Long walk to ...freedom. Part One: Getting admitted

Some believe that you become a doctor only after you have got an MBBS degree. In reality, from the time you are admitted into a medical school you become a part of the doctor’s community… the people in white coats!

 ’I solemnly pledge myself to consecrate my life to the service of humanity.

I will use my best judgement to help the sick and do no harm.

I will not give fatal drugs to anyone, even if asked, nor will I suggest any such thing.

I will not divulge the secrets of my patients regarding them as holy……’

There is something very hypocritical about this Hippocratic oath. Hippocrates, the famous Greek physician, must have formulated the oath for his disciples in the field of Medicine in the true interest of humanity and to uphold the sanctity of this noble profession. But now this oath-taking ceremony has been glamorized to befit white coat ceremonies to appease nostalgic minds, or worse still to harass doctors in court.

But then nostalgia and harassment run high in any Medical school. The Professors love to recall the days when they, as medical students, had studied till late in the night and spent the better part of this glorious period of one’s life in the dissection halls, the hospital wards, operation theatres or the library. Having been through this gruesome phase, some of them are sympathetic to the plight of medical students. But then there are some who take it out on this fast emerging strain of stress-resistant medical students who believe they can bunk classes, download video lectures and amazing new mobile apps about the Anatomy of the human body, attend concerts, have a nice time at McDonald’s and study Pharmacology with music in the background.

View full article published in healthmad.
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http://healthmad.com/medicine/in-white-coats-2/

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Metabolic theory of septic shock

Septic shock is a life threatening condition that can develop subsequent to infection. Mortality can reach as high as 80% with over 150000 deaths yearly in the United States alone. Septic shock causes progressive failure of vital homeostatic mechanisms culminating in immunosuppression, coagulopathy and microvascular dysfunction which can lead to refractory hypotension, organ failure and death. The hypermetabolic response that accompanies a systemic inflammatory reaction places high demands upon stored nutritional resources. A crucial element that can become depleted early during the progression to septic shock is glutathione.
Glutathione is chiefly responsible for supplying reducing equivalents to neutralize hydrogen peroxide, a toxic oxidizing agent that is produced during normal metabolism. Without glutathione, hydrogen peroxide can rise to toxic levels in tissues and blood where it can cause severe oxidative injury to organs and to the microvasculature. Continued exposure can result in microvascular dysfunction, capillary leakage and septic shock .
Read about the Early Goal Directed Therapy EGDT for sepsis management.
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Read about the link between iron and vitamin B12 deficiency and panic attacks. http://adf.ly/1AHkuI

On the off chance that you experience the ill effects of tension or get occasional panic attacks marked by episodes of hyperventilation, you could only be encountering the symptoms of a basic supplement inadequacy that is effortlessly correctable, as per Jonathan Benson of Natural News.

This unquestionably seems to have been the situation with 21 individuals who took an interest in a late study based out of Japan, which recognized an absence of both vitamin B6 and iron among members who experienced panic or hyperventilation episodes.

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Be like the river

Sometimes all  you can do, is not to
dream, expect or obsess.
All you can do, is go with the flow,
And hope for the best.

Going with the flow....

Finding work-life balance is like juggling responsibilities. As long as you keep doing it, nobody cares. Once you stop, it all comes crashing down. And you are the only one to be blamed. You chose to live life that way!

  I often wonder, is there such a thing as the perfect balance, the perfect woman, the perfect family, the perfect food,or the perfect relationship?

Maybe in some fairytale.  But real life is not a bed of roses but a soap opera. Everything changes. The key to survival is 'going with the flow'.

Priorities change daily and as full time working mothers, you have to flow through the demands and challenges as best we can. It won't ever be perfect. And it won't ever be balanced. However, if you are flexible and let things flow as they need to, you won't be worked up over ensuring everything is perfect.

'There are times when my kids or husband take full priority and I have to take care of them while work has to wait. Then there are other times that work is priority - whether it's a big project, meetings or travel, that's what comes first. And there are times that friends or extended family need my help. Balance really doesn't fit any of these scenarios....

 At times, I think I have nailed it and I'm doing really well in all areas. However, there are other times that I feel I haven't spent enough meaningful time with my kids or my husband and I'm falling behind at work. There have also been times that I have felt I haven't been there for my extended family or friends the way that I should be. The constant stress of balancing all of the above can certainly take a toll..' 

Be like the river.

Sheryl Sandberg, COO of Facebook, wrote in her book Lean In:

“Trying to do it all and expecting that it all can be done exactly right is a recipe for disappointment. Perfection is the enemy.”

Discussions or documentations? The way forward.

Discussions or documentations
Surveys suggest that time constraints push doctors to spend less time with the patient and more time documenting records. Important as documentation may be, it ends up with a waste of unnecessary investigations that could have been avoided had the doctor spent more time with the patient; taking a detailed history and doing a thorough examination. Many times we have been forced to look for Malarial parasites in smears from afebrile patients, or do bone marrow aspirations of thrombocytopenic patients (with low platelet counts) only to find platelet clumps on peripheral smears.
Have you ever done an investigation that you thought was unnecessary?

The doctor-in-law phobia