My First Patient Death: From Admission to Expiration

As a medical student, we’re “taught” how to act when during patient death: how to actually perform the necessary exams, how we are supposed to treat the deceased and, to a much smaller degree, how to interact with the loved ones. I went through this. I saw my share of patients who died during my rotations. This story is in that vein, but unlike all the ones I “treated” as a medical student, this patient is the one I claim as my first death. He was mine from evaluation in the ER, to care in the ICU, to the end. So here goes… “Time of death, sixteen hundred.” It’s such an easy statement to make, 5 short words, but, in the understatement of all understatements, that simplicity belied the enormity of the situation. He was 47. He spent his last ten days in the ICU, most of that heavily medicated and intubated. When were finally given permission to initiate comfort measures, he lasted ten hours. I remember getting paged down to the ER from the call rooms. My PGY-3 and I were having a normal call night, 8 admissions, 2 deaths, so we knew this would be something “good.” As was my privilege being the intern (and with no medical student), I was the first at bedside and I remember thinking “This guy is sick as sh*t.” Pick a...

DNA Bacteria Will Be Your New Hard Drives

Researchers at Harvard Medical School have used the CRISPR gene-editing tool to encode five frames of a vintage motion picture into the DNA Bacteria of E. coli bacteria. By reducing each frame into a series of single-color pixels and matching each color to a DNA code, the scientists were able to string together DNA strands that represented the video frames. Non-biological information has been encoded into DNA before, going back as far as 2003. However, this is the first time living organisms have been used as the message’s vessel. Living organisms are in a constant state of movement and flux, making them less stable and less predictable than the synthetic DNA material used in previous encoding experiments. Even though this technology is in its infancy, the research team was able to retrieve approximately 90% of the original message from the E. coli cells, effectively marking a new milestone in the advancement of our information storage methods. According to the research from Methods and applications, edited by Y.E. Khudyakov and W.A. Fields. 2003, for the US National Library of Medicine: Despite the broadness of the biochemical and medical applicability of artificial DNA presented in this book, some important aspects from a more chemical point of view are missing. These include new synthetic DNA constructs, such as locked DNA (LNA), metal-mediated base pairing (M-DNA), artificial DNA bases with or without hydrogen-bonding capabilities, new DNA base pairs for the extension of the...

How Should You Find The Best Research Possible?

For every pre-medical or medical student, this is always a lingering question. What is the best way to find a research mentor? Is there a magic key to getting the best research project? Should you be spending your days working on a lab bench trying to discover the mechanistic basis of diseases or should you be scanning your eyes through patient charts in the comfort of an office? Having gone through this myself, I would like to offer a few words of advice to all rising undergraduate and future medical students. My suggestion would be to approach this issue with three basic things in mind: 1. Pursue what you enjoy doing This may seem like the most obvious fact. However, students often seem to neglect their interest for a particular area of research for its supposed popularity and potential for publications. If you are not involved in work that you find interesting, you are undoubtedly going to have a difficult time tolerating it for the next however many years to come. Research takes long-term commitment. Once you find something you are truly passionate about, stick to it. But until you do, keep an open mind and don’t be afraid to switch from one mentor to another. 2. Set expectations with your mentor Whether you decide to do basic science or clinical research, make sure you have an honest conversation...

Why I Didn’t Do Pediatrics

I love kids. In college, my advisor was a pediatrician, because I thought that’s what I wanted to be. When I was in medical school, I was the co-President of the pediatric club. During third year, I scheduled pediatrics to be my third rotation because that’s the order in which you’re supposed to do the field that you’re interested in. (You don’t want to do it too early because then you’ll look like an idiot, but not too late in case you hate it and change your mind.) I’m not a pediatrician. So what happened? Here’s why I decided against pediatrics: 1) I spent my whole damn rotation sick with URIs and GI bugs. 2) Really sick kids make me desperately sad, to the point where even doing a practice question about a child with cancer ruined my whole day. 3) I am really, really bad at looking in screaming baby ears. And that’s like half of what pediatricians do. 4) I found medicine involving non-sick kids to be really boring. Strep throat? Boring. Rashes? Boring. Otitis media? Boring. 5) Parents = mega aggravating. (Of course, now I deal with adult children, which are also mega aggravating.) 6) When I saw a cute baby, I mostly just wanted to play with the baby, kiss him all over his cute little pudgy face, and then go home and make lots...

How to Find The Best Medical School For You

With so many factors to consider when applying to medical school, it’s difficult to figure out what school is truly the best fit for you. I didn’t fully realize what I was looking for in my best fit medical school until I started interviewing. Sure, any medical school’s website will give you lots of important details, but after actually seeing the school in person and talking to students about the program, the real differences between schools begin to crystallize. So, for everyone out there who’s applying to med school, I’m going to try to make your selection process easier. Based on my experiences interviewing and interacting with med schools, here are 4 factors to consider when figuring out what med school’s the best fit for you: MD vs. DO There are two types of medical schools: MD (allopathic) and DO (osteopathic). Choosing between MD and DO will likely be the first step in your med school selection process. While both schools teach the same basic curricula, DO schools also teach osteopathic manipulative treatment (OMT). MD also schools tend to require higher GPA and MCAT scores from applicants than DO schools. MD schools may also offer additional research opportunities for their students. Despite these differences between schools, remember that one isn’t necessarily more or less than the other. Whether you attend an MD or DO school, you’ll still come out...

Reprogramming Cells to Fight Leukemia

The FDA may soon approve a new cancer therapy that genetically alters a patient’s own existing T-cells to fight leukemia. This new, investigational treatment is known as CTL019 and is a type of chimeric antigen receptor T-cell (CAR-T) therapy. CTL019 utilizes a process in which T-cells are carefully harvested from each individual leukemia patient. These patient-specific T-cells are then genetically reprogrammed to express a chimeric CD19 antigen receptor and subsequently transfused back into the specific patient from whom they were originally collected. Once back inside the patient, these reprogrammed T-cells multiply, hunt down, and attack CD19-positive leukemia cells. Click here to read about this FDA update in the NY Times. A Food and Drug Administration panel opened a new era in medicine on Wednesday, unanimously recommending that the agency approve the first-ever treatment that genetically alters a patient’s own cells to fight cancer, transforming them into what scientists call “a living drug” that powerfully bolsters the immune system to shut down the disease. If the F.D.A. accepts the recommendation, which is likely, the treatment will be the first gene therapy ever to reach the market in the United States. Others are expected: Researchers and drug companies have been engaged in intense competition for decades to reach this milestone. Novartis is now poised to be the first. Its treatment is for a type of leukemia, and it is working on similar types of treatments in hundreds of patients for another form...

Suffering From Swallowing Disorders? 3D Printing Food Can Help

For those who suffer from swallowing disorders, the options for nutrition are severely limited. In many cases, patients may only tolerate specific textures to ensure adequate nutritional intake and safety. Approximately 1 in 20 Americans have a swallowing disorder, with over 10 million being evaluated for swallowing difficulties each year, according to the National Foundation for Swallowing Disorders. Image: Rainbow 2013-055, Frédérique Voisin-Demery/ CC by 2.0 Speech pathologists generally recommend that patients with dysphagia eat mostly pureed, minced and moist, or soft and bite sized foods, depending on the severity of their condition. Unfortunately, this limits people to foods that may look unappealing, and there is no doubt that eating pureed food all the time can be very boring and repetitive. But the 3D printing industry has a solution – 3D printing food that both looks and tastes appealing. Image: www.wasproject.it  Food created by 3D printers is having a bit of a moment, with restaurants that are incorporating 3D printers into their kitchens, and even some shops and pop-ups serving solely 3D-printed food. However, doctors and speech pathologists envision an entirely different opportunity for 3D-printed food: helping those with dysphagia improve their diet by offering a wider variety of experiences that still suit their condition. Image: Foodink.io By using 3D printers, clinicians see an opportunity to add colors, flavors and an infinite number of ways to present the food at...

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