>February 06 2002

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We’re in the middle of a pretty quiet two week stretch leading up to the end of our winter quarter. Then we have a barrage of exams lasting a week. The good thing is we have no classes that week. Histology will be over then and we will be on the downhill stretch for first year. Wow. It has flown by. I was thinking about how much I have learned this year and how things are really beginning to take. The image I come up with is one in which my knowledge base is a long downhill tunnel. At the beginning of the year I was getting all kinds of information thrown down the tunnel. I would get some of it to stick to the walls as it went down. Hopefully it would stay on the walls and not ooze completely to the end of the tunnel and fall out before the exam. Without me even realizing it though, some of these facts and concepts firmly attached somewhere along my information tunnel. Now I have several ledges and crevices built up where more and more stuff can accumulate. Some of the things we studied in Anatomy and Biochemistry are being repeated in Histology and Physiology, and what once seemed arcane and random now seems relevant and familiar. When somebody talks about angiotensin converting enzymes, I actually know what they are talking about now. It is a wonderful feeling to see a lot of things coming together and realizing that, yes I really can do this, and I will be a doctor one day. Don’t get me wrong, I still have to have my Stedman’s Medical Dictionary handy to read Ron’s diary, but I’m getting there!

One really cool thing we saw in Physiology was a video of some research Dr. Hester is doing on the circulatory system. He takes hamsters and under anesthesia splays their cremaster muscle (If you’re not sure where this muscle is, look it up – it may be painful if you’re male!) out under a microscope. You can actually see the blood coursing through arterioles, venules and the capillary beds. In the capillaries there is room for only one red blood cell at a time and there are junctions where red cells will wait for a gap in the main line to jump into. It looks like cars merging on to the interstate. The research being done is on hypertension and such. A drop of adenosine can be placed on the muscle and almost immediately the vessels will dilate substantially. Dr. Hester told us that back in 1982 he first saw this type of research being done and said to himself, “That’s what I want to do!” And he’s been doing it ever since. I didn’t have the nerve to ask the main question on my mind – “Don’t you ever get finished?” By the way, I think Cremasters would make a killer name for a kids soccer team.

One other thing going on today; my little boy Manning has been having a lot of reflux problems. He is fed via a gastrostomy tube and has had a fundiplication. (A portion of the fundus of the stomach is wrapped around the base of the esophagus creating an artificial valve to keep stomach contents in.) We had a barium test done today, and of course he did not exhibit any symptoms for the radiologists. We see his gastroenterologist tomorrow for a follow-up. We are thinking that he needs a new surgery to redo his fundiplication. The original surgery was done 3 years ago, and he never had any problem with reflux until his hemispherectomy complications last fall. I think he has probably just grown such, that the existing wrap has loosened up too much.

About Marcus Lee

Child Neurologist
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