You da best!

Today are my last class sessions for this semester, as I am "off" next session.
I want to thank all the fine Chamberlain students I have worked with and wish you success.
You deserve it!

Ode to the Midwest

Oh, land of wheat and cattle
I woulds't fain be a bear,
But every day's a battle
Just figuring what to wear.

Today there be'est thunder
Tomorrow snow and sleet,
And then who know what new assault
Will soak or freeze my feet?

But they tell me it be worth it
To tolerate this mess,
Because tho' rotten spring may be,
We love winter even less.

Please!

Find it this weekend!

Ya gotta have heart....

...and your heart's gotta have CONTRACTILITY.
Loss of contractility is one of the major causes of heart failure, which in turn is most often caused by coronary artery disease (atherosclerosis).
Evolution has come through with an organ that precisely balances literally dozens of factors as it works on our behalf. The heart has intrinsic contractility, unlike other muscles, that initiates its function. That contractility is in turn a function of numerous environmental and metabolic factors. Other organs and functions of the body can do a lot to help maintain our heart's contractility; we can do perhaps the most good by not smoking, not drinking alcohol, not using illegal substances, exercising, maintaining normal body weight--and, yes, treating others with gentleness, care, and love.
Maintain your cardiac contractility this weekend....<3

SHOCKING!

My students hear some of my pet issues over and over...but I think they are important (or they wouldn't be pet issues).
One that I think many have appreciated is the "WHAT DOES THAT MEAN?" approach to patient histories, in which we let the PATIENTS tell us what is going on rather than impose our own definitions on them.
Another is the OXYGEN + GLUCOSE issue; if you don't get enough oxygen and glucose to each and every cell in your body at all times, the curtains are on their way down.

Then there is SHOCK. Shock does not mean "emotionally freaked out" or scandalized; it means that there is NO PERFUSION, i.e, NO BLOOD FLOW TO TISSUES. The CAT scan shows a large area of hypoperfusion (localized shock) in the brain (the white area) due to stroke; this tissue is dead or dying. This is what SHOCK does to the whole brain (and all other organs), which demands 20% of total cardiac output. SHOCK is the ultimate medical emergency, no matter what the cause, and to use that term for emotional freaked-outness is WRONG.
In science, words MATTER.
Stay UNSHOCKED today!

Frank Starling, we love you!

The theories of relativity state (in part) that the laws of physics are true from all perspectives and in all environments. The Frank-Starling curve, which demonstrates the components of stroke volume (which, with heart rate, determines cardiac output, humans' single most important functional parameter), is pure and beautiful physics.

ODE
Oh, Frank-Starling how we love thee,
You keep us free from woe,
Please ever more be faithful,
As we on our journey go.

With all my heart

WHY???

I would guess that as a teacher and a physician, not to mention father and grandfather, I have heard this question more often than any other. I also suppose that H. sapiens is the only species that asks it. "WHY?" is cosmic, contextual, value-laden, and usually philosophical. It can be the basis for some interesting late night ruminations. It is also a question that often has no "real" or satisfactory answer, particularly if the questioner is under the age of 21.
Often the real question, however, from a practical and scientific perspective, is HOW?? This question often can be answered and become the basis for significant learning and more productive questioning.
Sometimes, though, the answer to WHY can be found. The photo above shows IRON. Iron is an essential element in the production of hemoglobin. Metals carry oxygen in a way that allows it to be readily transported and released. But why iron? Because it is the most abundant metal in the universe. If copper were similarly abundant and iron rare, it is likely our blood would contain it instead. And WHY blood is red is that when oxidized iron turns into a reddish oxide (like rust!). If our blood metal were copper then our blood would be green, like Lady Liberty! Wouldn't that be cool?
Take care of your iron this weekend--eat some spinach!

So beautiful

The plasma cell stains one of the most vivid of blue colors ever seen. The royal blue silk sheets my lovely wife recently bought come close, but plasma cells look more like velvet. In any case, this color reflects the very high concentration of amines found in these cells, which are highly differentiated B lymphocytes. Plasma cells produce one of our most wonderful proteins, immunoglobulins.
The immune system itself is an elegant cascade of responses to foreign invasion, and the globulins are particularly "ingenious".
But, like all of our parts, plasma cells have their evil side. Gathering mutations as we age, they can become malignant and the resultant disease is called multiple myeloma. The great Geraldine Ferraro recently died of this disease after a prolonged siege.
Appreciate your plasma cells today, and have a virgin Blue Moon to celebrate them!

A real red

Red blood cells--erythrocytes--are beautiful examples of evolutionary elegance. They do one thing--carry oxygen and carbon dioxide to and fro--but they do it with masterful efficiency and grace. Utilizing iron, which is what makes them red and is the most common metal in the universe, they quickly and silently provide the stuff of life to every single cell in the body in a mathematically precise rhythm that almost exceeds our human capacity for understanding.
And they are pretty, too! Be kind to your red blood cells today!

Ode to Bone

Oh, calcium and phosphate
Makes me strong and tall;
If thou didst not bond together
I would not stand at all.

A shapeless blob would I be
If electrons thou didst not share,
And gladly does my cartilage serve up
Its substance to thy care.

Oh, be thou ever faithful
And I will do my part,
Milk and cheese wilt I ingest
Tho' they may harm my heart.

But when I old and hoary be
Thy strength shall not be less.
And I will still stand strong and tall
When I am at my rest.

Hidden away

Surely bone marrow must be one of the most creative developments of evolution. Secreted away in the bones (when asked, most middle schoolers think blood is made in the heart--logical but wrong), the marrow produces the cells that carry oxygen and provide immunity, each carefully "back- regulated" by affected organs.
Sensitive to multiple environmental toxins, the marrow is protected by the hardest substance known. Still, we can harm it with what we ingest and where we go. Be good to your bone marrow this week!