Saturday, October 06, 2007

Heart failure

Late morning here, the chickens are restless and the goats are at play outside. And today we are not getting family and friends over, as previously planned, to organise an Amish style chook-yard-building, because my car is having emergency surgery, and this will take care of that troublesome cash excess we've been having. The car died a few metres out from work, and was taken away by a towtruck, and will apparently require the services of the transport team.

Most vexing.

Anyway. Before I get carried away, here is a link to this year's Ig Nobel Prizes. The Ig Nobel prizes reward published scientific papers that... well, follow the link. My favourites this year have been those in Lingusitics (awarded to Juant Manuel Toro, Josep Trobalon and Núria Sebastián-Gallés, of Barcelona University, for showing that rats cannot tell the difference between a person speaking Japanese backwards and a person speaking Dutch backwards), and Biology (Johanna van Bronswijk of Eindhoven University of Technology, Netherlands, for a census of the mites, insects, spiders, pseudoscorpions, crustaceans, bacteria, algae, ferns (!) and fungi with whom we share our beds).

Ask me why I never finished in science.

However. I am back from the coast, which was brilliant. The city I sortof grew up in* has a different smell, all wattles and melaleucas, and you drive over the coastal plain and see the sunset over the sea... it works on you, something in it calls to you. Along the side of the highway there were paperbarks and I wanted to stop the car and step out on the soil and feel the bark between my fingertips.

Anyway. Paperbark pollen is flat and triangle shaped, something like this, pine pollen is hollow and ovoid and ridged like the Hindenberg, chenopod pollen (pollen from those little shrub things that grow on drylands) is shaped like a woven basket. Here you can see some eucalyptus pollen mixed in with some sunflower pollen.

You know, I always had the same trouble with science, and I've got it a bit with medicine too. They show me images and I look at the image, I don't look at what it represents. When I was doing my honours year, looking down a microscope for ten hours a day, fifty days in a row, I would put the droplet of oil, mixed with the fossil pollen, on the slide and stare at it under the microscope. And I wouldn't see pine pollen and eucalypt pollen and poacea pollen, I'd see these pink-stained bulbs and structures, the flamingo-coloured light coming through them, and marvel a how they drifted slowly across the field of view. Same thing when I saw electron micrographs of renal cells in medical school. Never really clicked.

And I'm not trying to show how much more fey and ethereal I was than the common clods with whom I sat, because I envied them their ability to look at, say, an ECG or a chest Xray and seize upon the salient points. But that kind of stuff always came hard to me.

Anyway. Tomorrow is one of my last shifts at the ICU, and the day after back to work. We have four patients in hospital at the moment. Three of them have infections of the heart valve - you have bacteria on your skin that look something like this, when you inject they can get pushed in with the needle into the blood stream. They whirl around, trying to settle wherever they can, often ending up on the heart valve. They grow, and as they do, they damage the valve. Two of my guys are okay, but the other one has bacteria running rampant in his blood and is swollen and weak from heart failure.

And the other one - and I have just heard this today - appears to be an overdose, of a medication I gave her. In another sense, another case of heart failure. She has suffered no ill effects, the medical intern tells me, and was dischraged soon after the event, but this is something that will occupy my thoughts from now until Wednesday, when I see her - and long afterwards.

Thanks for listening, will reply to comments tonight.

*Sadly, still a work in progress


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