The Body is Awesome!

We're going through "The Truth Project" with some people from church... talking about science today, the search for truth, to understand the particulars of the world around us. Following the truth leads me to believe there is a designer. There are so many amazing and awesome things in this world to say it was just chance and randomness and time that gave us the universe as we know it.

Here's one little clip: "The Inner Life of a Cell" by a company called XVIVO, made for Harvard Medical School. Shows some of the cellular processes in just one white blood cell. What you see in 3 minutes goes on millions of times per second in your body. Wow.



The heavens declare the glory of God - Psalm 19:1
The fool says in his heart, "There is no God" - Psalm 53:1
Since the creation of the world, God's invisible qualities - his eternal power and divine nature - have been clearly seen, being understood from what has been made, so that men are without excuse. - Romans 1:20

Cancer sucks.

Been working in the Emergency department these past few weeks. Finished today's shift on a bit of a downer...

A fairly healthy looking guy in his mid-50's came in with sudden blindness in one of his eyes. Sure he had diabetes, but it wouldn't cause vision problems like that. Turns out he had been battling lymphoma (cancer of the lymph nodes) earlier this year, and had a mass removed in his forehead 9 months ago...

His CT Scan of his head looked a little like this (but not esophageal cancer):


So, how do you tell a middle-aged guy he has cancer in his brain?
How do you tell him his 6 months of chemotherapy didn't work?
How do you tell him his stem-cell transplant didn't work?
How do you tell him his time is limited, he's going to die?

With grace and truth, I hope.

"It is appointed unto men once to die, but after this the judgment." -Heb 9:27.

Medispeak Multiple Choice

During my studies and reading, I come across some interesting words. Some medical terms that have a funny ring to them. Here's a few, and this list doesn't even include muscles! Can you guess what they mean?? How many can you use in regular conversation??

1 - Borborygmi
2 - Gubernaculum
3 - Hematochezia
4 - Melena
5 - Uvula
6 - Obstipation
7 - Verruca vulgaris
8 - Astrocytoma
9 - Xanthelasma
10 - Tophus


Possible answers:
A - soft tissue projection from the middle posterior edge of the soft palate, ie: the dangly thing at the back of your throat.
B - cholesterol deposits in the skin, often around the eyelids
C - rumbling or gurgling of the intestines, from movement of fluid and gas; stomach growling
D - dark or black sticky tar-like poop, contains partially digested blood
E - severe or complete constipation, not passing any gas
F - reddish-maroon poop, from bleeding in the colon
G - star-shaped brain tumor
H - folds of peritoneum (abdominal cavity lining) that attach to the gonads during development in the womb
I - large lump of uric acid deposits under the skin, often over the elbow, occuring in people with gout
J - the common wart


Answers:
1-C; 2-H; 3-F; 4-D; 5-A; 6-E; 7-J; 8-G; 9-B; 10-I

Scoring:
0-3 right answers = this quiz gave you obstipation?
4-6 right answers = take care of your borborygmi, then hit the books
7-8 right answers = no xanthelasmas blocking your view
9-10 right answers = genius! you can diagnose astrocytomas

Doctors and virtue

From "The Hand of God", by Bernard N. Nathanson:

The minimal description of a doctor then is this: a highly trained technician, daily exposed to exceptionally powerful material and spiritual temptations. It has been my experience that only those who have an inflexible inner spiritual column supporting the immense weight of medical obligations and responsibilities survive intact the lure of the worldly temptations in the medical world: the uninterrupted flow of money, the drumfire of flattery, and the inebriating effects of special privilege. It is no accident that great early physicians and scientists were deeply spiritual: Hippocrates swore his oath to his gods; Aristotle (perhaps the greatest empirical scientist of all time) revered the idea of God as the Prime Mover; Claudius Galen, who built upon the work of Aristotle and Hippocrates, early on declared himself a monotheist and was cherished by Arabic and Hebrew physicians who followed in his wake; and Rabbi Moses ben Maimon (Maimonides), a codifier of the Talmud, was a talented physician to the court of Saladin in Egypt and wrote the Guide for the Perplexed, which strove to marry the elements of spirituality with the science of medicine. William Harvey, the discoverer of the circulation of blood, was convince of the evidence of a Supreme Creative Intelligence and practiced his Protestant religion zealously. Without such an absolute guide to virtue, doctors, exposed as they are to greater temptations than most, are likely to fall further.

So this begs the question... what kind of doctor do you have? What kind of doctor am I?

Medical schools these days are good at selecting smart, even brilliant, students, but they have no way of instilling virtue. Indeed, there is often a bias against anyone with such a foundation, although we seem to get in anyways!

There has been the appearance lately in medical schools across Canada (and I'm guessing the States and elsewhere) of "Professionalism" and "Ethics" classes in an attempt to fill the void left by and increasingly secular and amoral physician body. And of course, we don't take the oath of Hippocrates anymore - it was changed and edited and spit shined in order to cover those that practice the more fringe medicine that we see being forced on society (abortion, assisted suicide, embryonic stem cell use, etc.). But I digress.

The point is, if you have the option, find yourself a doctor with moral integrity and virtue.

O Jesus, You who suffer...

O Jesus,
you who suffer,
grant that, today and every day,
I may be able to see you in the person of your sick ones
and that, by offering them my care,
I may serve you.
Grant that, even if you are hidden under the unattractive disguise of
anger, of crime, or of madness,
I may recognize you and say,
"Jesus, you who suffer, how sweet it is to serve you."

Give me, Lord, this vision of faith,
and my work will never be monotonous,
I will find joy in harboring the small whims and desires
of all the poor who suffer.
Dear sick one, you are still more beloved to me
because you represent Christ.
What a privilege I am granted in being able to take care of you!

O God, since you are Jesus who suffers,
deign to be for me also
a Jesus who is patient, indulgent with my faults,
who looks only at my intentions,
which are to love you and to serve you
in the person of each of these children of yours who suffer.
Lord, increase my faith.
Bless my efforts and my work,
now and forever.

- Mother Teresa of Calcutta, taken from "Mother Teresa: A life for God" by Lavonne Neff.

Attack on Conscience... again

The CBC Edmonton website had a random article today about a pro-life doctor who refuses to provide referrals for abortion. Dr. Johnston was commenting on the upcoming review of standards by the College of Physicians and Surgeons of Alberta, where they may require physicians to refer a patient to an abortion center if the patient asks. This would essentially make it illegal for a doctor (myself included) to use our moral judgment in advising and treating our patients. And a brief reading of the comments shows most people do not understand the nature of medicine or the nature of abortion.

Practicing medicine is a moral activity. We, as physicians, recommend to our patients what they ought to do with their bodies/health. It is then up to the patient to proceed. As such, we must use our clinical judgment, but also our moral judgment in recommending what we feel is best for our patients. If we cannot do this, then the autonomy of the doctor is hampered and we become simply automatons of the system. Just because a law is in place does not make it right. And just because a patient demands for a procedure does not make it right, either. Particularly when there are so many negative sequelae to that procedure. See Abort73.com for excellent overviews of the abortion topic.

A fitting quote from Theodore Dalrymple in his book, "Life at the Bottom":

If the doctor has a duty to relieve the suffering of his patients, he must have some idea where that suffering comes from, and this involves the retention of judgment, including moral judgment. And if, as far as he can tell in good faith, the misery of his patients derives from the way they live, he has a duty to tell them so - which often involves a more or less explicit condemnation of their way of life as completely incompatible with a satisfying existence. By avoiding the issue, the doctor is not being kind to his patients; he is being cowardly. Moreover, by refusing to place the onus on the patients to improve their lot, he is likely to mislead them into supposing that he has some purely technical or pharmacological answer to their problems, thus helping to perpetuate them.