Sunday, September 21, 2008

Bugz, Bugz, and More Bugz



I have this urge to wash my hands every 10 minutes. I will never look at a rash the same way. I am frightened by any chief complaint that begins with fever, or stomach pains.

Over the past 11 days, I have been seen my differential diagnosis for fever expand. And do not get me started on diarrhea, a subject in itself.

We transitioned from immunology to microbiology/infectious diseases. Put simply, microbiology involves learning the autobiographies of criminal bacteria, which each have different shapes, life cycles, toxins and targets. And then we have to follow the crazy bugs through their disease rampages, as they tear through our tissues and evade our immune surveillance, causing inflammation and infections that are each so different and yet so similar in terms of clinical presentation.

Classic case: 25 y/o presents with fever, chills, muscle pains and sore throat.
(this could be 1 of like 20 diseases, and this is a conservative estimate).

The number of diseases caused by bacterial pathogens is impressive. Actually, it's amazing how we are surrounded by bacteria and how they colonize our tissues, and we somehow seem to be in some sort of equilibrium (until we get sick or eat something funny).

The funny thing about this block is the names of the bugs we have to know; they are unreal and unnatural. Bacteriologists fail to follow the rules of spelling we learned in elementary school. It's interesting how some scientists decide to name a bug after themselves. For example, Alexandre Yersin, a physician from the Pasteur Institute discovered the pathogen causing the plague and named it "Yersinia Pestis," after himself. Now, the black death will be connected to his last name. I do not know if I would want to attach my name to something like that.

I did learn that as a child we were already playing homage to Yersin and the black death, as we sang "Ring around the rosies," (refers to the red flea bite), "pocket full of posies" (people during the medieval times kept spices and herbs in their pockets to deodorize the smell of the dead bodies), "ashes, ashes, ashes- we all fall down" (victims coughed up dried blood and people suffering from the black death, would fall down to their death). I wonder who decides which nursery rhymes children learn.

The number of bugs we must learn for our Midterm tomorrow is magnanimous, like the volume of watery diarrhea expelled with cholera infection. On Friday, our professor (after teaching us the 10th bug at the end of the lecture hour), said something to the effect of: "This is the time that you are all probably hating medical school." (He was spot on; it is somewhat overwhelming to learn this much detail about bugs).

Although there is a massive amount of information to be internalized, I do find infectious diseases to be somewhat intriguing. All these years of hearing about pneumonia or meningitis or lyme disease and not know really know anything. Now, I know how serious these diseases are with an understanding of the microbiology of these bugs that have developed intricate methods to evade our immune systems. I am even more paranoid about washing my hands now.

With a fat pile of stack cards to be reviewed, I best be off to mastering these bugs rather than being phased by the microbial word that surrounds us.

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