Abnormal Anatomy

Another day gone . . . I should be studying but I would rather write a quick update. We don't have a test until . . . midnight you say? oh, I better get on that . . .

Actually I did already complete the quiz due at midnight tonight, but only because I thought it was due at 5:00. The thing about med school is they expect you to be on top of things, and I think so far I am not. But then it seems like very few of us are, so I am not alone. Thank goodness for the few that are are super organized and prepared; that look up the syllabus weeks in advance, that study the lecture notes before the lecture, that obsessively check the student web portal for posted material. If not for them I would not know when Quizzes, Journal Clubs and Problem sets were due, because nobody tells us here. I guess they think we are all responsible adults . . . :) Honestly though, I am figuring out the system and soon I too will know what is going on.

As for classes, still loving it. Even the studying is not so bad because I actually do want to know the material. Granted years from now (or even months) I wont remember, or probably care, what the Wnt pathway is, but it will be there somewhere in the back of my brain. And the really cool thing is that all the molecular pathways that we are learning really do have huge effects in our own bodies, and the disruption of the activity of just one protein can be fatal. I wont go into detail (although I have considered using this blog as a form of review and subjecting you all to the material that we are learning) but just know, it is a miracle that your body is working.

My favorite is probably anatomy and cadaver lab. Even though it is a lot of memorizing terminology, it is really amazing to see first hand how everything works together. however, it has not been an easy road so far; our cadaver has been a bit challenging. We started at the skin on the chest and dissected through the muscles and ribs before removing the chest wall (rib cage) to expose the heart and Lungs. At this step we had our first problem. Normally there are two layers of tissue, one attached to the rib cage and one surrounding the lungs, that should slide past each other easily. However, damage to the lungs can sometimes result in adhesions where the sac around the lung actually attaches to the chest wall. Our cadaver, being a smoker (we assume, cause of death was lung cancer) had this problem, and not in a small way. The entire chest wall was adhered to the lung and Dr Gosling had to remove it by force (have I mentioned Dr Gosling's approach to dissection? He gets both hands in and pokes, pulls and tears, but I guess since he knows what he is digging for, it works out). Once we removed the rib cage we noticed something else strange. There was only one lung. Likely the lung was removed in an attempt to remove the cancer but the result was that the left lung was huge and the heart had been pushed over to the right side. OK, not quite a normal specimen, but at least one lung was intact and everything else was present. We thought. That was until today when we went to remove the pericardium (the sac surrounding the heart), which was already gone, and identify the veins and arteries on the surface of the heart, which were a bit confusing as the patient had had bypass surgery (adding an artery that was not naturally present) as well as all the connections to the right lung having been tied off during the removal of the lung. To top it all off, there were wires buried into the tissue surrounding the heart for which we could not distinguish the function. The really amazing thing about all of it is that the man lived well beyond the surgeries (evidenced by the extent of the tissues surrounding) despite having one lung, a heart that was fused to the back of the chest wall and a lung fused to the front his body was able to compensate and survive. Luckily though, there are 23 cadavers in the lab and plenty of classmates willing to share their organs in the interest of education.