saturday:
woke up, woke sandy up via text message, apologized, got brunch together, went to erwin's apple orchard.
picked a half-bushel of apples (gala, empire, jonahmac, cortland, macintosh) and a coupla pounds of raspberries, searched for and successfully found a set of keys that went missing
came home, froze berries, made 'nana nut bread, froze that.
found a box of pictures in frames that i never unpacked
rearranged the contents of living room and bedroom shelving
the result: less clutter, more space for showing off pictures, art, plants - hooray!

sunday:
woke up, made list, hit joann's and michael's.
came home, re-potted gerbera daisies, an orchid, and a few other things
decided i didn't like kitchen and was finally ready to rearrange it
rearranged kitchen
made apple muffins, started freezing those.
made delicious chicken basil wrap for dinner

am currently drinking delicious pear brandy beverage and perusing the web.
i swear to god, though, i must be going through some sort of fall nesting behavior
today i didn't stop moving for ten hours straight

still on my list to-do:
cut basil from patio garden and freeze
make more apple-based foods
(if you're wondering, i'm making things i can freeze because there are still SO MANY APPLES and these ones don't keep well long-term)
do laundry since everyone and their mother needed our building's one machine today
finish apple butter currently in crock pot
make green tomato salsa since one plant gave up the ghost last week
get new picture frames
put up pictures with my new stud finder and drill i bought myself

you see? 
ridiculous list, all about the house.
we won't even get into the list of academic things i need to do....

ah well
must start winding down or i will never get to sleep.

yesterday, Lane was in Denial about her approaching upper respiratory illness.
she insisted to herself that her stuffy nose was from the cold weather
or the cats
or something that was NOT the upper respiratory illness being passed around the M2 class via LectureDroplets(TM)

this morning, Lane woke up with nares completely plugged by glue-snot (TM).
she is no longer in denial.
she has been too busy using up the world's supply of kleenexes.

a few hours ago, Lane began Bargaining.
come on, sickness
she said
if you leave and go bother someone else i will give you a cookie. i will give you two cookies!
she waited for the sickness to consider her offer and she took a shower to sweeten the deal

Lane walked out of the shower with one half of her sinuses blocked solid, permitting not even the tiniest bit of air to pass though
and the other half of her face dripping water-snot(TM).
Lane is trying to decide between Anger and Depression

somehow the illuminated eye reminds me of some fantastic galaxy, or universe, or something.

i think probably this impression comes from the fact that when you look at the back of the eye through a dilated pupil, the optic nerve glows yellow like a sun.

1 big exam and 1 little exam are between me and thanksgiving dinner with mike.

come on baby blue
shake up your tired eyes
the world is waiting for you
may all your dreaming fill the empty sky

but if it makes you happy
keep on clapping
just remember i'll be by your side

Sarah Palin represents everything that is wrong with America.

this just in: americans stressed out about economy.
and women are disproportionately more worried:  84 percent of women, compared with 75 percent of men.

"I think it's reasonable because women have the unenviable task of balancing the budgets at home," says Manhattan resident Alfred Gottschalk.

let's not also forget that women are disproportionately affected by poverty already, and that women make 25% less than men for the same work.

seeing as we have less money to start out with, we have less money cleared after living expenses (which means that inflation will hit harder), and we're more likely to be single parents, i can't really see how this is surprising.
i don't think i would use the word 'reasonable,', though, even if the gentlemen i'm quoting didn't quite find the word he was looking for.

to the people who have found success in their careers and remembered what it took to get there.

men who hold traditional gender views make more money than women and egalitarian men

and

mcCain's choice of palin as vp has tied him with obama as to which candidate has a "better understanding of women"

who says patriarchy is dead?

my knee hurts like hell.
i managed to smash it into the arm rest of my bed futon.
again.
seriously. i managed to jam the arm rest's corner into a spot normally protected by the actual kneecap, where my leg bones come together.
it really hurts.

i hate this stupid futon. i've been fantasizing about replacing it for months now; i've had countless bumps and bruises from it, and The Boy has hit his head several times while sleeping.

when i moved to ann arbor, i foolishly turned down an offer of a full-sized loft, and kicked myself ever since. i've considered buying an identical one from ikea, but i've been holding off for months, waiting to see where The Boy would end up with his first job. if he ended up in the area, i reasoned, we wouldn't need a stupid loft bed, we could get a bigger apartment and a real bed.

given the current economy, however, and the terrible pay rates in detroit, the chances that i'm going to be getting a roommate and upgrading apartments aren't looking good.

it's a major pain in the ass to haul furniture and rearrange such a tiny place, but it's also literally painful to keep this futon around and keep hurting myself with it.

help me, internets.
should i

• wait a few more weeks and see where mike goes, then decide? (decide not to decide)
• suck it up and deal with the damn futon - after all, it was cheap!
• buy another skinny futon without the stupid arm rests of doom?
• buy a full-sized ikea loft? 

i am home, allegedly prepared to lead our pro-choice student group.
i am fired up.
and i am hopeful.

(and if you want to make a donation to our travel fund
or start a chapter at msu
or buy a t-shirt
let me know.)

losing sleep is bad.

we use the most up-to-date information when treating patients. we counsel them about nutrition, exercise, adequate sleep, and abstaining from too much alcohol.

and yet, the medical training system is based on the tenets that doctors should function without sleep or food or be labeled as 'weak.'

same goes for seeking help for depression, substance abuse, and having a lifestyle that allows you to exercise and relieve stress.....

we need to start using the same standards for our own health as we use for others. this is ridiculous.

we're in week 2 of our infectious disease sequence (which is, by far, the best-organized we've had so far).

we started with respiratory infections (rhinovirus, RSV, coronavirus, Strep pneumoniae, Legionella, influenza etc etc etc) and have moved to skin bugs and the diseases they cause (abscesses, necrotizing fasciitis, endocarditis, bone and muscle infections, toxic shock syndrome)

we've also had interesting talks on bioterrorism and flu pandemics.

there has been a marked upswing in hand-washing.
it's about time.

this was today's schedule:
9-10: lecture on the prevalence of elderly adult/ vulnerable adult abuse
10-11: lecture on the prevalence of child abuse (complete with photos and real stories)
11-12: lecture on the prevalence of sexual assault and its effects on victims' lives
1-3: lecture on the tuskegee study

we did finish with two hours of brief workshops on mind-body medicine, but jesus christ, guys. 

there are tiny bones in your middle ear that amplify sound coming in on the air. the air hits a drumlike surface called your tympanic membrane, which sets the bones moving. sounds create a piston-like action of the bones against another membrane into your inner ear, where the piston creates waves and amplifies the sound.

inside your inner ear, you have a spiral staircase with the equivalent of a guitar-string membrane spiraling up its length. at the base of the staircase it is tightly strung; at the top it is loose and heavy. as a sound travels up the staircase, it finds its magical frequency spot and induces vibrations in the membrane. there are little tiny cells with hairs on them that sense this vibration because their tops are immovable and their bottoms are not.

when the cells move, they send a signal to your cochlear nerve, which keeps a map of every frequency being transmitted at a given millisecond and tells your brain. your brain puts it all together and translates the cochlear nerve's chemical nerve information into what we know as sound.

you probably already knew all of that.

did you know that those ear bones are so tiny that you could easily fit all 6 of yours (from both ears) on a pencil eraser? and yet despite their size they are true joints, with cartilage in between them, like a miniature elbow or wrist joint. when old people go deaf, it's often because these tiny joints have gotten tiny arthritis over the years.

crazy, huh?

your random fact for the day: 'borborygmi' is a legitimate medical term, describing abnormal bowel sounds in the initial stages of acute obstruction.

tomorrow i learn how to do abdominal exam. reading about normal bowel sounds and auscultation of the liver, i pull out my stethoscope to listen to my own tummy.
conclusions: i cannot find my liver. my insides make funny noises. no borborygmi noted.

kitty was on the bed with me, so i swung the stethoscope over to her. i wanted to try listening to kitty's heart and tummy, to see if i could.

epic fail
too much purr.

yesterday i shadowed at the Whitmore Lake Health Clinic. it was pretty neat, Dr. T let me do very brief interivews ("What brings you in today?") and presentations to her (Mrs. H presents with a cold of one weeks duration.... "). it's harder than you might think, even for a simple thing like a cold:

- - - - - -
how long have you had this cold?  how did it start? how has it changed?
are you congested?
do you have sinus pressure?
ear pain?
sinus drainage?
sore throat? do you think it's from sinus drainage or something different?
headaches? what are the headaches like?
fever and chills?
body aches and/or fatigue?
has it affected your appetite?
dizziness? describe your dizziness [vertigo vs. lightheadedness]
cough? dry or wet? how much mucus? what does it look like? is it all the time? mostly at night? does it keep you from sleeping?
when did each of these things start? does anything seem to make them better or worse?
are you taking anything for your symptoms? tell me about the dosages and when you take them. do they seem to be helping?
any other symptoms or anything else you've noticed?
- - - - - -

but it was fun and Dr T was really super nice.

here's the shameless plug part:
the Whitmore Lake Health Clinic accepts and treats everyone regardless of their insurance status or ability to pay. as a result they are in serious danger of being forced to close their doors.
a student group called HAH (Healing at Home) has started raising funds for the clinic. we're a new group, but since October we've managed to raise more than $5,000, which is fantastic.
unfortunately, it's nowhere near enough. our dream fundraising goal is half a million dollars (!). it's needed to pay the physicians' and nurses' salaries and cover medications and utilities and basically guarantee that the clinic can keep helping people who can't afford to go to anyone else.
i've talked to the people who work there; they're full time and have taken drastic pay cuts to do this work. nevertheless they still need to be able to support themselves and can't work for free.

if you feel like donating (any amount) let me know. also, consider signing up for igive.com
here's how it works:

*Go to igive.com
*Choose "Whitmore Lake Health Clinic" as your charity.
*Register with igive.com (no major personal information required)
*Anytime you need to do online shopping, check on igive.com first to
see if that store has a deal with igive.com
*If it does, link to the store website through igive, and a portion of
your purchase will be donated to the clinic, at no extra cost to you!
*% donated varies by store

the student group takes zero money from fundraising, so 100% of donations go to help the clinic. and it's tax deductible! think about it =)

the electricity browned out right before 10 tonight then died completely
and stayed off until about 1230

in the meantime the wind picked up
and the temperature dropped
and the blocks of student housing looked like a movie scene
maybe one with monsters
where the wind sends leaves skittering across sidewalks and sleet against the glass
of buildings with only candlelight in the windows

and you know that things aren't right
because it's too quiet and too still

now the power's back on
but the cats are jumpy
the lights are flickering
the wind is still howling
and it still feels like something is waiting to happen

another exam passed
another sequence begun:
endocrinology/reproduction

your strange fact for the day: the typical [edit: pair of] human testicle contains more than 250 METERS of ducts.

weird.

today i learned whyy it's baaaad to take tylenol (acetominophen) before, during, or after drinking. see, tylenol is metabolized by several pathways. the easiest pathways happen quickly, and at low drug levels they turn almost all of the tylenol into harmless compounds with no problem.

there is another metabolic pathway, however, that involves an enzyme called cytochrome P450. ethanol has the interesting effect of making the liver make more P450, while inhibiting the enzymes already present in cells.so if you go out for a night on the town, by the end of the night your body has increased levels of P450, but most of it is temporarily inactivated by the ethanol.

P450 also metabolizes tylenol, but it's a slower reaction than the first two. this means that it takes increased levels of P450 to see appreciable levels of the P450 version of broken-down acetominophen. unfortunately, a small fraction of this metabolite is grabbed by another enzyme and converted into an extremely toxic compound which covalently binds proteins and causes severe toxicity.

so picture it: you go out, booze it up, and wake up the next morning with a raging headache (and increased P450 levels, although you don't know it). you pop a couple of tylenol and fall back asleep. when the tylenol reaches the liver, elevated P450 levels create a reactive compound that very quickly can lead to severe, acute liver failure, and you wake up with fulminant hepatic necrosis. ouch.

the bottom line: tylenol + ethanol = you need a new liver. seriously. don't do that.
this moment in medical school brought to you by today's pharmacology lecture.