Post #1 of October

Ah. Next week will be a PBL-free week, due to Labour Day. This is good; not because I have less work to do, but because I have more time to catch up. Oh, how perspectives change...
This week was pretty unremarkable - I guess that after 25 or so weeks of uni, things seem kind of like the same. We had another respiratory case this week, but an even more complex multi-factorial one; and we started on basics of the neck and breathing anatomy. Then we had various lectures on respiratory control and drive, and finally, to wrap up this wonderful week, we had our formative anatomy spot test, which went by very quick (10 minutes - essentially identifying various structures) and an Evidence-Based Medicine lecture (on the difference between causality and simple association/link between two things - say, smoking and lung cancer), which, I admit, was pretty good - lecturer was well-spoken, well-dressed, well-prepared; which made for a very easy lecture to understand and take notes from. So, after reading this recall, you're probably just as bored as I was during this week - and for no reason; I mean, hey! Medicine! Prestige! Wealth! Awesomeness! Around the corner! Should I not be excited at every twist and turn, every avenue of discovery that awaits? Well... sort of, but it doesn't really lend itself well to being interesting reading.

I, however, was firmly reminded of a very important concept in medicine, this week - the concept of "medicine-is-not-static" (for lack of a better concept name). One of the more popular physiology books (although we're lead to believe there are only two that ever exist), Guyton's Medical Physiology 11th Edition, was published in 2006; fairly recent, one would assume. This is the latest version of Guyton - and since it is fairly readable and in general quite a good text, many in the course often refer to that, and nothing more, treating it as the authoritative textbook on physiology. However, during our PBL we had found that:
1) one area of the brain stem that was apparently very important in inspiration (in breathing) is now not very important at all
2) another area of the brain stem that seemingly only dealt with expiration, dealt with both
3) there was utterly no mention of the current leading thinking regarding a very important specific part of that area of brain stem.
In short, if someone were to use this textbook, and this textbook only, they would be out of step in regards to how we breathe. It's the first time that this has actually happened to me; reading a textbook and finding that there are contradictions from lectures and other texts - but I have a feeling I'll be expecting a lot more. This is not to knock Guyton (which I again emphasise is an excellent textbook); just that 3 years can already be considered outdated in physiology. I've been told that this 'outdated-ness' varies wildly with various parts of medicine though.

Well, the long weekend awaits. To be productive, or not to be... I'll see.