Thursday, August 18, 2011

Rene Le Fort, History, and Radiology

My two interests of radiology and history combined during a resident lecture today at lunch. The attending physician, Dr. C, described the research of French army surgeon Rene Le Fort. In the early 20th century, he outlined specific facial fractures. He interest in studying this macabre medicine was allegedly born upon his visit to Notre Dame cathedral.

There, he observed the buttress with the fly, supporting the posterior tower. Rather than use more cement for a sturdier tower, the great architect wanted to install stained glass. His solution was the flying buttress. Le Fort made note of these supports and wanted to find analogous support in the face. And so, with hundreds of cadavers, he used a system to
be able to predict lines of fractures based on direct and indirect stress or collision.

He used hammers, boots, and more, to literally smash the faces of these cadavers. He would then boil the heads for 24 hours so the meat would fall off the bone. He then would study the fracture lines. Another alternative w
as to soak the heads in a dye for 6 months, which would achieve the same purpose. Perhaps in the early 20th century it was costly to boil water for 24 straight hours.

Because of his observations and manuscripts, radiologists today report Le Fort fractures in their dictations. There are currently three Le Fort fractures, with the third being most severe as it consists of a complete separation of the face from the skull.

History and medicine.

Wednesday, August 17, 2011

Parking spots

We drove up and around and around the hospital parking garage. Talking and driving aimlessly we pulled right into the nearest spot to the hospital entrance. It was the greatest moment of the day...until we pulled into the nearest spot to the supermarket entrance later on. I told Anna both times we should walk home and just leave the car in those spots, to gloat.

Extra driving time is always worth it when you get that spot. The sad part about this day was we weren't even trying. It was too easy. Life is never that easy, but it was for us then.

I gazed deep into the eyes of the awaiting drivers when we pulled away from the spots so I could telepathically stress how important of an event this transfer of parking spots was. In reality, I was sulking for the loss. Don't ever take for granted good parking.

I was going to blog about my sweet day in neuroradiology. But for some reason parking lot karma trumped it.

Thursday, August 11, 2011

Insight to Psych

Psychiatric refers to mental illness. Like the body, the mind gets sick. Actually, our health, mind and body, sits statically on a spectrum. Our bodies are assembled, built-up, fortified, remodeled, and broken down. Dust to dust. By 90, almost %50 of people will have some sort of dementia. Which makes me wonder, what are my chances? But over the last six weeks I've come to learn, it's not about chances. We get sick because we are human. And our minds get sick like our bodies. You can count on it.

The difference between having a down day and two straight weeks of down days might not seems like much, but it's enough to tag you with Major Depressive Disorder. The difference between you checking your locked door three straight times versus 30 straight times is the difference between "normal" and OCD. And the only thing keeping a drunkard on the streets from being petitioned into a psych unit is the fact that there's no loved one willing to sign the paper to get him forced treatment.

Those patients in psych units are not far removed from us on the outside. Yesterday they went to work. Tomorrow they'll go back. They are our co-workers. Our neighbors on the bus. They are not different. They have the same mind, the same neuro-chemical pathways susceptible to imbalances, and the same responses to medication.

But they are inpatient because they or a loved one thought they were more sick in mind than the rest of us. It's amazing to see the anti psychotics or mood stabilizers restore an individual back to coherence, back to the ability to carry out activities of daily living. Olanzapine works on the mind no different than hydrochlorothiazide on blood pressure. There is a physical receptor the medicines affect. It's not just theory to me anymore because I've witnessed it work.

It's strange to see fourteen people in a living unit on lock-down. We have them diagnosed and packaged. We feed. Me medicate. We often condescend. But if you sit and talk, you'll hear something familiar, and before long you'll be saying to yourself, "I think that way," or "I've done that." I just haven't thought or acted in such a way to be a threat to myself or others. But being idealistic, I believe ever threatening thought or action is actually a calling out for help. Whether conscious or not, it's a calling out for help. Why else are we here? And not being a humanist, I think we all cry out, looking up. Ride on!

Wednesday, August 3, 2011

Runner's World

For the first time this summer monsoon weather spent the night to hang out this morning. Thunder and lightning brought back a thousand memories of youthful shenanigans.

The best part was being able to soak it in. Drove Anna to the airport at 4:30 am under moderate rain and thunder. Then it started to get light. But the sun had to pound through two membranes of cloud, succeeding in only breaking the one closest to ground, so it remained eerily orange-grey.

I was a road hazard on the way home. My camera makes me ADHD, trying to get all the cool, momentary shots in time. Luckily the roads were mostly empty.

I arrived home, placed my body on the bed and told my head to go to sleep. But the window kept rattling, daring me to go out for a run. How could you not. One of running's secret pleasures is to go out under a drizzle, with the weather cool. The breeze gives a pretty good sideshow of swashing desert greenery accompanied by that ever-so-cool whistling through the leaves.

So I was out on the river trail, running and grinning. Pure sport. Take it anywhere, anytime. No lockout can touch it like other sports. And free adrenaline. Now I'm late getting to the hospital...typical