Happy 2011!
Thursday, December 30, 2010
Saturday, December 18, 2010
Tuesday, December 14, 2010
Monday, December 13, 2010
"Come into my lab...

~ Frank N. Furter, The Rocky Horror Show
Some of my students have never had a "lab practical" before! It's time they did! Not scary, rather fun....
One of the things that is hard to teach--but I try!--is that students in the health professions are "crossing over" from being a layperson to having the right--nay, RESPONSIBILITY--to go places they have not gone before. This is difficult in some of the "grosser" areas of study....Being a clinical professional is not for the squeamish.
But most difficult of all is tearing down the wall of personal space--literally and figuratively--that is particularly high and thick in the West. Asking personal--VERY personal--questions and seeing people naked is NECESSARY to being effective. It's all in how it's done; respect and grace and consideration are required, but in the end we must go where we must in order to help our patients.
The "slab" is in fact quite large....
Friday, December 10, 2010
Thursday, December 9, 2010
The heart is"just" a muscle...

The above is one of the most famous medical images in the world--the "EKG", more properly the ECG--the electrocardiogram.
What it represents is the flow of electrical energy through the heart as the latter does its life-sustaining job. Nerves and muscles come together to create a magnificent work of precision, strength, and endurance.
What most people don't realize is that the electricity of the heart--of all cells, in fact--is exactly the same as the electricity that comes from the socket. It starts as chemical energy, whereas household electricity starts as heat or kinetic energy, but they both end up as moving electrons--electrical energy.
In a very real sense, we are one with the lightning!
YOWZA!
Wednesday, December 8, 2010
Beautiful but lethal

For reasons we don't understand, and for which we can only be thankful, this terrible virus has remained isolated in its locale and sporadic in its appearance. When it does attack, it does so with fearful virulence, killing most people it infects (which are often health care workers) by essentially causing them to bleed to death internally and externally. There is no treatment.
Homo sapiens is still just one species, and not a very hardy one at that. It behooves all of us to become as scientifically literate as possible, in preparation for the day when Ebola (or some other competitive species) breaks out of its current limited environment and comes for us.
I am thankful today for the nursing students who have determined to dedicate their lives to their fellows, despite the very real risk to themselves. You guys are the best!
Tuesday, December 7, 2010
Monday, December 6, 2010
Curioser and curioser

Prions? Not so.
Prions are essentially self-replicating proteins that can cause disease (BSE, or "mad-cow" disease" is just one). They have no DNA, they don't seem to "metabolize", yet they reproduce and cause mayhem among eukaryotic cells. In the scheme of living things they don't qualify (by some standards) but I think they are alive. In fact, to me they are a further indication that "life" is an integral part of the "way things are".
There was a blurb on the internet over the weekend that suggested that the existence of arsenic-eating bacteria has some profound influence on our understanding of life. If that's the case (and I don't think it really is), prions got there first.
I love it when man's puny intellect is challenged...to me, that is strong evidence of the existence of REAL omnipotence!
Friday, December 3, 2010
Newer and newer....

Thursday, December 2, 2010
Way too much of a good thing (or good things....)?
We would be dead at a very early age without our white blood cells--granulocytes, lymphocytes, macrophages. But with too many of them we are also at high risk.
Both types of death, ironically, are generally as result of shattered immunity.
Too much of a good thing, indeed, can be fatal. Leukemia pushes the rapidly dividing young white cells, which are not yet effective mediators of a proper immune response, out into the body, where they are useless and in fact predispose to infection.
Fortunately leukemia is a group of malignancies upon which much progress has been made in the area of therapeutics. It is survivable, and even curable in some cases.
But its treatment requires a serious balancing act between destroying the "bad" and not the highly sensitive "good".
Get your check-up. It may be the best way to detect leukemia early, and therefore at a stage that can be treated more effectively.
Both types of death, ironically, are generally as result of shattered immunity.
Too much of a good thing, indeed, can be fatal. Leukemia pushes the rapidly dividing young white cells, which are not yet effective mediators of a proper immune response, out into the body, where they are useless and in fact predispose to infection.
Fortunately leukemia is a group of malignancies upon which much progress has been made in the area of therapeutics. It is survivable, and even curable in some cases.
But its treatment requires a serious balancing act between destroying the "bad" and not the highly sensitive "good".
Get your check-up. It may be the best way to detect leukemia early, and therefore at a stage that can be treated more effectively.
Wednesday, December 1, 2010
Don't call them "germs"!

"Germ" is actually short for "germinate", which means to grow, and which is by and large a good thing (seeds germinate, for example).
Also, reproductive cells (egg, sperm, and their progenitors) are referred to as "germ cells", also good things.
And most microbial organisms are not harmful! In fact, were it not for many of them we would not have survived thus far.
If one wants to talk about nasty microbes, the best term to use is "pathogen", which is short for "pathogenic", meaning to cause disease.
Scientific literacy is about being specific as much as anything else!
Tuesday, November 30, 2010
Timing is everything...

Originating in the bone marrow, a subset of lymphocytes migrates during gestation to the thymus gland. There they "learn" to identify antigens, both foreign and native. It is in childhood that these cells are most active, when they set their "memories". In later life they are then prepared for the daily onslaught of parasites, toxins, and foreign bodies that seek to harm us.
Research has shown that children who are "unexposed" to a broad array of antigens have difficulties later with immune disorders of all types. The thymus involutes by puberty, so this timing makes perfect sense. Parents who misguidedly "protect" their children from common antigens and vaccines are doing them no favors. Our immune systems have evolved to use childhood as the time during which we lay down a healthy and vigorous immune system--there is no data to suggest it can be "overwhelmed" except by real disease at this stage. The fact that we are seeing a generation of immune deficient, hypersensitive, and disordered young people is a direct result of our scientifically illiterate approach to our own bodies and those of our children.
In a very real sense, children who are allowed to get "dirty" are healthier than those who are kept "too clean." Recent studies document this as a direct cause of the increased incidence of allergic asthma specifically.
And children seem to know this....
In a very real sense, children who are allowed to get "dirty" are healthier than those who are kept "too clean." Recent studies document this as a direct cause of the increased incidence of allergic asthma specifically.
And children seem to know this....
Monday, November 29, 2010
It's DNA....

One of the greatest breakthroughs in medical science as been recombinant DNA technology. Among other things, it has allowed us to produce human insulin and various "biotech" medications and tests that have given us a great advantage in our study and treatment of chronic disease (it's been pretty useful in acute disease as well).
Products of recombinant DNA technology, in which desirable genes are inserted into the target genome via viral or bacterial transmission, are NOT "artificial". They are essentially hybrids. The history of life itself rests on hybridization. Genetic engineering started 10,000 years ago with the emergence of agriculture; that process is not more nor less "natural" than recombinant engineering. Sexual reproduction itself is recombinant DNA technology.
So don't let the scientifically illiterate scare you--look it up for yourself and make your own decisions. Genetic modification is by and large a positive adaptation!
Wednesday, November 24, 2010
Be thankful for it.
Here we see it (by EM) "unlinked", simple yet so powerful. We are only beginning to learn its secrets. But what we know already reveals how perfect it is for what it does, and for what it needs to do to make sure life continues.
Science is about exploring the nature of our world, not about philosophizing about where it came from.
I, however, know in my mind and heart that we are fearfully and wonderfully made, and see DNA as further proof of that.
Have a great holiday--I will be seeing some of MY DNA in my new baby granddaughter, Aletheia, and other bits of it in the rest of my family. Beautiful!
Tuesday, November 23, 2010
Small but mighty...

Nowhere is the incredibly delicate complexity of the human body more clearly seen than in the endocrine system, where the pituitary runs the show.
Enthroned in the sella turcica (which is NOT an Italian sports car), it connects all higher order functions, emotions, and sensory inputs to that otherwise immobile lump we call the body. Through its intricate feedback loops it controls every cell, every reaction, every movement--millions of them each second. Usually without a hitch.
So think kind thoughts about your pituitary today and it will continue to hum along,
proving once again that we are fearfully and wonderfully made.
Monday, November 22, 2010
Pros and eus....

Prokaryotes are organisms without nuclei (kingdom Monera) and eukaryotes are with (the other four kingdoms).
What is truly remarkable, though, is that the genetic material of both, and of viruses, which are not (yet) considered a living kingdom, is DNA-based. Therefore, the likelihood that we are unrelated is virtually zero. Even more remarkable is that life, in the form of prokaryotes, probably came into existence not after 2 billion years but almost as soon as the Earth cooled enough to support it. Far from being an "accident", it seems that life was "programmed in" to the birth of the universe. This concept is explored in many books, but one of the best is
The Goldilocks Enigma, by Paul Davies.
Regardless of one's beliefs about origins, this "inevitability" of life means we are not a vanishingly small probability but a prime factor in the makeup of the universe.
Friday, November 19, 2010
Thursday, November 18, 2010
Wednesday, November 17, 2010
Fungus among us....

Amphibians and plants have not been so fortunate. The current world-wide die-off of frogs and related animals and the continuous battle we fight on behalf of our crops are a result of fungal invasions...relentless and intractable.
Part of the reason for fungal power is their role as a decomposer--they eat trash, literally. And if that trash is wet, all the better. They are also great at killing their microbial competitors--penicillin came from a fungus as have other antibacterial agents.
Some fungi are good--lovers of stinky cheese and mushrooms (like me) appreciate them in their proper place.
But watch out--fungi can turn on us in a New York minute if it is to their survival advantage.
Just ask the poor peepers.
Tuesday, November 16, 2010
Monday, November 15, 2010
Sulfuric Acid rocks!
Now that we have your attention, please turn it to acids and bases.
These useful compounds help organisms process things they need in a world that is composed of things that in their turn might require a little "assistance" with that processing. Sucking up protons, pushing in protons--acids and bases can make indigestible items like rocks and steaks and even potentially poisonous substances useful.
Living organisms are themselves buffers that resist the negative effects of acids and bases.
Be thankful for those proton pushers!
These useful compounds help organisms process things they need in a world that is composed of things that in their turn might require a little "assistance" with that processing. Sucking up protons, pushing in protons--acids and bases can make indigestible items like rocks and steaks and even potentially poisonous substances useful.
Living organisms are themselves buffers that resist the negative effects of acids and bases.
Be thankful for those proton pushers!
Saturday, November 13, 2010
Love your neuroglial cells...

The neurons get all the attention, but it's the neuroglial cells that really make us what we are neurologically. To paraphrase a Streisand song (Queen Bee), "The neurons got the muscle but the neuroglia's got the hustle."
Like the best insulator in the universe it is, neuroglia (when rapped around an axon or dendrite it is called "myelin") keeps the signal in the neuron pure and focused as it moves along carrying its message. And FAST! I love the kangaroo analogy, but in reality it should be a cheetah.
One only has to see the effect of damaged neuroglia to realize how critical it is. Most neurodegenerative diseases are of the neuroglia, and it is the disruption of signaling effectiveness and efficiency that leads to the distressing signs and symptoms of multiple sclerosis, Alzheimer's disease, cerebral palsy, and other conditions. Due to its ability to reproduce (as opposed to the non-mitotic neurons) neuroglia is unfortunately the source of most neurologic malignancies.
On the positive side, it now appears that the metabolically very active neuroglium is responsible for much of acquired intelligence and all learning, since as it grows and reproduces it allows the more static neurons to establish better and more creative connections. It needs plenty of oxygen and lots of carbs, so exercise, eat your pasta, and ditch the cigarette butts in the cause of SCIENTIFIC LITERACY and GENERAL INTELLIGENCE!
Neuroglia rocks!
Friday, November 12, 2010
We love buffering!

Sounds simple. Runs hard.
The process of donating a proton, or a positively charged hydrogen ion, can cause significant chemical changes in the metabolic environment, destabilizing proteins, lipids, and carbohydrates and disrupting cellular processes, including energy production, protein synthesis, and reproduction. The more forcefully the acid foists the unwelcome proton upon surrounding organic molecules the more deleterious the result. One only has to realize that our stomach acid (hydrochloric, pH 2) can "melt" a tough steak to understand
why acids are so harmful to our tissues.
It is noteworthy that our body's normal extracellular environment is not actually neutral (pH 7) but slightly basic (7.35 - 7.45). My students hypothesize that the "reason" for this is that the environment in which we evolved and live has more acids of potential harm, and so endowed the body with a slight "head start" in the buffering process.
Excellent thinking!
Negatively charged bases, which "suck up" protons, can also cause serious cellular damage;
they are just not as common in our environment. Lye, a severe caustic, is strongly basic and can "melt" tissue as easily as sulfuric acid.
The body has evolved complex and delicately balanced systems to keep us from becoming too acidic or basic, either of which can lead to serious ahomeostasis or death;
this is another aspect of our being fearfully and wonderfully made!
Be grateful for your buffers!
Thursday, November 11, 2010
The race....

Gene therapy has likewise been a disappointment, for different reasons. The theoretical value of replacing "faulty genes" with "good" ones is still clear, but in practice the obstacles have been tremendous. Our genes have developed to resist changes that do not bestow reproductive advantage, and overcoming that resistance has proven fearsomely complex.
Despite our grandiose beliefs to the contrary, the natural form of evolutionary change has done us quite well, thank you, since long before we put on white coats and looked in a microscope, and I expect it will continue to do so. We tamper with it at our own peril.
Wednesday, November 10, 2010
Learning by...osmosis?

The actual metaphor should be DIFFUSION, in which the solute moves across the famous SPM from an area of HIGHER concentration to LOWER. The resulting concentrations are equal but the direction of movement is toward the "emptier" solution. Like a brain?
However, neither analogy is correct regarding the learning process. The actual metaphor is closer to FACILITATED DIFFUSION, in which the material moves down the concentration gradient using an enzyme or cell receptor and consuming energy, or ACTIVE TRANSPORT, in which a carrier protein moves the information consuming even more energy.
Either way, learning is not passive and requires energy!
Tuesday, November 9, 2010
Cancer....

Somehow, our bodies' exquisitely balanced defenses break down with time or repeated assault and what has been a blessing, responsible for growth and healing and reproduction, becomes literally malignant.
Unscrupulous quacks will try to get victims to believe that cancer can be cured with the Banana Fiber Diet, or the Salt Water Cure; the only defense against such vicious cruelty, which is all it can be called, is knowledge of the underlying pathophysiologic mechanisms and how to read scientific literature. Know your body!
Become scientifically literate--it could save your life or that of someone you love.
Monday, November 8, 2010
Carbon-based life....

Now it makes so much sense to me--the material, not the use of O chem as a terrible winnower.
I hope my students feel the same....
Friday, November 5, 2010
If you have nothing else to do this weekend...

This is certainly one of the most wonderful evolutionary adaptations sexually-reproducing species have developed. Not to mention one of the most confusing....
ALL biologists and clinicians MUST understand meiosis, because it is the basis for the wonderful genetic diversity that is both a blessing and perhaps a risk.
You guys have fun!
Thursday, November 4, 2010
Water....
How does ti doe its job? What does it really do besides make us wet?
Understanding water is a key to understanding physiology.
And to staying clean and juicy!
Understanding water is a key to understanding physiology.
And to staying clean and juicy!
Wednesday, November 3, 2010
Physics first....
Historically, the sciences were studied "biology first", probably because biology is so "obvious". In addition, the "real" nature of the physical universe was not understood until the relationship between matter and energy was elucidated by Einstein and others in the early 20th century.
Over the past 20 years a movement within scientific pedagogy has developed that rightly teaches physics first. The nature of matter and its relationship with energy is the foundation of scientific understanding; that builds "up" into chemistry, which in turn allows biology to be understood as never before.
The basis for our studies in human biology is, in fact, physics.
Most people think physics is "hard"; it is, in fact, quite simple. Atoms, molecules, chemicals, cells, organisms--it's natural!
Over the past 20 years a movement within scientific pedagogy has developed that rightly teaches physics first. The nature of matter and its relationship with energy is the foundation of scientific understanding; that builds "up" into chemistry, which in turn allows biology to be understood as never before.
The basis for our studies in human biology is, in fact, physics.
Most people think physics is "hard"; it is, in fact, quite simple. Atoms, molecules, chemicals, cells, organisms--it's natural!
Tuesday, November 2, 2010
Cells even die....

Apoptosis, the process of programmed, orderly cell death, is essential to our bodies' structure and function. Were it not to happen in development, we would have webbed hands and feet, too many neurons, and a face from a horror movie. But, like it does everything, the body carries out this process effectively and efficiently, not even leaving any debris behind. In fact, should the body stop its orderly sculpting we may suffer from one of our most relentless enemies as a result--cancer.
Be grateful for death--it really is part of life.
Monday, November 1, 2010
Matter...

All energy and matter, therefore, are manifestations of the spectrum we call "light".
And God said, "Let there be light."
Friday, October 29, 2010
Thursday, October 28, 2010
Anatomic may not be anatomic....

The dominant chamber of the heart in size, mass, and function is the left ventricle, which in reality dwarfs the other three chambers. In fact, if one visualizes the heart in its actual dimensions its physiology is easier to understand and remember.
I hope my students carry this lesson with them, as cardiovascular physiology is one thing that every clinician must know COLD (actually, hot--37 degrees C).
Wednesday, October 27, 2010
If only we were joiners....

Nowhere is this rather misguided attitude more unhelpful than in the realm of science. Science is a truly international endeavor, whether we want it to be or not. We persist in often going it alone, even when it is to our demonstrable detriment.
The most glaring example of this shortsightedness is in our refusal to use the metric system.
The metric system is not only used by the other 95% of the world's population (even the Brits use it for science), it is easier to use than our antiquated "system" and is simply much more logical.(What a concept!) Countless headaches and real damage have been caused by this mulish attitude, including the spectacular failure of a Mars probe (to the tune of several billion dollars) based on the failure of an American team to convert measurements to metric. Were we sensible conversion would have been unnecessary.
Science and medicine use the metric system, and it seems a waste of valuable time, not to mention a constant source of irritation and potentially real damage to life, to have to teach students how to convert. But it has to be done. Maybe some day we will realize that Communism is dead. In the meantime, we stumble along thinking we are being heroically independent when we are just being obstinately jingoistic.
Tuesday, October 26, 2010
A new paradigm....

the image above incorporating DNA seems apt for today.
While the knowledge of the "code of life" has not opened the door to immortality,
we are beginning to understand the real complexity of the interaction between the organism and its environment through research into epigenetics--what controls the genome, what turns its various bits on and off. That is, I believe, the future of medicine.
It finally resolves at the molecular level the age-old argument about nature v. nurture:
nurture turns on the nature which affects how the nurture turns the nature off which affects....
The organism in its environment produces the individual, unique in all the world.
Fearfully and wonderfully made, indeed.
Monday, October 25, 2010
Beginning

As I start my second semester as a teacher of adults I am thankful for the lessons learned. I always want to be better today than I was yesterday. I welcome my new students and ask that you approach this beginning as a time when we can commence learning from one another.
And, really, there are no endings, just movings-onward and upward.
Saturday, October 23, 2010
Friday, October 22, 2010
End of semester thanks....

I want to express my thanks to:
my fine students, who have taught me and been patient with me--you are the best;
Dean Bair for being a great leader and boss, and for being so supportive and positive;
Dean Portmann for teaching me the practical stuff;
President Goodwin, for smiling all the time;
my new colleagues for accepting me as one of the group;
Debbie and Monica for dealing with me so kindly and being so helpful;
to my family for their love and tolerance;
and to the Father of Lights for His beneficence!
Thursday, October 21, 2010
Good science is not about opinion....

This "method" involves primarily OBSERVATION and MEASUREMENT.
Yes, data must be gathered systematically and hypotheses formed, but without the ability to OBSERVE and MEASURE there is no science;
the fancy statistics and clever hypotheses are meaningless.
Good science is also about WHAT and HOW, not WHY. It is this latter question that leads people down the rabbit hole of philosophy. If there is no agreement on WHAT is happening, the other questions are immaterial.
Good science is not about , "Yes, but...." Questions need to be specific enough so that the answers stand on their own--YES or NO. It is this tendency to overgeneralize--a major weapon of the ignorant--that leads to scientific illiteracy.
And good science is NOT about "majority opinion." The majority is often wrong.
OBSERVE and MEASURE.
Thanks, Rog!
Wednesday, October 20, 2010
Giant Microbes!!

SCIENTIFIC LITERACY NOTE: Microbial organisms are NOT "bugs"; in fact, insects in general are not "bugs". True bugs are the Hemiptera, a large family of insect, characterized by hard "shells" that are actually part of their forewings, a specific pattern of wing overlap, and a distinctive leg anatomy. Stink bugs are true bugs!
Tuesday, October 19, 2010
This has been a great semester....
The data shows an active mind is at less risk for running down, so keep yours humming!
Science, and especially biology, is a great place to start. Check out The Compleat Science Teacher for some tips.
Enjoy!
Monday, October 18, 2010
Poverty and poor health....

Notice particularly Africa and South America, rich in resources but with very high personal poverty rates. Life expectancy in some of the "earth tone" areas is GOING DOWN, heading toward 40 and below. And where are most of the resources CONSUMED? You guessed it. Many of the poorer nations actually export medical and science personnel to the U.S.
As health care and science professionals we have a duty to use our knowledge for those who are in need. Let's stop draining the world of its medical and scientific talent and start sharing ours with it.
Saturday, October 16, 2010
It is...

This instrument was used in astronomy and navigation in ancient and medieval times, which meant it was used in astrology. How did astrology relate to medicine?
A horoscope "predicted" illness and also helped physicians and surgeons of the time to properly schedule procedures--bloodletting, amputations, administration of medicines, and other mayhem-- based on the portents in the planets, moon, and stars. No matter the portents, there was no anesthesia, and most of the treatments were ineffective if not downright dangerous or toxic, which made the timing of a procedure pretty much irrelevant unless the chart advised not getting it at all.
Friday, October 15, 2010
BOOGERS??!!

My Saturday A&P class is discussing the respiratory and urinary systems; lo, and behold, add in the colon and VOILA! you have THE ELIMINATIVE SYSTEM! Who knew? I'll bet anyone anything that a Brit came up with this name and classification.
The respiratory system is "eliminative" in that it excretes carbon dioxide, volatile toxins (such as alcohol) and produces more earthy waste like phlegm, sputum, snot, and boogers.* Most people know what comes out of the urinary system and the colon. :-)
* One of my favorite students at Brooks was the young man who, when asked on an exam for the scientific name for "booger", had the courage of his convictions and gave the correct answer: BOOGER. That boy ended up winning the Principal's Award in 8th grade. Too cool!
Thursday, October 14, 2010
Subscribe to:
Posts (Atom)