Wednesday, September 26, 2007

Mixed Nuts

First, I have to say that Ambulance Driver's explanation of the cardiac conduction system is the coolest medical thing I've seen since I learned about IV ethanol. When an SA node and an AV node love each other very much, and decide they want to create an electrical partnership...you'll see, it's hilarious.

As for IV ethanol, it's only officially indicated for cases of methanol poisoning (methanol and ethanol compete for enzymatic binding sites and breakdown; ethanol wins, as it has a higher affinity for alcohol dehydrogenase). In essence, there's an enzyme that breaks down alcohols. Both methanol and ethanol are alcohols; that's what the -ol at the end of the name means. For instance, a lot of sugar-free products are sweetened with 'sugar alcohols.' Look at the ingredients on the next pack of sugarfree gum you buy. I bet you a fiver malitol, sorbitol or some other -ol is on there. Anyway, methanol itself--grain alcohol--isn't terribly poisonous. However, when your liver breaks it down, it produces formic acid, which is the same thing that's in a fire ant's "sting." Needless to say, formic acid isn't good for you, and this is what makes people go blind (if they're lucky) or dead (if they're not). So in comes a patient with methanol poisoning, and the clever ER doc, after figuring out what they've done (perhaps smelling it on their breath--it doesn't smell like booze, that's for sure) hooks 'em up to an ethanol IV. Par-tay indeed, if metabolic acidosis (having overly acidic blood, which is exactly as good for you as you'd imagine it to be), vomiting, diarrhea and other assorted symptoms are your idea of a ripping good time. Of course, I knew some people in college who didn't consider a night of partying complete until someone hurled (I miss you, Bruno) so who knows.

But this is not merely a repository of medical knowledge! Fie! So, what else have I been up to? Of late I've been starting to hear back from med schools (OK, just UCSF so far, but they want me to do the secondary app! And I'm not even Californian! Boom shaka-laka! And c'mon, it's in San Francisco--the Motherland, the place from which gayness comes, wafting over the country like rainbow-hued fairy dust borne by the jet stream...). I've been re-reading the Sandman series by Neil Gaiman, which I highly recommend; at first I was hesitant when, my freshman year, my friend N. hooked me up with the full series. Fantasy? Comic books--I mean, graphic novels? C'mon, man, we're in college now. But no, this series has better writing than a lot of 'real' books I've read--even some I've had to read for classes--and the artwork itself is sublime. When I start to feel dispirited, in fact, and as if I've been wandering these past few months without producing/doing much of value, I look at my reading list. Then, of course, I remind myself that I've been writing and painting, too, and working, and training for a marathon, and applying to medical schools...and then I feel like less of a loser. The drive of the perfectionist is a difficult thing to kill. So, here are a few books from this summer's reading list that I'd like to recommend.

The Opposite of Fate-Amy Tan
The Secret Life of Bees-Sue Monk Kidd
From a Sealed Room-Rachel Kadish
The Naked Brain-Richard Restak
Mozart and the Fighter Pilot-Richard Restak
Harry Potter and the Deathly Hallows (sigh)-J K Rowling
Reading Lolita in Tehran- Azar Nafisi
The Cook's Tour-Anthony Bourdain
Lolita-Vladimir Nobokov
The Places In Between-Rory Stewart
The Bookseller of Kabul-Asne Seierstad
Gilead-Marilynne Robinson

I tried to read The Satanic Verses by Salman Rushdie, but I just couldn't do it. I made it 150 pages before I just said "screw it" and returned it to the library. It wasn't what I expected it to be (and no, I didn't expect incantantions or necromancy or Islam-bashing...I just didn't expect what I got).
Oprah, eat your heart out...was I the only one who felt a near-physical pain when she started adding classic works of literature to her book list? Faulkner et al? On the one hand, it's good that people are reading works from the literary canon--if not because the canon itself is of intrinsic worth (which I sometimes doubt, given its tendency to be dominated by dead white guys) then because the canon offers a sort of cultural common ground for discussion and reference that doesn't involve Beyonce or Dancing With the Stars. On the other hand, I hate to see people acting like Oprah zombies, whatever the good of their actions, and I wish it didn't take the involvement of a multimedia superconglomerate to get people to read good books. Meh.

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