The Date

During my second year of medical school I decided to make more an effort to be social. To that end, I had decided to attend the annual medical school Halloween party. It was held at the VFW in one of the smaller St. Louis suburbs (Each of our parties seemed to be held at a different VFW. Allegedly we made such a mess that we were never allowed back at the previous ones).
I had thrown together a costume at the last minute and dressed as Willie Nelson. I bought a cheap red wig and braided it into long ponytails. I dusted it with some gray and white paint to add some age. I trimmed the ends of the braids to get enough hair to make a matching beard which I attached with spirit gum. With some cardboard and aluminum foil I made a huge belt buckle. With my cowboy boots, a horrid plaid shirt and a baseball cap that I had scrawled “Farm Aid” on, my costume was complete.
The VFW was hopping. A DJ was playing some decent dance music and there was an open bar. Everywhere you looked there were medical students in cheap costumes and a slightly maniacal look in there eyes.
I was standing in the fairly long line for the bar and had just made it to the front of the line. A girl dressed as a hippy came up and asked if I could grab her a beer. Being the gentleman that I am, I grabbed one for both of us. I handed her the beer and we spent the next hour or so talking. Her name was Lisa and she was a nurse at the university hospital. She and her nursing friends made it a point of attending most of the medical school parties.
As her friends dragged her off to another party, I realized that I should have gotten her number. I asked the bartender for a pen and some paper and he found an ancient pencil I could use. I ran out the door of the VFW after her to get her number and bumped into her coming back in to give me her number. Phone numbers were exchanged and things were looking good.
A few days later, some friends of mine decided to attend The Nightmare Before Christmas. They asked if I wanted to go. I agreed and thought that this seemed to be the perfect excuse to ask Lisa out. I called her up and she agreed, saying that she had heard it was a good movie. She gave me her address and I told her I’d pick her up in couple of hours.
I showered, shaved and got dressed. I didn’t want to be too dressy or too informal so I decided on the medical students informal uniform: dockers and a button down shirt. I put on my one nice pair of shoes and went outside to clean the car. I pulled up to the dumpster next to the apartment building so I could quickly clean it out. When I’m busy at work or school, junk tends to accumulate in my car (lecture notes, mail, magazines, medical journals, etc.), and I needed to empty it out so I could make a good impression. I opened the passenger side door of my old Tercel and started throwing out the accumulation a handful at a time.
Then I heard a very distinctive “ching” sound and realized that I had just thrown my car keys in the dumpster. Damn! Luckily the container was mostly empty, but I still had to jump in after them, wade across the dumpster and sift through about a foot of trash until I found them.
I ran up to my apartment to quickly change clothes and wash up. I was already running late, so I just grabbed the nearest pair of shoes and ran back to my car. I only had the one pair of good shoes, so I ended up in a slightly beat up pair of athletic shoes. I headed across town to the (much nicer than mine) apartment complex where she lived. Driving up and down the streets, I simply could not find her apartment. After about ten minutes of looking, I talked to a passerby and discovered that she lived not in apartment 1430, but in apartment 1430 ½, around the back of the main building.
I knocked on the door of the building.
“Come on in!” she yelled. “I’m almost ready.”
I opened the door and her dog, a giant Samoyed, made a lunge at me. I dodged and spun, but he kept coming after me.
“Prince! Stop that!” She shouted at the dog, but the giggle she added at the end didn’t suggest any real discipline. By now, he had stopped chasing me and seemed to have decided that I looked like a fire hydrant. He closed in, sniffed, and then raised his hind leg.
“I’ll wait for you outside.” I hurriedly said as I slipped out the door and away from Prince. Lisa came outside a minute later, nicely dressed in skirt and blouse. She smiled at me, but I swear I saw the smile falter a little bit when she got a look at my shoes.
We hopped in my little Toyota and headed to the theater. We made it just as the movie was starting but luckily my friends had saved us some good seats.
Five minutes after the movie started, her cell phone rang. She grabbed it and started a whispered conversation with one of her nurse pals. After receiving some dirty glares from the people around us in the theater, she headed to the back of the theater to finish her conversation. In a few minutes, she plopped back down in her seat. Just then, her phone rang again and once more she retreats to the back of the theater. This process of phone call migration continued for the rest of the movie.
After the movie, my friends were heading over to Cyrano’s where they served this absolutely sinful creampuff with ice cream and fudge sauce dessert that was famous across town. I asked Lisa if she wanted to go, knowing that nobody said no to a dessert at Cyrano’s, but she declined. She added in an aggrieved tone that she needed to go back home and feed her dog.
I drove her home and parked in front of her building. I got out of the car and walked over to the passenger side of the car to let her out. She hadn’t waited for me, however, and was already striding to her door. “‘Night,” she called out as she walked in her apartment and (I assume) securely locked her door.
I think it’s safe to say that that remains my worst date ever. I’ve never been entirely certain what went wrong. I have a few guesses. First, I suspect that she found me more attractive dressed as Willie Nelson. Second, I have a strong suspicion that she preferred more affluence in her dates, apparently forgetting that the vast majority of medical students (including me) live below the poverty line. Plus, I think the shoes may have done me in.
Epilogue: Two years later as I was starting my final year of medical school, I stopped by the “Welcome New Students” reception thrown by the school at a local bar. I grabbed a Bud Light and met up with one of my friends. We saw another friend of ours and headed over to talk to him. He was chatting with this bevy of cute girls and he introduced us to them. The last one, of course, was Lisa. She fixed me with a chilly stare and, with the icicles dripping from her words, said, “We’ve met.” I could only laugh.

Courtesy: Scott

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H1N1 Vaccine Will Be Approved, Ready For Use By September

By September, the first H1N1 (swine) flu vaccines will be approved and ready for use, WHO director of the Initiative for Vaccine Research Marie-Paule Kieny said Thursday, Reuters reports. Kieny also expressed optimism that "vaccine production yields were improving, following a disappointing start that triggered some worries about supplies," the news service writes.
By early next month, Kieny said scientists will have the results of the first H1N1 vaccine clinical trials, which aim to determine "how many doses of the new vaccine will be required to provide sufficient protection against the virus," the Los Angeles Times' blog "Booster Shots" reports. "Preliminary studies have suggested that the antigen being used does not provoke as strong a response as that in the seasonal flu vaccine, and that it may be necessary to use two doses -- which would halve the total number of people who could be immunized" (Maugh, 8/6).
Reuters reports that "[o]nce initial clinical trial results are in, regulators will be able to approve the vaccines from next month and the first countries are expected to start mass vaccination programmes, Kieny added" (Lynn/Hirschler, 8/6).
Obama Will Discuss H1N1 With Mexican President, Canadian Prime Minister
In related news, President Obama is scheduled to meet with Mexican President Felipe Calderon and Canadian Prime Minister Stephen Harper in Guadalajara, Mexico, Sunday and Monday to discuss ways to deal with the anticipated resurgence of H1N1 this fall, Reuters reports in a separate story. The leaders are expected to issue a joint statement about their collaborative efforts to limit the severity of H1N1, White House Deputy National Security Adviser John Brennan said.
"I think everybody recognizes that H1N1 is going to be a challenge for all of us and there are people who are going to get sick in the fall and die. People have been dying over the past number of months from H1N1," Brennan said (Holland, 8/6).

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Intense, Prolonged Exposure To World Trade Center Attack Associated With New Health Problems Several Years Later

Large number of individuals, such as recovery and rescue workers, nearby residents and office workers, who experienced intense or prolonged exposure to the World Trade Center attack have reported new diagnoses of asthma or posttraumatic stress 5-6 years after the attack, according to a study in the August 5 issue of JAMA, a theme issue on violence and human rights. "The September 11, 2001, terrorist attack on the World Trade Center (WTC) killed thousands and exposed hundreds of thousands to horrific events and potentially harmful environmental conditions resulting from the collapsing towers and fires," according to background information in the article. Studies have documented adverse respiratory and mental health conditions associated with direct exposure within 1 to 3 years following the event, however, the longer-term impact on health has been unclear. Robert M. Brackbill, Ph.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues of the New York City Department of Health and Mental Hygiene, and Columbia University, New York, examined the incidence of two of the most commonly reported health outcomes: asthma and posttraumatic stress (PTS) symptoms indicative of probable posttraumatic stress disorder (PTSD) among adults 5 to 6 years after the attack.

The researchers used data from the World Trade Center Health Registry, the largest postdisaster exposure registry in U.S. history, which prospectively follows a group that reported a range of WTC disaster - associated exposures on September 11 and during its immediate aftermath. Wave 1 of the study, conducted in 2003-2004, included enrollment of 71,437 adults in four groups: rescue/recovery workers, lower Manhattan residents, lower Manhattan office workers, and passersby; 46,322 adults (68 percent) completed a follow-up wave 2 survey in 2006-2007. The surveys included questions regarding symptoms of asthma following September 11 and event-related PTS symptoms indicative of probable PTSD, assessed using the PTSD Checklist (a self-report symptoms rating scale). The researchers found that overall postevent incidence among those without a prior history of asthma was 10.2 percent, with rescue/recovery workers having higher postevent asthma diagnosis rates than the next highest group, passersby on September 11 (12.2 percent vs. 8.6 percent). For all eligibility groups combined, intense dust cloud exposure was associated with postevent diagnoses of asthma (13.5 percent vs. 8.4 percent for no dust cloud exposure). Thirty-nine percent of all respondents reporting postevent diagnoses of asthma also reported intense dust cloud exposure. "These analyses confirm that intense dust cloud exposure was associated with new asthma diagnoses for each eligibility group, including the 1,913 passersby who only had exposure to the area air and dust on September 11," the authors write.

Among rescue/recovery workers, risk for asthma was highest among those who worked on the pile on September 11, with risk diminishing with later start dates. Asthma risk also was independently associated with some damage to home or office, and risk was highest if there was a heavy coating of dust at home or at the office. Among residents, those who did not evacuate reported higher rates of asthma than those who did. Of the adults without a diagnosis of PTSD before September 11, 23.8 percent screened positive for PTS symptoms indicative of probable PTSD at either wave 1 (14.3 percent) or wave 2 (19.1 percent). At follow-up, the prevalence of PTS symptoms increased in every eligibility group, with the greatest increase occurring among rescue/recovery workers. At the wave 2 follow-up survey, passersby had the highest levels of symptoms (23.2 percent), while residents had the lowest (16.3 percent). Across eligibility groups, passersby had the highest prevalence of chronic PTS symptoms and office workers had the highest prevalence of resolved symptoms while rescue/recovery workers had the highest prevalence of late-onset symptoms. With regard to mental health diagnoses, 13.6 percent of all participants previously free of PTSD reported receiving a PTSD diagnosis from a mental health professional since September 11; 14.0 percent reported receiving a depression diagnosis; and 7.4 percent reported receiving both. Event-related loss of spouse or job was associated with PTS symptoms. Co-occurrence of postevent asthma and PTS symptoms was common in the follow-up survey.

Among enrollees with postevent asthma, 36 percent had PTS symptoms; among enrollees with these symptoms at follow-up, 19 percent reported a new diagnosis of asthma after September 11. The researchers add that applying reported outcome rates from the follow-up survey results to the approximately 409,000 potentially exposed persons, roughly 25,500 adults are estimated to have experienced postevent asthma and 61,000 are estimated to have experienced symptoms indicative of probable PTSD. "Our findings confirm that, after a terrorist attack, mental health conditions can persist if not identified and adequately treated and that a substantial number of exposed persons may develop late-onset symptoms. Our study highlights the need for surveillance, outreach, treatment, and evaluation of efforts for many years following a disaster to prevent and mitigate health consequences," the authors conclude.

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TV And Computer Screen Time May Be Associated With High Blood Pressure In Young Children

Sedentary behaviors such as TV viewing and "screen time" involving computer use, videos and video games appear to be associated with elevated blood pressure in children, independent of body composition, according to a report in the August issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. The recent trend in obesity is a major public health concern and its effect on blood pressure is of particular concern, according to background information in the article.

"The clustering of cardiovascular disease risk factors in overweight youth suggests that risks may be immediate and not just indicative of potential future problems," the authors write. Although elevated blood pressure is associated with genetic factors, healthy physical, dietary and sleep habits seem to be relevant contributors to blood pressure levels in children. However, there have not been any clear links between sedentary behavior and elevated blood pressure in children younger than age 9. David Martinez-Gomez, B.Sc., of Iowa State University, Ames, and the Spanish National Research Council, Madrid, Spain, and colleagues examined associations between sedentary behavior and elevated blood pressure in 111 young children (57 boys and 54 girls ages 3 to 8).

Sedentary behavior was determined by an accelerometer generally worn over the right hip and by parental reports stating the average time the children spent watching TV, playing video games, painting, sitting or taking part in other activities with low levels of physical activity each day for seven days. Time watching TV was defined as time spent watching TV, videotapes or DVDs. Computer use was defined as the time spent using a home computer or video game. Researchers defined screen time as the total amount of time each child spent using a TV, video, computer or video game. The children's height, weight, fat mass and systolic (top number) and diastolic (bottom number) blood pressure were also measured. The children's average sedentary time and screen time per day were five hours and 1.5 hours, respectively. Boys spent more time using computers than girls, but there were no significant differences in time spent on other sedentary behaviors. "Sedentary activity was not significantly related to systolic blood pressure or diastolic blood pressure after controlling for age, sex, height and percentage of body fat. However, TV viewing and screen time, but not computer use, were positively associated with both systolic blood pressure and diastolic blood pressure after adjusting for potential confounders," the authors write. "Participants in the lowest tertile [one-third] of TV and screen time had significantly lower levels of systolic and diastolic blood pressure than participants in the upper tertile."

"In conclusion, the results of this study showed that TV viewing and screen time were associated with elevated blood pressure independent of body composition in children," the authors write. "Given that total objective sedentary time was not associated with elevated blood pressure, it appears that other factors, which occur during excessive screen time, should also be considered in the context of sedentary behavior and elevated blood pressure development in children."

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New HIV Virus Found In Gorillas

Scientists who found a new human immunodeficiency virus (HIV) in a Cameroonian woman living in Paris, have discovered it is an unusual variant of HIV-1 that could have come from gorillas.

The research that led to the findings was headed by Dr Jean-Christophe Plantier of the University of Rouen in France and is published in the 2 August online issue of Nature Medicine. Drs David Robertson and Jonathan Dickerson from the Faculty of Life Sciences at The University of Manchester, UK, were also involved in the study.

There are three established lineages of HIV-1, known as M, N, and O, which came from chimpanzees, but this new variant appears to be the prototype of a new lineage derived from gorillas and shows no evidence of recombination with the other known lineages, wrote the researchers.
They propose that the new lineage be called HIV-1 group P.
There are 33 million people worldwide living with AIDS which is caused by the HIV-1 virus group M (groups N and O are mainly confined to Cameroon).
HIV is a product of cross-species transmission of Simian Immunodeficiency Virus (SIV) found in chimpanzees, thought to have crossed to humans from eating infected bush meat.
While first recognized in 1980, HIV is thought to have started some 80 years earlier in and around the African country that is now called the Democratic Republic of Congo.
The 62-year old Cameroonian woman at the centre of the study moved to Paris in 2004 and began to have symptoms shortly afterwards. Her blood sample showed discrepancies in her viral load, and further tests revealed she was infected with a new strain of HIV that more closely resembled SIV from gorillas than HIV from humans.
However, before moving to Paris the woman had lived in a semi-urban part of the central west African Republic of Cameroon; she had not come into contact with bush meat or gorillas.
Because of this information and the fact further tests showed that the virus was able to replicate in human cells, the scientists suggest the strain may well appear elsewhere.
Robertson told the media that:
"The discovery of this novel HIV-1 lineage highlights the continuing need to monitor closely for the emergence of new HIV variants."
"This demonstrates that HIV evolution is an ongoing process. The virus can jump from species to species, from primate to primate, and that includes us; pathogens have been with us for millions of years and routinely switch host species," he added.
In the same way as the current swine flu pandemic is showing us, this is another example of how viruses can now move very quickly around the world because nowadays large numbers of humans travel long distances in a short space of time.
Plantier's team in France are part of a network of laboratories that has been monitoring HIV genetic diversity, while the The Manchester Life Sciences team helped with the computer-based evolutionary analysis.

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Live Long and Prosper---Doctor's lounge (3)

It was a late fall Monday, during my third year of medical school. I had just finished a horrifically boring month of Geriatric Psychiatry at the VA hospital, and now was doing a month of Adult Psychiatry at the local psychiatric hospital. It was a locked ward, and every day we had to be buzzed in to the unit, and be buzzed out at the end of the day.
There were three medical students working the ward. We each took turns taking new patients when they were admitted and working them up. It was my turn to work up a new patient that had been brought in Sunday night.
The senior resident handed me the patient’s folder. It was a thin folder, suggesting that this was her first stay at the hospital – generally a good sign. The resident quickly dashed that hope.
“Mrs. D was brought to the ER last night for severe depression. There was no suicide attempt; her family was worried because she was staying in bed and not willing to move for the past week. Since being brought to the ward last night, she hasn’t moved at all; she’s just lay in bed staring at the ceiling.” She smiled a crooked smile at me. “Good luck.”
I looked through her chart and ER notes. There was nothing particularly alarming or interesting. She had been on outpatient treatment for depression on and off for about five years. No suicide attempts. No significant medical or family history. She was divorced with two teen-aged children.
I walked to her room, the last door on the left, opened it up and looked in. The room was dark, and a large woman was lying unmoving on the bed, staring at the ceiling. Her breathing was slow and steady and she did not seem to be in any kind of distress. I knocked and entered the room.
“Hello, ma’am. I’m the medical student, Scott. How are you doing today?”
There was no response. Not even a twitch of muscle or a flicker of eyelids.
I pulled a chair next to the head of the bed and sat down. I tried again, “Are you in any discomfort? Is there anything I can do?”
There was no change. She continued lying in bed, staring at the ceiling.
I pulled out the history form, and asked the first question. “How long have you been feeling depressed?”
No answer. No movement. It was like trying to talk to a brick wall. It was time to try a different tack.
“Tell me about your children. How old are they?”
This time there was a brief twitch of the eyes, but no other movement.
“Are you and your children getting ready for Thanksgiving?”
There was another eye twitch, but nothing else. Clearly, she could hear and probably respond, but was choosing not to.
“You were brought to the ER last night,” I said, getting no response. “So you missed Star Trek, (Star Trek is an American science fiction entertainment series and media franchise) then.” This was Star Trek the Next Generation’s last season, and it was shown on Sunday nights in St. Louis.
Her eyes opened, and she turned her head my way. “Why? Did I miss anything important?” she asked. I laughed, and we spent the next hour talking about Star Trek.
Once up and out of bed, she recovered quickly and was home by the end of the week. We established a good rapport, and had many long talks. I was glad to see her get to go home, but also sad, because she was one of the few bright spots in an otherwise dreary rotation.
There was an important lesson to be learned: Where standard dialogue had failed, where even family concerns were not enough, Star Trek had triumphed.

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Emotional Difference Between Males and Females

Everyone knows that men and women are different, But, aside from external anatomical and primary and secondary sexual differences, scientists know also that there are many other subtle differences in the way the brains from men and women process language, information, emotion, cognition, etc.

One of the most interesting differences appear in the way men and women estimate time, judge speed of things, carry out mental mathematical calculations, orient in space and visualize objects in three dimensions, etc. In all these tasks, women and men are strikingly different. This may account for the fact that there are many more male mathematicians, airplane pilots, bush guides, mechanical engineers, architects and race car drivers than female ones.
On the other hand, women are better than men in human relations, recognizing emotional overtones in others and in language, emotional and artistic expressiveness, esthetic appreciation, verbal language and carrying out detailed and pre-planned tasks. For example, women generally can recall lists of words or paragraphs of text better than men.

Medical Reasoning Of Emotions:

The human brain has two distinct hemispheres, left and the right brain. Left brain is responsible for logic reasoning, planning, orderly thinking and the right half governs emotions, imagination and interpersonal skills. Both halves work together by exchanging information through a bundle of nerve fibers connecting them.

As a baby boy grows into school going child, more emphasis is laid on the use of left brain skills, leading to development of the right brain at a much slower rate. Men have less communication between two halves of brain due to the degeneration of neurons under the action of Testostorone. Thus men with less connection between two parts, tend to be predominantly governed by the left brain by being less emotional and more logical.Exactly, opposite things happen in case of baby girl.

So, Females are "more" Emotional Than Males.

Why is this so?

A recent medical research states that in case of boys, while developing in the mother's womb a hormone called testosterone is produced in excess, this hormone mildly damages the nerve fibers connecting the two halves and makes the connection weaker. This difference in connectivity of two halves in baby boys and girls have some intriguing aftermaths. Testosterone is the hormone which is responsible for Fertility in Males.

Man handle emotions differently:

Men are not emotionless, it's just that men handle emotions differently than women do. They usually don't talk about it. Most men dislike to share their innermost thoughts.

To end with, there is stigma about men and their feelings. Women are often accused of being too emotional and men the vice versa. However, sometimes women can be insensitive and men hypersensitive. The truth is, neither men nor women are emotionally centered and masterful. Both genders struggle with emotions. Its just that one masters slightly than the other. Remember men are not emotionless automatons. They articulate their fears, dreams, likes and dislikes with more sense of love and sensitivity.

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