The Nature of Medicine: Part II
I have just completed the hardest paper I have ever written in my life.The title of that paper is called 'Shelter Blues - Experience and Selfhood', and it is almost like a critical review of the book 'Shelter Blues: Sanity and Selfhood among the Homeless' by Robert Desjarlais. It was just a 6-pages double-spaced, 1800-word essay - and it took me 3 nights to complete it (normally I would take like, 3 hours?!). Guess what? Because of this paper I slept only 4 hours each night both Monday and Tuesday.
If you think questions like 'why did the author used rhodamine dextran instead of GFP as the fluorescence marker? what other alternatives are possible?' are considered 'critical evaluation questions' worthy of journal club time, wait until you get questions like:
'How and why are questions about “experience” so central to Desjarlais’ ethnography?'
'How does his theoretical approach play out in his ethnographic work in the shelter?'
'What does this all have to say about the concept of “selfhood” in relation to the homeless?'
I am so glad that I am done with the discussion leading for this class. It is getting harder and harder and more and more crazy that my history background ceased to become relevant and my regular logical ways of thinking ceased to work.
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> Shireen: This will sound like a reply to your most recent post and thus it is.
I was quite surprised as to how you wrote the last sentence - 'patients all have individual experiences of their illness' - that sounds so anthropological that I can't believe that it actually comes from you. I don't know if you mean what I usually interprete such a sentence as, because if I were to stress something scientific I would use words like 'clinical manifestations' etc. and not 'individual experience'. That is because a person's illness experience is not only shaped by the clinical manifestation of his illness but also the people around him, the cultural and political settings around him, his relationships with his doctor(s), and various other internal and external factors.
In this sense no patient falls into any stereotype - or the 'norm' - because everyone's circumstances are different. That leads me to the point in which there has always been criticisms against the use of a '35-yo Caucasian male, w = 60kg and h = 170cm' as a normal average human in clinical trials and then extrapolating all results from this average human stereotype. How valid are these results? But the dilemma would be: if you attempt to vary your sample group, what would be the basis of your choice of the criteria to be varied? Thus, how valid would your results still be - in either case?
Textbooks always tell us something, but reality is always different, and the danger about textbooks is that they make us feel too comfortable. That is in the everyday life of a biologist too because, sigh, things just don't work even when all published literature says that it should and you are 100% sure that you are doing the right thing. Sometimes I just have to blame the Hopkins water in having a strangely high concentration of the fifth element and thus affecting the buffering capacity of the buffers and the accuracy of the pH meter.
I have a friend who is allergic to metoclopramide, and once he had an adverse reaction to it in a hospital and they took almost a day to figure out why. Someone close to me passed away a few years back from sepsis - and the trigger was something as common as UTI. I was once given a regular dose of amoxicillin for an URTI, it didn't clear, the doctor switched to erythromycin, and it still didn't clear - and eventually I have to be hospitalised for pneumonia which eventually cleared with 4 days of IV penicillin and a 2-week course of Augmentin. Latest example was my aunt's laparoscopic hysterectomy.
Those are all exceptions to the standard common and simple stuff - there could have been possible complications listed somewhere but well, they are not what we see everyday. Grace has commented that 'biology is not logical', which I strongly contest because I think that medical biology is all about finding logic among a big meaningless mess; things will not be logical only because there is something we don't know or we simply don't care. But it also gets to show how random biology and medicine can actually be, and how much heart we have to put in in order to make something work.
Time to go home - I am typing this on B-level in the library :P There will be a Part III coming along!
Labels: Life, Studies and Career
