Really nothing much happened last week. That’s my main excuse for not saying anything interesting. We finally, after several months of attempting to arrange it, got a muscle biopsy from a pretty feeble old man. The expert informed my preceptor, via a personal telephone call, that it was definitely dermatomyositis, and then chewed him out for not recognizing and treating it earlier. My poor preceptor was a little dumbfounded, since the man had none of the classic signs of dermatomyositis (Gottron’s papules on the hands, the shawl rash on the shoulders, or heliotrope rash under the eyes). He did look like polymyositis, which is dermatomyositis without the rashes. The expert also stated that IV immunoglobulin (iv ig) is the treatment of choice, based on a report issued last week. My preceptor swallowed this one also, putting aside his own preference for the much simpler method of plasmapheresis, for the recommendation of the expert, who was no doubt involved in writing the report. He then assigned me to look up the possible side effects, then looked them up himself, and read them to me. I hope he’s not expecting me to produce an article on the topic, or anything, since I definitely didn’t do any schoolwork this weekend.

Saturday I took two of my sisters and some friends skiing. We had a good time, but somebody please remind me not to volunteer myself as a ski instructor again? Towards the end of the day, the nine-year-old boy observed that he would like to do this again soon. I said it was a good idea, in order not to forget too much, but he should get his parents to pay for a proper ski lesson next time. He said that he didn’t see any need for that, since I was doing just fine, without getting paid! But he was so polite when he knew what he was talking about, and so good-tempered about falling off his skis twice for every one run, that it was impossible to resent his ideas. It was probably just as well that I thus spent most of my time on the green slopes, because the second time I tried to go down a black, a snowboarder rolled over in front of me, and of course then I went rolling too, and said rude things to him, which really he didn’t deserve.

Last week I did get the two best compliments I’ve ever been given, and neither of them had to do with medicine. A group of us were supposed to have an ethics discussion, led by the ethics professor, my acquaintance from the first two years. She heard me discussing with a liberal Catholic friend the recent execution in California, and exclaimed “Alice, you support the death penalty? I can’t believe it! I mean, I always thought you were a committed Christian, so how can you possibly support the death penalty?” In front of all the other students, of course. I was terribly pleased that she said that about me being a Christian, since I have sometimes wondered whether I make it plain enough, although also frustrated that for all our discussions, she doesn’t yet realize the logic behind my statements. I mean, I know she’s a liberal humanistic unitarian-type “all religions are good” philosopher, so I can tell what she will think about every ethical question we’ve covered, but she’s always surprised by what I think are straightforward, consistent if apparently extreme, biblical interpretations. So after the class I told her about Cain and Abel, figuring she would be too horrified by the idea of enforcing almost all of Mosaic law. Her response was “but what about human rights?” I did allow that the US justice system misfires a good deal, and does not by any means meet the Mosaic standard of evidence; not that this invalidates the concept of the death penalty. For example, I think Scott Peterson’s conviction was a terrible miscarriage of justice. From what I heard, there was no direct evidence linking him to the deaths. They disappeared into this place, and he was seen in the area at a workable time; that was all. No eyewitnesses, no footprints or fingerprints or DNA or anything. I’m not asking for CSI-style brilliance; but circumstantial evidence does not meet the requirement of “in the mouth of two or three witnesses.”

Then, on Friday, my preceptor mentioned that he used to be on the admissions committee of my school. Students are always fascinated by the inner workings of the committees which control their destinies; not to mention that I still have to deal with residency admissions. So I encouraged him to reminisce about it. He explained that he is biased in favor of students who have a lot of extracurricular activities, especially sports, whereas some other people were biased in favor of the best GPAs. Another lady, he said, was the first female doctor in the area, and she strenuously opposes pro-life people. I said, “She can’t manage to stop all of them, because I got in, and I think I made it pretty clear in my interview that I was pro-life.” (More than clear; most of the interview was an argument about pro-life and creationism, and how can you possibly believe all that and be a doctor; I think now he was just being the “bad cop” side of the interview.) He said, “Oh, I knew that; in fact, that’s pretty well known about you.” So I was flattered. Here I didn’t know him till a few weeks ago, and he and apparently a good deal more of the powers in the school know about me and prolife, and whatever else I’ve argued about.

Advertisements