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| "A final diagnosis sometimes is revealed under the microscope."-C.Dorsett
As my Anatomical Pathology clerkship comes to a close, I can't help but appreciate how much it made me appreciate life and to consider taking a new approach to my studies in order to understand medicine.
Like a broken record, at each session "pathology makes medicine easier to understand" was repeated. Initially, I thought the Pathologists were just biased. I later found out how true that statement was as the month progressed and my studies intensified and my knowledge grew.
Now that it's almost over, the following are three major take homes I would like to share with you.
1. Consider Changing Your Lifestyle In Order To Extend Your Life Expectancy.
I was beyond surprised to find out how many persons suffer from Diabetes and the complications of the disease, or those who smoke and develop pulmonary tumors. These things can all be avoided simply by taking the time to adjust the modifiable risk factors such as diet, exercise, smoking cessation and managing stressors. If you have the opportunity to add years to your life by simply omitting negative risk factors from your life, wouldn't you want to do it?
Commit to walking at least 30 minutes per day and increasing your water consumption while reducing your consumption of high fat foods.
2. If You're a Student, Trying To Make Sense of Medicine, START With The Pathology And Work Backwards.
This takes a while to get use to, however, once you continue practicing it gets easier and you will begin noticing the overlap of the physiology that is involved in some pathological processes. Mind maps work extremely well for this process and allows for simple review.
As we had a case report to prepare and present, I realized how tiresome writing post-mortem examination reports can be to the novice, because some patients present with more underlying conditions than you can count and finding out what could have resulted in their death isn't always as simple as a myocardial infarction. For instance, if your patient was a known diabetic, with hypertension and was treated for end stage renal disease, one can simply suggest that they succumbed to the progression of the diabetic hypertension. This may be true, however are you able to explain clearly the pathophysiology or the sequence of events that would cause the development of pulmonary edema? It was in Anatomical pathology that I learned just how much human physiology I understood and those areas that I weren't so sure about and took short cuts to learn.
3. When You Don't Have a Clue What The Diagnosis Is...
Take some time and review the histopathology slides. There are a lot of clues that can assist with your final diagnosis that lie on a microscope slide. Often times I don't enjoy histology, I'll admit; mainly because it requires a lot of time, dedication and either you understand the structures seen or you don't, which means you need to add a little more microscope time to your study schedule.
I was able to appreciate and confirm a diagnosis by simply reviewing a sample of a patient's lung.
When all else seems grim, return to the basics-microscopy.
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Faced with Doubt
Sunday, October 18, 2015 |
“Don't dig up in doubt what you planted in faith.”― Elisabeth Elliot |
It's Sunday night, and without fail I'm seated at my dining room table trying to organize the mountain of lectures I have to tackle. I'd rather be sleeping; however sleep will have to come later. The past three years has served me my fair share of self doubt. I most recently stumbled upon the above quote and I can't help but repeat it to myself whenever I feel as though I should just call it quits.
There may be someone else out there who may have felt this way, or currently feeling this way. Don't worry brave one, you're not alone. It's almost as if once you accept your place in the medical school of your choice, you are automatically enrolled in lessons of humility, faith, patience and true dedication. Consider it a right of passage. Countless others sat where you sit, endured the belittling by consultants and spent many grueling hours hunched over Moore's Clinically Oriented Anatomy trying to make sense of the Circle of Willis. You're no different from them. Neither am I. So why doubt?
We're all human, and we have our moments of weakness. Those are the moments that test our strength. Will we cave under pressure or endure till the end? Will we allow the noise of the market to darken our light? or allow it to shine even brighter?
As I head back to the books, I just want to encourage someone, somewhere who may be in need. You've come this far to quit now. God has a purpose for you. Don't give up just yet!
Tablespoon Thursday: Neutrophil Alphabet
Thursday, October 15, 2015 |
“When a lack of white blood cells exposes the horizon of being, one has to make a choice. To cloister yourself away in a germ-free environment, alive but alone, or to embrace the woman you love and catch your death of cold at the marriage ceremony? What a great show. It’s inner-directed script was unmatched by any other soap opera.”― Benson Bruno, A Story That Talks about Talking Is Like Chatter to Chattering Teeth, and Every Set of Dentures Can Attest to the Fact That No.. |
This semester has given me a new appreciation for time management. Being thrown into the deep end offers two outcomes, either you 1) sink or 2) swim. After two years of lectures with ample free time to study for final examinations, having examinations at the end of each month and the end of a block was my wake up call. From multiple choice questions and extended matching questions to structured short answer questions means that my studying has to be all the more involved and not the superficial stuff I did previously. I must say though, studying the pathology and working backwards to understand all of the biochemistry and physiology really has helped solidify my understanding of the pathophysiology of diseases and has given me a whole new appreciation for medicine.
Take a look at the case with the neutrophil alphabet, the photo is credited below. It's amazing how much information a peripheral blood smear holds.
Research. Embrace It.
Monday, October 05, 2015 |
| “Google' is not a synonym for 'research'.” ― Dan Brown, The Lost Symbol |
When I saw that research was a mandatory component in order to receive the Bachelor of Medicine part of my Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.) degree I'll admit, I wasn't too thrilled.
At the end of our year 2 examinations, back in May 2014 my class was placed into groups, assigned a Principal Investigator and given a topic. This is what we would spend our summer and Christmas vacation doing; Conducting Research. Previous graduating years were afforded the opportunity of choosing their group members, topic and even their supervisor.
Our topic initially was "The effectiveness of academic research in policy development in the Caribbean". Quite broad and one I would not have picked if I had the opportunity to. It was the first study of its kind to be done in our Faculty and now I know why.
At the end of our countless meetings (where we brainstormed our methodology, study design as well as our study's aim and objectives) collectively we decided that our title needed revision and so we agreed on the title "The Extent to Which Academic Research Influences Policy Development in the Caribbean Countries of The Bahamas, Guyana and Trinidad and Tobago." Once we had a clear topic, we needed to narrow down the policies that we would be studying and the areas of medicine. As a result the communicable disease HIV/AIDS due to its sustained prevalence, the non-communicable diseases Type II Diabetes and Hypertension due to its recent increase in Caribbean countries and as travel and trade are more globalized, the vector-borne diseases Dengue and Chikungunya are now emerging in countries where they were otherwise non-existent, these were chosen.
Policy planning, development and implementation is not an overnight process. Rather its just the opposite; it takes years!
It can involve as little as 8 steps to as many as 11, and its foundation is built on research. Being ignorant to what policy development entailed, I didn't expect to see research anywhere in the process. As our study developed and we started speaking with personnel of the Ministry of Health's Policy Planning, Development and Implementation Departments of our focus countries, I realized how vital its role is in the overall process.
In the Caribbean, research is being conducted, published and presented and yet their findings aren't making it on the desks or in the line of sight of those who are able to allow it to be utilized when healthcare policies are being revised or when new ones are being formulated. It made me wonder if this is the major contributing factor to the state of our healthcare systems throughout the Caribbean.
I can tell you, having to review Journal publications from the West Indian Medical Journal, poster presentations from the Caribbean Public Health Agency and policies from the MOH of three countries as they relate to HIV/AIDS, Type II Diabetes and Hypertension and Dengue and Chikungunya, is not an easy task. It can however be very difficult especially when faced with a lack of cooperation despite your Ethical Approval.
Yet, we pushed forward.
What this study proved was that we in the Caribbean are still moving very slowly in an ever advancing world. It was reassuring to know however, that we do follow and meet the standards and guidelines that are in place by the Pan American Health Organization as well as the World Health Organization and the Centers for Disease Control when it comes to our policies for the aforementioned areas of medicine.
It made me question why our regional research findings are not being used, to which the answer was for one country, the findings were not available or easily accessible when they needed them to revise or plan new policies and another went on to mention that their country lacks an organized structure or body whose sole purpose would be coordination of stakeholders and resources in order for academic research to be conducted and the findings to be used in the policy development process.
As expected, each Ministry of Health will be faced with certain limitations that would affect which policies will be revised and whether or not new policies would be implemented. That goes without saying. My question was, at the end of all of this "How can we get the Ministry of Health of each Caribbean country, to pay attention to the research that is being done, and to utilize their findings along with those of academic research being conducted internationally?"
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The Policy Developers
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