Have been always fascinated thinking about free will! There have been many experiments in the recent past using fMRI and PET to show that free will is a suspect and our decisions are made before the brain has registered the activity! Without going into the technicality I wish to state that i fail to completely understand these experiments. All they are saying is that there is perceptible time difference between the brain recording the activity versus the actual act being done. Will welcome thoughts on this from laymen and experts!
I like to believe in free will and think that i am in control of my life.
This belief has been shaken by my recent reading about mind controlling infections and fungi! Toxoplasma gondii infects both cats and rats. It needs both to complete its life cycle. Rats get infected through raw meat or cat feces. Once inside the rat it grows to maturity without harming it, but to complete its life cycle it now needs to infest cat. Things get interesting here. Toxoplasma makes rats enjoy being fearless by raising the dopamine level in amygdala. The fearless rat becomes an easy prey for the cat and this helps our hero toxoplasma to get into cat. Now toxoplasma also infects humans! It has been documented that it can cause humans to behave differently.
Fungus Claviceps purpurea produces natural precursor to LSD! Will refrain from mentioning more about LSD as of now. But fungi have mind bending properties and this is well documented in ants and mosquitoes.
Now need to go and check what am i infected with! Digital worm......
Thursday, December 27, 2012
Wednesday, December 26, 2012
Doctor! Experience with ENT
How best do i capture the incidence today at ENT department of Manipal hospital? Since few weeks mom had been complaining of the sensation of something being stuck in her throat. She had been really concerned and according to her, she also had change of voice on few occasions. The fear in her was because of the fact that a near relative recently had been diagnosed of vocal cord cancer. She had met the relative as the individual was completing radiation treatment.
Finally, i decided to take her to Manipal hospital today. At the registration they mentioned that Dr.Girish Rai is there. I guess they inform this to know whether we wish for any specific doctor. I could have asked for Dr.E V Raman, whom i have met couple of times but decided that Dr.Girish Rai should be good enough. We waited for our turn. As we entered the examination room, i remained silent, refraining from my usual introduction of being a cancer specialist etc. Also i wanted mom to explain her complaints in her own words. He asked her what is the problem and mom explained. He looked at her throat and her nostrils. Asked whether she has headache. He took a swab and sampled her throat. Asked the junior to order for a CT scan of the PNS. He explained that she has infection in the sinus and will require endoscopic surgery. Mom protested saying that she has nuchal headache. He dismissed her saying all are interrelated. Mom looked at me with eyes pleading for some support/intervention. I was in no mood!
Here was a lady with complaint of something being stuck in the throat and the investigation being asked was CT PNS with Endoscopic surgery being considered a possible solution.
Why am i picking fault or not happy with this?
I did ponder about this for sometime. He must have seen pharyngitis, inflamed tonsils/adenoids which made him to take a swab. Already deduced that this must be a tough infection which will require FESS followed by ?
It is my conservative outlook that my mom needs to be treated with antibiotics first and reviewed which makes me question his approach. Or rather the fact that he did not bother to do IDL, indirect laryngoscopy. Why do IDL when there is infection?
I did not get the CT or the swab cultured. Mom will do steam inhalation, drink warm water and take 5 days of antibiotic. Hope this should make her better.
Any decision with fraught with risks?
As a physician how best do i achieve the objective of getting my patients healthy? Do i need to bother about algorithms? Do i need to have evidence based medicine as a guiding framework? Do i need to take cost into consideration?
I did feel that there is a tremendous need for good family physicians. Their tribe is decreasing and impacting healthcare and nation at a large. Need to back this up with data. Also feel that most individuals are comforted by vising the specialists.
This is one incidence at Manipal, may be there are many.
I do have to acknowledge that my previous experience at Manipal has been very good. This pertains to the department of Orthopedics, Pediatrics and Plastic Surgery. Will record them later. We are more motivated to give feedback when we are not happy! This creates an imbalance in the kind of reports we read. For me this gives a hint to the mistrust placed by my friends, relatives on healthcare.
Finally, i decided to take her to Manipal hospital today. At the registration they mentioned that Dr.Girish Rai is there. I guess they inform this to know whether we wish for any specific doctor. I could have asked for Dr.E V Raman, whom i have met couple of times but decided that Dr.Girish Rai should be good enough. We waited for our turn. As we entered the examination room, i remained silent, refraining from my usual introduction of being a cancer specialist etc. Also i wanted mom to explain her complaints in her own words. He asked her what is the problem and mom explained. He looked at her throat and her nostrils. Asked whether she has headache. He took a swab and sampled her throat. Asked the junior to order for a CT scan of the PNS. He explained that she has infection in the sinus and will require endoscopic surgery. Mom protested saying that she has nuchal headache. He dismissed her saying all are interrelated. Mom looked at me with eyes pleading for some support/intervention. I was in no mood!
Here was a lady with complaint of something being stuck in the throat and the investigation being asked was CT PNS with Endoscopic surgery being considered a possible solution.
Why am i picking fault or not happy with this?
I did ponder about this for sometime. He must have seen pharyngitis, inflamed tonsils/adenoids which made him to take a swab. Already deduced that this must be a tough infection which will require FESS followed by ?
It is my conservative outlook that my mom needs to be treated with antibiotics first and reviewed which makes me question his approach. Or rather the fact that he did not bother to do IDL, indirect laryngoscopy. Why do IDL when there is infection?
I did not get the CT or the swab cultured. Mom will do steam inhalation, drink warm water and take 5 days of antibiotic. Hope this should make her better.
Any decision with fraught with risks?
As a physician how best do i achieve the objective of getting my patients healthy? Do i need to bother about algorithms? Do i need to have evidence based medicine as a guiding framework? Do i need to take cost into consideration?
I did feel that there is a tremendous need for good family physicians. Their tribe is decreasing and impacting healthcare and nation at a large. Need to back this up with data. Also feel that most individuals are comforted by vising the specialists.
This is one incidence at Manipal, may be there are many.
I do have to acknowledge that my previous experience at Manipal has been very good. This pertains to the department of Orthopedics, Pediatrics and Plastic Surgery. Will record them later. We are more motivated to give feedback when we are not happy! This creates an imbalance in the kind of reports we read. For me this gives a hint to the mistrust placed by my friends, relatives on healthcare.
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