A heartbroken rat

Last week I had to take a "Laboratory Animal Science" course, since I will be working with mice as a part of my MD dissertation. This is a requirement in Germany, if one wants the Medical Doctorate title (or Dr. med. as they call it here).

There are three practical days in this course, in which we get comfortable handling rats and mice. I was in charge of looking after a curious female mouse and a sweet male rat. My mouse promptly bit me on my thumb as I picked her up. When I picked up my my rat from the neck, he just looked at me and didn't even squirm. He sat very still, as I cradled him in my arms and stroked him - like a cat.

"These animals act just like people," my course instructor mused. "The females are aggressive, but the males are gentle."

It's true that the male rats were very quiet when they were picked up, while the female rats screeched at the top of their lungs. (I actually can't stand the sound.) Like women, female rats also looked out for one another: If one was being held down, her girlfriend would sneak up next to her and try to bite the handler.

This lovefest unfortunately didn't last long. I "looked after" the animals by basically torturing the poor things for the whole afternoon. I learned to punch holes in their ears to distinguish them from their neighbors. I was taught how to give them injections, either through their tails or abdomen. I also learned how to take blood samples, which were usually taken from facial veins and, sometimes, even from behind their eyes.

"You'll feel some resistance behind the eye socket, but you just have to push through it," my instructor told me. I shuddered.

The mice and rats were all under anesthesia at this point - their eyes blankly staring, their bodies limp. I picked my mouse up and cradled her in my hands to warm her up. Although her heart was still beating, her body had gone cold.

At this point, we were told to practice "sacrificing" the animals. With mice, this meant dislocating their spines from their skulls with our bare hands. I just couldn't do it. I asked my neighbor to do it for me.

"Wouldn't you kill a mouse if you saw it in your basement?" another classmate asked me.

Many of the rats in the class, however, died just from the anesthesia - which was unusual, we were told. But my rat was still fast asleep, though his heart was beating weakly. One of the course instructors wanted to demonstrate a heart puncture, and she settled on my rat. As the needle plunged into his heart, my rat softly whimpered and then let out a long, loud sigh.

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It reminded me of something I read of Charles Dickens: "In the early evening he sighed, a tear ran down his face, and he died."

"Why me?" my sweet rat seemed to be saying.

And then he died - literally of a broken heart.

Stroke Unit auf Deutsch

I spent my first day in the stroke unit and helped the nursing staff take care of patients who had recently suffered strokes.

Let me tell you: Working in this unit in a foreign language is not easy. I had stressed nurses yelling instructions to me at 100 mph for most of the day. Apparently, I had to look after a stroke patient with dementia, who thought her oxygen mask contained some deadly gas. She kept pulling all her cables out, including her catheter. I was supposed to stop her, but how can you reason with such a patient, when she's convinced that you're out to kill her?

So, I got yelled at a lot - in German. And every time, I had a mini freak out in my brain.

Jop, that pretty much summed up my day, but replace Dr. Bunsen with the Swedish Chef.

Surviving the Pflegepraktikum

At Charité, it's required that medical students complete a Pflegepraktikum - or nursing internship - for three months. Its aim is to teach students how to take care of patients.

I chose to do mine at Campus Benjamin Franklin (CBF) in the neurology department, since it has the largest stroke unit out of all the Charité campuses. Since I'm pursuing clinical epidemiology research in stroke, I thought interning in the stroke ward would complement my experience nicely.

The worst part of the internship is the work hours. I need to be at the nurses' station by 6:50 am, ready and dressed in mint-green scrubs.

Basically, I help nurses with their daily duties. Here's how my early shift generally goes:

  • 6:50 am - Handover: Morning shift personnel are briefed by nurses who worked the night shift
  • 7:15 am - I wake up patients to take their blood pressure, temperature and pulse rate.
  • 8:00 am - I help serve breakfast, which usually consists of bread rolls, cheese, salami, yogurt and spreads (butter/jam/honey/quark). I also offer them coffee or tea. Sometimes, I sit with patients and help them eat.
  • 9:00 am - I help clean up breakfast.
  • 9:45 am - I help wash, bathe, change, dress and turn the patients. Sometimes, I make their beds.
  • 10:30 am - Break: Breakfast time.
  • 11:00 am - I log vital signs into patient charts.
  • 12:00 pm - I measure blood sugar levels in the ward's diabetic patients.
  • 12:15 pm - I help serve lunch to patients and clean up after them (just like breakfast).
  • 2:00 pm - I offer patients tea or coffee from a cart.
  • ~3:00 pm - Freedom!

I'm also constantly running after call lights, which glow red whenever patients press their nurse call button. I fetch whatever they need or help them go somewhere. And from the nurses, I often hear, "Euuuuiii-na! Kannst du bitte..." (German for: "Euna, can you please...")

I've worked in hospitals before, but I've never had a physically taxing job like this one. I've only been here a week, but I'm already exhausted.

Venture into clinical research

I'm happy to share the news that I have joined Bob Siegerink's clinical epidemiology group at the Center for Stroke Research Berlin (CSB) as a medical student researcher. Although I started working with them in October, my employment contract "officially" began in January, which is why I'm only releasing this news now.

So, I've been busy these past several months learning more about neurology and public health and am already working on a couple of projects with my colleagues. One includes helping to revise and translate Germany's clinical guidelines on the secondary prevention of ischemic stroke and transient ischemic attack. The other looks at the stroke funding landscape in Europe.

Since I'm already leaning toward specializing in emergency medicine and public health, it seemed like the logical choice to combine some kind of emergency event with epidemiology. Cardiology already seems so saturated with research, whereas neurology - especially stroke - still holds much potential. And the brain is such an enigmatic and miraculous organ!

Besides, I'm a huge Oliver Sacks fan. Even in death, the man continues to inspire me.

#WIMmonth

I didn't know there was a "Women in Medicine" month! On social media, it's referred to as #WIMmonth.

The Association of American Medical Colleges (AAMC) is using the campaign to #protectGME, or to secure more funding for graduate medical education. You can read more about it here: http://action.aamc.org/t/women-in-medicine

I'm closely following the situation, as well as the projected US physician shortage, and will write about it in a future blog post.

Is US Health Care Policy an Infectious Disease?

I attended a (rather depressing) talk today called: "Is US Health Care Policy an Infectious Disease?" by Dr. Steffie Woolhandler and Dr. David Himmelstein - which was interesting in light of the recent SCOTUS ruling. Despite the health care overhaul, we still have such a long way to go to provide affordable, quality care to all.

The speakers showed this cartoon in a powerpoint slide in order to illustrate just how complicated "Obamacare" is. And they pointed out how President Obama early in his presidency had talked about a single-payer national health system, but then ditched that idea right away. (Disclosure: Both Woolhandler and Himmelstein are co-founders of the US-based Physicians for a National Health Program.)

A few quotes stuck with me:

"The health-care reform process exposes how corporate influence renders the US Government incapable of making policy on the basis of evidence and the public interest." - The Lancet

"Why would anyone look to the US for health care quality and cost?" - Dr. Steffie Woolhandler

"The two tallest buildings dominating the Boston skyline are named after insurance companies. That's indicative of the state of US health care today." - Dr. Steffie Woolhandler

On another note, I interviewed Dr. David Himmelstein seven years ago for my RFI story: "Deregulate the Healthcare Industry or Increase Federal Supervision." Even back then, he told me, "The private insurance industry - they are extremely rich and powerful folks. And they are prepared to spend vast sums of money to affect the political process, and I think that's our problem. Let's stop making medicine about money. Let's make it about taking care of people."

That was back in 2008. Has anything changed?

Herzlich willkommen!

champagne.jpg

Welcome to my new and improved personal site.

I've decided to start from scratch and rebuild my blog, which I plan to update more regularly. More details to follow soon! 

In the meantime, please enjoy some virtual champagne to commemorate my first post (again). ;)