October 6, 2010

gatorade = diarrhea you can drink (aka welcome to renal physiology)

Life is a struggle
not against sin,
not against the Money Power
not against malicious animal magnetism
but against the hydrogen ions.

-H.L. Mencken, Exeunt Omnes, The Smart Set, 1919

and that's sort of how it feels today. I write a lot about the profound parts of medical school or the cool parts of being on the way to becoming a physician, but leave out a lot of the grueling details. We just started learning about the kidney this weak, which is arguably the most complicated organ in the body, and it's just not that exciting. It's super important - don't get me wrong - kidney failure is one of the worst medical complications one can have, so far as I understand it - but it's just not that glamorous (as much as our professors try).

our morning was all lectures on acid-base physiology in the kidney and began with the same quote that this post begins with: life is a struggle against H+ ions. The reasoning behind this was what our professor then proceeded to explain to us for the next um, four hours.

then I spent most of the afternoon reviewing the lectures from this morning to try to figure out just what IS the difference between metabolic acidosis and respiratory acidosis and are we more afraid of acidosis or alkalosis in general?

(answers: metabolic acidosis is caused by having too great a concentration of HCO3, whereas respiratory acidosis is caused by having too great a partial pressure of CO2; and we are MUCH more afraid of acidosis than alkalosis because it can make your heart stop).

luckily it was pouring and studying at my big kitchen table while drinking a hot water/OJ/ginger/honey combination that is supposed to help me feel un-sick was pretty alright.

and for fun (because life isn't JUST a struggle), an article from the newyorker about what it would be like if all the dieties got together and planned the world according to feng shui. amazing.

and PS: "gatorade is like diarrhea you can drink" is a direct quote from one of my professors - but I have to add that it's not like all diarrhea, only the kind that has electrolytes in it.
yup - medical school makes for strange conversations.
"But there is suffering life, and there are defeats. No one can avoid them. But it's better to lose some of the battles in the struggle for your dreams than to be defeated without ever knowing what you're fighting for."

-Paolo Coelho, author of the Alchemist (and many other books)

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