Back in town

I'm finally back in town, finished with my post-graduation travels to my and my girlfriend's respective family homes. I anticipate having several days ahead of me devoted to running errands and finalizing details relating to my new house; however, I will liberally sprinkle some time wastage among my other duties and tasks. In that vein I hope to watch a few new movies and generally lay about.

Thanks to everyone who commented on my blog in my absence! Hopefully I'll think of something interesting to write in this space in the coming days.

Ian M.D.

I graduated today! It's late, so I'm not going to say much... but I delivered a commencement address at my med school graduation ceremony, and had the distinct honor of sharing the stage with Dr. Michael E. Debakey, our invited commencement speaker. After that I spent some quality time with my mother and about twenty of my girlfriend's friends and family. What a day!

I'm sleepy.

Grey's Anatomy -- "Save Me"

This episode's title was "Save Me," and the plot synopsis from the abc.com website is as follows:

Meredith grows increasingly dissatisfied with the unknown details of Derek's life. Meanwhile, Alex treats Devo, a patient whose religious beliefs jeopardize her chances for recovery; Izzie contemplates reconnecting with her estranged mother; Zoey, a pregnant woman in her 40s who's been diagnosed with cancer, disagrees with Cristina's medical advice; and the interns are mystified by Cable, a patient who's being treated for seizures and who thinks he's psychic.


The show seems to be hitting its rhythm in terms of developing the relationship between Meredith (Dr. Grey) and Derek (the neurosurgeon), with an abundance of witty banter and a gradual peeling back of Derek's layers. Unfortunately, Cristina -- the heartless mannequin in scrubs -- continues to make me want to send the remote control hurtling through the television screen. I can thankfully say that I have yet to encounter any such insufferable personalities in medicine, and I hope that trend continues.

As for the medical details of the show -- well, I think they still need serious help from an actual physician. If any of the writers would like my assistance in that regard and happen upon this blog at some point in the future, I hope they consider this my offer to provide much needed consultation for a nominal fee.

* One of the patients on the show had a temporal lobe arteriovenous malformation (AVM). Interestingly, the writers hit upon a truth in suggesting that such a lesion can cause seizures and behavioral changes which could be mistaken for psychic phenomena; indeed, temporal lobe masses such as AVMs are classic causes of "uncinate fits," in which patients exhibit bizarre patterns of activity, olfactory hallucinations, and other unusual phenomena. Unfortunately, the writers missed the mark in suggesting that an AVM is a lesion necessitating immediate therapy. Unless it has already begun to bleed, AVMs typically have a lifelong risk of rupture of roughly 2-4% per year. Given that the patient in question was young, he should have been advised to receive treatment, but it needn’t have proceeded in any sort of hasty fashion. In fact, depending upon the size and exact location of the AVM, he might have been a candidate for non-invasive radiosurgery to ablate the lesion rather than an open neurosurgical procedure. Such a treatment takes a longer time and carries with it the risk of rupture of the AVM before efficacy is achieved, but it spares the patient the considerable risks of morbidity/mortality from surgery.

* Another patient on the show had an ascending paralysis that prompted Derek to take him to the operating room for removal of a presumed expanding hematoma. It’s pretty darn unlikely that an MRI would lack the sensitivity to visualize a lesion large enough to compress the spinal cord; the only way that such scenario would be likely to occur would be if the spinal canal were particularly narrow, which of course would itself be evident on MRI.

The rest of the medical content was relatively straightforward, making accuracy easier to achieve. I’m still rather amazed at all the hook-ups taking place on the show. How do all the interns find time to have carnal relations with their attendings?

Back to blogging

Wow, my blog is truly moribund. I'll try to give it a good precordial thump to restart the old heart tonight.

I've found myself quite busy with outside pursuits lately, especially the planning for my senior class show, as well as the writing of two speeches. I delivered one of these just last night at my school's alumni reunion banquet; all in all I think it went well, though as usual I spoke far too fast (apparently what feels excruciatingly slow to my brain is, in reality, rather rapid) and tended to fidget incessantly while talking. At least my girlfriend managed to tape the proceedings, so I have some evidence of my speaking flaws as a starting point from which to improve.

Let's see...in other news, I finished reading a book called The Twenty-Seventh City, which is the first novel written by Jonathan Franzen (the author whose name became famous more for the Oprah Book Club brouhaha than for his writing, although he writes quite well). I picked it up mainly because it is based in my new hometown; the picture of the Arch on the cover was enough to convince me to shell out the money. All in all it was only an average read, more compelling for Franzen's prose than for any profound thematic concerns or illuminating characterization. I did, however, learn a few more tidbits about my little city in the Midwest, and as a result I can now amaze my friends with random pieces of trivia.

I just started reading Catch-22 -- one of those all-time great novels that over the course of my formal education I managed to neglect or avoid.

I also finally saw another episode of Gray's Anatomy, so I suppose my next post should serve to resume my prior habit of reviewing this ABC program.

This is supposed to be my vacation

As of Friday evening, I no longer have any medical student coursework or rotations to perform. My work here is almost finished. However, I seem to have an ever-ballooning docket of extracurricular obligations demanding my attention; today, for example, I helped a friend move into his house (a task which I will find myself repeating about twice a week until everyone I know is settled his/her new abode), then later spent the bulk of my evening doing laundry and preparing the lesson for another neuroscience case session. At least tomorrow, when I take a seat in front of a group of eager 1st year students, I'll be clothed in an undershirt and a black button-up shirt on top, with the intention of keeping my axillary hyperhidrosis below the threshold of detection.

When will I get to relax? All next week I'll be working frantically on our class variety show -- the organization of which falls largely in my lap -- and preparing a speech for our graduation on May 20th. After that perhaps I can resume the mental hibernation my taxed cortex so desperately desires.

Full circle

I just spent the past hour teaching a clinical case session to a group of 1st year medical students. I must say, I felt rather strange sitting there with all eyes upon me -- the supposedly knowledgeable one -- while trying to engage my tired brain. I also learned a couple of important things. Importantly, one should never have contempt for a teacher in front of a group who demonstrates a brief stint of pure idiocy. When not under scrutiny, the brain often undergoes subtle lapses of concentration that can be circumvented entirely by a deep breath and a deliberate closure of the eyes; however, when an entire audience clings with tenuous attention to your words, somehow the gravity of the situation can stretch out those concentration lapses like taffy on a warm summer day -- and soon the sticky mess adheres to every thought until fluid communication becomes impossible. Teaching is hard.

Also of note, withold your snickers and derisive glances when a teacher displays with every raise of the arm a massive, ignominious armpit stain. For some reason, the armpits serve as the barometer of public speaking; when I am in public, my armpits don't sweat, and when I am speaking, my armpits don't sweat, but whenever I speak publicly, the sweat glands dump their salty product all over my clothes. I didn't realize this fact until I got to med school, but now I feel ashamed for every having made fun of my high school english teacher's huge pit stains.

Well, time now for a journey to the health club for an hour on the stationary bike. You wanna see sweat? I'll show you sweat.

The Amityville Remake

Well, after spending several hours in an anatomy lab surrounded by formalin-soaked corpses in various stages of dissection, I figured the best way to cap off my evening would be to take in a horror flick. The only viable option appeared to be the new remake of The Amityville Horror, so off I went to watch it -- by myself.

Okay, at this point I imagine that half of you found nothing in the previous sentence to cause consternation, and the other half are aghast at the idea of venturing to a theater unaccompanied. I do it fairly often, though, so I suppose that makes me either independent or in need of counseling.

Anyhow, the movie turned out not to provide the scares it promised, largely because it offers nothing new; it merely takes the plot of an old movie, tweaks it mildly, and then throws in what is apparently the new sine qua non of horror -- freaky children. Of course, from the very beginning horror movies have featured children in their plot lines, to great effect in such cases as The Exorcist (the original) and The Omen. However, I think the past six years mark the beginning of a new trend, which is the inclusion of sinister, dead, ghostly, ghastly children as the prime mover for fright. I trace the origins of this recent trend to The Sixth Sense, released in 1999, which showed the world that nothing is scarier than little kiddos done up to appear cadaveric, walking around like zombies, vomiting and looking preternaturally somber. After the success of that film, we saw a boom in movies with moribund munchkins -- just look at The Ring 1 and 2, The Grudge, and now The Amityville Horror. And these are just the movies in which freaky kids figure prominently; they also make startling cameos in zombie movies (Resident Evil: Apocalypse and Dawn of the Dead), psych flicks (Gothika), and surely many more that I’m neglecting.

The thing about these movies is that they not only employ freaky children, but rely almost solely on seemingly gratuitous imagery of ghost kids looking as though they stood up and walked out of the morgue – they have bullet holes in their heads, pale faces with blue veins snaking across them, fixed and dilated pupils, etc. Further, these kids demonstrate peculiar behaviors such as howling like cats and displaying their black-hole little mouths, turning green, and staring through the audience members’ souls. If called upon to locomote, these freaky ghost children will generally move like normal children, except they do so at 2 X film speed so as to make their inexorable advance towards the screen seem ever so inescapable; moreover, if changes in elevation are involved, such as climbing down stairs or out of deep wells, the children will invariably climb like Gollum in The Lord of the Rings, with their legs reaching out above their heads thanks to the tremendously improved range of motion that death apparently confers upon the human hip joint. Oh, and one other thing – if the dead child is a girl, she will have long, black, wet hair that hangs forward to obscure her face, hiding, of course, the hideous mangled atrocity that some makeup artist has created underneath. And, of course, if at any point a mirror appears in one of the scenes, a dead child’s image will materialize in the background.

Well, I’m rambling on. The point is that horror film makers think they have lit upon a ready-made scream-producer in the scary dead child, and they seem intent on burning shiver-inducing kiddie images onto our retinas. As I just realized tonight with The Amityville Horror, though, the scream-o-matic child has lost its novelty.

And I have certainly lost interest in seeing any more films with dead toddlers.

P.S. I found this interesting article about the lasting effects of horror movies on children. Of particular interest to me was the fact that "52 percent of the sample reported disturbances in normal behavior such as sleeping or eating after viewing a frightening film or TV program." Hmmm... sounds about right. After watching the movie Alien as a young kid, I refused to eat at the dinner table for months for fear that a little xeno-beastie would pound its way out of my chest and land on the pork chops. Also, I like this quote: "For about two months after the movie, I had nightmares about blood," the participant said. "The nightmares didn't always involve sharks, but always contained gross amounts of blood. To this day, I remain horrified of blood." Well, I watched more horror movies as a kid than anyone else I know -- and now, after all those years of blood, guts, and gore, I'm going to be a surgeon. Go figure.

P.P.S. I'd like to know -- what do you think is the scariest horror movie? Which scenes still haunt you when the lights go out at night? What images and sounds from horror flicks send a chill down your spine?