Skip to main content


2.18. PNA = pneumonia

Pneumonia, like jam, comes in many flavors--all of them bad. Mucus coughed up can be creamy yellow (Staphylococcal pneumonia), green (Pseudomonas), rusty (Pneumococcal), currant jelly (Klebsiella), or pink and frothy (not just pneumonia, but pulmonary edema.) A sputum culture can be done to identify the offending organism.

One can get this infection of the lungs out in the world (community-acquired pneumonia) or from a hospital (nosocomial pneumonia). There's also "walking pneumonia" (Mycoplasma pneumoniae), and ventilator-acquired or aspiration pneumonia.
That doesn't mean one must pick one of these poisons. Flu shots are better than nothing (pneumonia often follows a flu), and anyone older than 65 without contraindications might consider the pneumococcal vaccine (sepsis from S. pneumoniae was the main thing that did my mom in at the age of 63--maybe they should lower the recommended age).

Patients present with fever, chills, flushed face, sweating, shortness of bre…
Recent posts

2.17. Sphincter of Oddi = a weird sphincter

Ampulla of Vater: not Luke's father. Rather, the exciting Y where two ducts converge in a yellow wood and move into the duodenum (small intestine, part I), never to be heard from again.

Angle of His: reads like a typo, possible religious reference, or place where cats hiss and snakes bite. Possible compliment re: his jawline, or the acute angle formed as his esophagus enters his stomach (so hot).

Circle of Willis: not going to say this out loud for fear of Freudian-mispronouncing it, when it's merely a circular arterial complex at the base of the brain.

Duct of Wirsung: this duck ain't flying nowhere, with wind or wing nor song, because it's the pancreatic duct.

Golgi apparatus: sounds Rube Goldbergian, and looks it--tiny, convoluted complexes in the cell involved in transport of protein, etc.

Islets of Langerhans: possible vacation spot (on a drug holiday!), aka part of the pancreas that produces the insulin that keeps most of us nondiabetic and also, alive.

Loop of Henle:

2.16. renal = everything kidney

If you live in Asia or are a recent immigrant, you've probably tasted a kidney. Boiled or red-cooked, grilled or stewed, a plump, animal kidney can be crunchy or tender depending on cooking method. A polycystic (human) kidney looks deep-fried and covered with bubbles, a gigantic shrimp cracker gone wrong.

Kidney and nephron structure & function are the stuff of nightmares for anatomy and physiology students everywhere. However, having to memorize what's permeable or not at which convoluted tubule or portion of loop of Henle limb, or having to also know all the medication actions at each of those parts, is nothing compared to having an actual issue with one's kidneys. If blood is the essence of life, kidneys are what keeps life pure and balanced enough to continue.

No larger than a computer mouse on each side, at just 0.5% of the entire body weight, the kidneys have to filter all of one's blood volume, about 150-180 L of blood each day, producing 1000-2000 ml of uri…

2.15. SOB = shortness of breath

We all have a little, upside-down tree in our chests--the bronchial tree. It holds between its branches a pulsating heart, and delivers to it fresh, oxygenated blood to supply the rest of the body. It provides oxygen not through photosynthesis, but rather, gas exchange.
In assessing a patient with breathing difficulty, a simple visual scale of a singular, horizontal line is used: indicate the severity of your symptoms on a scale of "no shortness of breath" to "shortness of breath as bad as can be."

Bronchial sounds, auscultated over the trachea or primary bronchi, have a harsh, hollow, blowing sound. Vesicular sounds, heard with a stethoscope over peripheral lung fields, rustle like the wind in the trees. Abnormal sounds range from fine crackles, like hair rolled between fingers near the ear; rales ("velcro" sounds); squeaky, "musical" wheezing; rhonchi (low, coarse, snoring); to pleural friction rub (scratching sounds). These may indicate atele…

2.14. RBC = red blood cell

If one has more red blood cells in one's blood, does that make one somehow more red/warm, more capable of love? If one has fewer, does it make one colder, and care less?

Image source:
No, of course not. An abnormally high number of red blood cells may make one look flushed, but these blood elements have nothing to do with feelings. Red blood cells, aka erythrocytes, through their hundreds of thousands of hemoglobin molecules, carry 4 molecules of oxygen per hemoglobin molecule, everywhere in the body. This makes the basic metabolism that enables life possible. Too little or too many red blood cells are not good. Neither are abnormally shaped ones.

Low red blood cells = anemia, which could be caused by blood loss, low production, or destruction. To help with deficiency-related production problems, one may increase intake of iron, folic acid, or vitamin B12. If low levels are related to a condition, such as pregnancy or Crohn's disease, treatment may or may not ex…

2.13. H2O = water

Some say amniotic fluid smells like sea foam, or forest loam. Life came from the sea, depends on it, and ultimately, will return to it. Human bodies are more than 60% water, and the blood coursing through arteries and veins, more than 50% H2O.
However, too much water can drown us from the outside, or inside. Every year, newborns die from water intoxication (from extreme electrolyte imbalance) because of adults diluting canned formula in an attempt to make it stretch several times too far. Kids drown in the deep end of pools, or, having gasped water into their lungs, suffer from secondary drowning hours after a close call at the beach. Sorority and fraternity pledges also die from water poisoning days after hazing events involving water-chugging + excessive exercise.

Water may be safer than alcohol, but not when so much is consumed that excessive loss occurs of sodium, potassium, magnesium and calcium, all important to keeping the heart, brain, and lungs functioning. Fluid and electrol…

2.12. Clinicals nightmare

It may be spring break, but the subconscious continues to construct private hells on its own schedule.

6:30 am. Nightmare land. 
It's clinical day at a public park, and between jungle gyms, swing sets and slide structures, everywhere are hospital beds, bedside tables covered with medical paraphernalia, IV poles, computers, nurses, technicians, and patient families on picnic mats.
We had done our research on a primary patient the day before, but upon being released into the public park hospital after morning report, we discovered that all the navy-blue-clad registered nurses had decided to ice out the nursing students.

Every single nurse refused to let us work on any of their patients. They even locked the glass-doored nurse's station so we couldn't get in to look up patients or get any supplies. Whenever staff members saw one of us smurfs (royal blue uniform, steamed-bun-looking white shoes) approach, they turned their backs.

"Please, if we don't have our two patie…