Toxicology Applied IRL

It all began yesterday when I came home from a long day of studying forensics and toxicology. As I entered the flat the whole place reeked of a stinging and toxic smell. My first thought was gasoline, or the gas used in the heating system, but I just couldn’t put my finger on what it could be. I went around sniffing like a worried dog in order to locate the source, but with no success. My nose quickly got desensitised and I still had lot’s to do so I more or less shrugged it off.

The next day was even worse. Now it even began in the hallway. Stronger, stinging and with an alarming touch of serious hazard to it. Once again I tried to find the source, but now I realised it wasn’t just my flat but the whole complex. The ventilation system seemed to be where it came from so I figured the garage underneath was the place – unless someone has a meth lab in one of the apartments above. I grabbed my running shoes and went outside into the fresh air and ran down to the far side of the building complex where the garage entrance is situated. When the doors are open you can see the 100 metre deep garage opening up wide, extending underneath all the flats.

It turned out to be three guys painting the floor of the garage in the part just underneath my flat. On my right hand was a huge pile of buckets, plastics and loads of scraps from the previous floor. It all reeked with the same stingy toxicity. I had to sneak closer to get a photo. Here’s one chemical they use, and what’s most probably give of the fumes:

Turns out this is an epoxy resin foundation primer: http://lenachemical.com/lenachemical/data/mlen/Lena.P100R.pdf

Also turns out the fumes of this primer is not really healthy at all, including respiratory irritation, asthma and sensitisation to anaphylaxis allergy. Recommendations say that ventilations ought to be used, but I could see none, nor could I see any respiratory protective equipment on the guys walking around applying it.

Another thing is that these buckets are standing outside right next to the wall of the building and according to the chemical description it’s prone to exothermic reactions if left mixed in larger quantities – and indeed, the bucket was oozing grey smoke, bubbling and the metal rim was hot, but just enough not to burn my hand. Here’s some info from http://www.azom.com/article.aspx?ArticleID=1097#_Exotherms:

“This (“exothermic reaction”) normally happens only in bulk mixes, as mixed resin applied to a job is usually in a thin film (e.g. coating, glue line, laminate layer, filler layer, etc) from which heat readily escapes. Causes of exotherm are usually a combination of the following circumstances:
• Mixing a large volume of resin / hardener and not transferring to a tray with a large surface area.
• Not using the mixed materials quickly enough, particularly if it is a ‘fast’ resin / hardener system (gel time 5-20 mins).”

I seriously doubt this is according to safety standards.
So I finally found out what it was and I have now open all the windows, all the doors and have to enjoy the chilly autumn air in order to prevent my flat from becoming an epoxy fume reservoir.

And that’s how you apply toxicology to real life.

A busy beginning

Fourth year has suddenly begun in a pace faster than what neither I, nor my colleagues, could ever anticipate. The first four courses, ranging from a week each, included Clinical Anatomy, Bioethics, Psychotherapy and Immunology - the latter still ongoing.

Additionally, Pharmacology just won't cut us some slack that easy and hang over our shoulders as a grim shadow and reminder of the final exam to come, with both practicals and lectures running simultaneously.

So, from "early" morning to late evening we've running between the weekly yawn-generating morning subject and the busy Clinical Anatomy dissections in the afternoon until about when both the hour and minute hand of the wrist watch point to six.

I think we all knew that the exams will be plentiful this year so mentally we settled with the idea of taking exams more or less every week. However, time is a precious resource and one have to spend it wisely in order to manage the exams in such short notice, especially when being used to have weeks for preparation as was the case in the second and third year. Using the time in between lectures is a good idea, and pushing oneself to go on reading after school and at weekends is paramount.

Fortunately for me anatomy comes easy, as I've repeated it during second year. This gave me some time to focus on the other topics, i.e. biomedical ethics and psychotherapy.

Unfortunately, to my big disappointment, these topics seems to be of rather low priority and judging after the event I think I spent too much time in proportion to the actual gain. A real shame indeed, as I believe ethics will be an important part of the future praxis.

Back to exams. When to take exams and general planning of one's studies is alwas a topic of discussion among us students. I figured that booking them as early as possible would be the way to go and it proved to work out well so far. Postponing only makes a student's life difficult, even thou doing so is tempting.

Semper Paratus, Scientia ac Labore, no procrastination

Retrospective Ethics

This Friday we finished our second and last part of the biomedical ethics course and next week I will go for final examination, thus I dedicated the whole weekend for reading ethics and have stumbled across some rather interesting and horrifying examples.
I think all of us are aware of the atrocities taking place during WWII in the Nazi concentration camps and the human experimentations performed on the captives. However, what I didn't realise was that just as in any other experimentation these "researches" also resulted in collection of data and conclusions.
   A straight forward examples are the "studies" of hypothermia, a critically low body temperature. This was conducted by putting living humans on ice to see how they reacted to low body temperatures and the following recovery from it - cruel and highly immoral indeed.
   But what perhaps chocked me the most was how this data has been referred to in recent articles and modern studies. The ethical question is of course, whether or not to use such data in the first place.

Ethics of research is really interesting once you dig a bit deeper.
I can recommend some horrible but mesmerising reading on the topic, even for those not interested in medicine in general.
   Another good example is the Tuskegee Experiment, where a dark history of U.S. public healthcare is brought into light.

Supply and Demand

Neglect ain't a beautiful thing, yet we all exercise it from time to time.
But since the interest of getting first hand opinions and perspectives on the study of medicine has recently increased, both to my surprise and happiness, I have decided to finish what I've started and really adapt this journal as a contact and information platform for anyone who might find their way here.

It seems my referral statistics point towards traffic from keywords on google, such as "european university", "med school", "premed", "Charles uni" and "anatomy", etc. etc. has become more frequent.
Additionally, a handful of Swedish students have written me in their struggle of finding a way leading to medical studies with aim of taking the very same road I did - so I feel I owe them to be more active.
Thus, I write this to ensure you; I'm still alive, fighting the good fight, struggling with the ever so exciting matters of 4th year medical education. Now, probably more than before, can I really see the full picture of the pre-clinical years of medicine and therefore, give you an honest and detailed picture of what is to come - given you chose to walk down the very same road.

I will wrap things up in a followup post ASAP, just in case someone might check in on a more regular basis - or at least for the sake of breaking the silence.

Study Weekend

The winter suddenly hit Prague.Snow was falling from morning to evening non-stop. Unfortunately the temperature never dropped blow zero, which means a lot of slush-puppy on the roads. More fortunately thou, is that is it perfect weather for reading, something both me and Kristýna need to do.

I'm having the very first checkpoint test for this semester, in the only subject we will get continuously tested in; pathophysiology.

The other subject are Pathology, Pathobiochemistry, Microbiology and Propadeutics of Internal Medicine but no tests will be held - instead you are expected to read up on each subject by yourself.

Kristýna will face her state exam in paediatrics in less than two weeks, so of course her mind is in between the pages as well.

The pathophysiology course began four weeks ago by introducing a hardcore chapter right from the start, namely haematology - including all the leukaemias, lymphomas, coagulatopathies and anaemias. An interesting but heavy chapter which takes time to wrap your head around.

Yet another Recap

A cup of coffee, check.
Rainy weather, check
Studies done, check (or should I write czech?)

Last time I posted a decent strip of text in this thing they call blog was almost a year ago. You see the pattern, the further one advance in these studies, the more difficult it gets to get some time over for other stuff.
The last year was a turbulent but yet exciting one.
I must admit, year 2 of medicine took me by surprise. I was told that it'd become easier but oh what a  fool I was to begin the year with hopes of an easy life.
There is no such thing.

For those who are not acquainted with the 3nd year study plan we have two main courses; Physiology, Biochemistry and Genetics.
The latter is one of those "stuck-in-between-two-semester"-courses, where we take the final exam in the end of winter, i.e. February. The problem is that you have no time but to barely keep up with the lessons during the first half, and then you have double the trouble before the exam.

I wont elaborate much further on the individual courses, just settle with the fact that it was yet another year of heavy studies - although much different from the first.
Reading and understanding it taken to another level, physiology is not so much about memorising as is Anatomy. Biochemistry on the other hand, is an endless road down the land of metabolic pathways and such, which I found initially overwhelming but later much appreciated.

After not too much trouble with the physiology final exam, in the week number 2 of the examination period, I took another two weeks boot-camp for biochemistry and it was obviously too little time to cover it all to a satisfying level - so I ended up walking out on the exam with a rather painful D in my book.
The result was of course a summer spent reading the chemistry back and forth, booklet cover to cover - although I did not really mind. Once my mind was settled with the thought of a "shorter-than-normal" vacation all I had to do was to see the good with the bad.

Due to troublesome dates of examination terms I ended up taking it in the beginning of September, just days after finishing my summer intern-ship at the surgery unit back home and with mere weeks left for next year's enrolment.
Going through this "sudden-death"-like exam with an excellent grade was like dropping the largest of stones off my shoulders and I could finally enrol for 3rd.

Well, already 1 month into the third year (time really pass by quickly), I have completely changed my study strategics - getting ready for another amazing year -  but that is another story I'll share later.

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When the lecture is way too clinical...

Main lesson learnt from today's genetics lecture in gene therapy, as found at Wikipedia:

- In the TV series Dark Angel gene therapy is mentioned as one of the practices performed on transgenics and their surrogate mothers at Manticore, and in the episode Prodigy, Dr. Tanaka uses a groundbreaking new form of gene therapy to turn Jude, a premature, vegetative baby of a crack/cocaine addict, into a boy genius.

- Gene therapy is a crucial plot element in the video game Metal Gear Solid, where it has been used to enhance the battle capabilities of enemy soldiers.

- Gene therapy plays a major role in the sci-fi series Stargate Atlantis, as a certain type of alien technology can only be used if one has a certain gene which can be given to the members of the team through gene therapy.

- Gene therapy also plays a major role in the plot of the James Bond movie Die Another Day.

- Gene therapy plays a recurring role in the present-time sci-fi television program ReGenesis, where it is used to cure various diseases, enhance athletic performance and produce vast profits for bio-tech corporations. (e.g. an undetectable performance-enhancing gene therapy was used by one of the characters on himself, but to avoid copyright infringement, this gene therapy was modified from the tested-to-be-harmless original, which produced a fatal cardiovascular defect).

- Gene therapy is the basis for the plot line of the film I Am Legend.
Gene therapy is an important plot key in the game Bioshock where the game contents refer to plasmids and [gene] splicers.

- The book Next by Michael Crichton unravels a story in which fictitious biotechnology companies experiment with gene therapy.

- In the television show Alias, a breakthrough in molecular gene therapy is discovered, whereby a patient's body is reshaped to identically resemble someone else. Protagonist Sydney Bristow's best friend was secretly killed and her "double" resumed her place.