do next so fast that I didn't have a chance to think it through and do it on my own. She jarred me out of my tiny groove. Today I managed to get the regular teacher to preside over my blood pulling, instead of the TA, and I felt so much better. OK. Next step: get to where the TA doesn't bother me.

The poor girl who tried to get blood from my arm missed the vein entirely. Out of three student attempts to draw my blood, only one has been successful, and I think the needle went all the way through my vein that time. I had a bruise that traveled up my arm for a week afterward. This last woman was too slow moving and tentative. My veins don't just sit there, they try to get away. You have to pin them down and stab them like you mean it, if you want blood from them. I don't want the students to be discouraged, so I don't tell them that I have "hard veins". The lady at the clinic never misses.

What is the most common cause of atelectasis (collapsed lung)?
( answer )

What can be called pneumonia that is not caused by infection?
( the answer )

I had a pleasant weekend in good weather. Worked my hydro shift Saturday morning, then in the afternoon went up to Austin Hotsprings on the Clackamas River with M. The area of the springs has been recently rearranged by the owners using a bulldozer. The pools have all been filled with gravel and there are new concrete barriers blocking entry to the place. Rumor has it that a woman and two children were badly burned there about a month ago. Apparently the owner was trying to minimize his liability by destroying the pools, but somebody had already built a new pool and while we were there we were working on a second one. You can't stop a hot springs from coming up out of the ground, and you can't stop people from trying to get in it. People stay clothed at this hotsprings because it is so close to the road, and because a lot of Russians use it, and they are conservative.
( the rest )

I have been noticing that many of the students that I am in school with have very foul breath. I was doing EENT exams on a classmate this am and his breath was enough to make me stand FAR back. One cannot be a doctor and have a killer stench emanating from the frontside. I want to say something, but so far I have kept quiet about it. I just make noise out here in the vast internet.

I've been reading the assigned chapter (chapter 7 of Amy Lansky's book Impossible Cure; The Promise of Homeopathy) and decided to do a little web search to see if anyone else had some thoughts about the way that homeopaths like to present the science about their pet topic. I discovered that I am not the only one who thinks the presentation of the material is biased and that the so-called science is distorted so badly as to not merit the name "science" anymore. But check out the links for yourself, if you're interested. I found these by searching for "Linde 1997 homeopathy", referencing his 1997 meta analysis "proving" that homeopathy is 245% more effective than placebo. Linde's analysis included research in all languages, making it difficult for any non-linguistically oriented individual to directly critique his much-quoted analysis.

First, here's the Linde meta analysis
http://www.ncbi.nlm.nih.gov/pubmed/9310601
And a nugget of Linde's work:
http://www.crd.york.ac.uk/CRDWeb/ShowRecord.asp?ID=11999000167
( And now for lots of links to the other side of the story. )

It's all the buzz.....somebody scratched swastikas and anti-gay words on walls in a new gender neutral bathroom on the 2nd floor, and in the "energy medicine" room on the 3rd floor. The gender neutral bathroom came into being because of efforts of the Queers and Allies group on campus, and the way in which it was promoted seems to have alienated a few people. The responses to an anonymous survey revealed substantial tension around the subject, and yet this tension was publicly not addressed. I did not know until today that the creation of this restroom took away the only faculty lounge. There is a plan to have a campus-wide meeting to discuss the incident and what to do about it. I can guarantee you that the perp will not be in attendance.

In this student population the assumption is that we are all environmentalists, eat organic food, ride our bikes, are liberals and progressives, and that we are nondiscriminatory toward all people including gays, other races, genders, religions. But this stereotype of the naturopathic/Chinese medicine student is just that, a stereotype. We are all different. Some of our population are very young people who have not yet separated their values from their parents'. Worldwide the trend is toward greater bigotry and lesser tolerance.....so this is not a one time issue, this is forever, this is for life. We won't win people over to tolerance by being intolerant. I am worried that the school's efforts to reduce hate-oriented actions of all kinds may backfire. I hope not.
( the email that came today )