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.

Awesome-ness

My textbooks arrived! Actually it arrived yesterday, but no-one was home so they re-attempted today. So I purchased 3 books from an Indian distributor on AbeBooks.com, at the cost of AU$160 including shipping, via FedEx. They were Rang & Dales Pharmacology 6th, Netter's Atlas of Anatomy 4th, and Boron & Boulpaep's Medical Physiology 2nd Ed - two softcovers and one (the Boron) hardcover. Being the hardcover, Boron's cost about half of the total bill, but there appears to be no softcover version of the textbook.
On first inspection, it appears that I got the cosmetic-damaged goods. The corners are either bent (on the Boron hardcover) or slightly damaged (softcovers); the softcover spines are a bit damaged on the bottom. I'm not very sure whether this is the case for all retailers, and when I purchase more books in the future, I'll be sure to compare experiences.
One thing I noted was that although the Netters and Boron were labelled "International Edition", the Rang and Dales wasn't. As a result, the Rang and Dales also came with a StudentConsult code, which was surprising - I wonder whether it was a mistake or if the Rang and Dales doesn't have an international edition...
The paper is of excellent quality, and in full-colour. So I think they're quite genuine (the Boron is printed in Canada), just subsidised for their target market (desperate med students from developed countries trying to save as much moolah as possible). Netter's atlas looks brilliantly vibrant, and from this, I'm generally quite happy with this purchase. The local editions of these books would be about AU$400, so there's a saving of about 2.5 times (after considering postage); the drawbacks are the cosmetic dings and the International Edition labelling.

In other news, I think HP6 doesn't deserve the bad beating its getting from some members of the public. It's a bold move to not contain an epic battle scene; certainly a departure from the norm. I was chuckling a fair bit during the movie too, twas nice to escape the general darkness of the film. But in short, yes it does depart from the book, no you shouldn't avoid it at all costs, but yes you may want to consider your expectations before watching.

What a day.

Today, I managed to miss Macarthur (which was one stop from Campbelltown). Let me explain - there's no direct train from where I catch the train to get to Macarthur - our uni's unofficial train station. So today I would catch a train to Campbelltown, the station everyone thinks is the end of the southern train line, and catch a train from Campbelltown to the 'real' end of the southern train line - Macarthur. This train doesn't stop at Macarthur though, it heads all the way to Moss Vale, which is approximately 40 kilometres away. Me being me, I managed to miss that one stop, and ended up at Menangle Park, the next stop. Herewith, upon finding the next train was an hour away, and thinking that one stop would be approximately 2km or so, I hatched the brilliant idea to walk back to Macarthur. Boy, was I wrong. The road that appeared to follow the train station turned left...and then turned left again...and there was no end in sight. So after 20 minutes I arrived back at the station, caught the train back to Macarthur, and was on my way.

Our first real anatomy practical was pretty super (abdomen/groin region) - having surgeons/surgical registrars were pretty cool, they were really knowledgeable and knew how to teach (very important, one would think), so yeh pretty awesome. Only bugger was that whenever they'd ask some questions about stuff, they'd draw a blank look from us and in general, we felt very stupid. We also did some surface anatomy, though only for a half hour or so.

We also got exam results back - I passed with a 60 average, but as a result, was in the bottom 3rd of the cohort. Still satisfied though, gave it a fair amount of effort and will be looking forward to improving that result. I felt that my mark was quite equivalent to my effort in the HSC, maybe a little more (so, ATAR of about 98 as a guesstimation) - obviously theres not really any comparison, since there are so many other factors that come into play, but that could give an idea as to what to expect. Looking for a 70+ in the finals so I can even up with a Credit average for the year, so I've got a big task ahead of me... *nods*

Our first physical examination for ICM was also pretty interesting...pity our patient though, who persevered with us (well, only one of us was performing the examination, but I digress) for an hour as we learnt how to percuss (tapping the abdomen, listening for the resonance of sounds to indicate hollowness and the presence of liquid and solid) and to palpate (fancy word for using our fingers to search for organs), and were assured (or amazed?) at our tutor's statement that the entire examination should take, at most, 5 minutes. Which reminds me, I should be writing up some notes so I can recollect what she said about signs and symptoms...

I also got email notifications that my stethoscope had been sent via Aus Post today, and my order for textbooks from India (about $50/textbook inc shipping) got processed. Also got my Talley and O'Connor clinical examination book yesterday, and found out that I really did not have any book-contacting skill anymore :\ Lots of bubbles and even a few jagged edges. Bleh. So yeh, exciting couple of days :)