Paramedichron #4

Any sufficiently advanced technology is indistinguishable from magic.
- Arthur C. Clarke, "Profiles of The Future", 1961 (Clarke's third law)

I feel like I am attending Hogwarts School of Witchcraft and Wizardry, the boarding school attended by Harry Potter and his friends.  Or, more accurately, I am satisfying the prerequisites necessary just to pass through the huge carved wooden doors.  Either way, the concepts and mechanisms revealed in this abbreviated summer course of Anatomy and Physiology are fantastical and amazing.

Every week, we have a reading assignment and a quiz.  The readings started with a linear march through sequential chapters, but by week three, we are hopping around the thick book, at the fiat of our instructors.  The book is heavily cross-referenced, which serves to make the daunting information slightly less unintelligible.  Getting this information to stick in the network of synapses and neurons between my ears demands a full scale assault on the facts and concepts, with hand drawn diagrams, copious highlighting, and repeated visits to an equally fact-dense website.

We eighteen "anointed" (in the wry words of the venerable Dr. C.) come from a variety of Washington state agencies, with a few lucky extra-state candidates who tested into the South King County Medic One program.   Most us are also on duty in our departments while taking this "online" course.  In round numbers, in addition to the standard forty-hour work schedule, our studies require another forty.  This has caused no small amount of strife between unions, administrations, and Dumbledore.  There is a weekly study session, described by the Paramedic program as optional, consisting of test review and lecture.  That no one voluntarily misses this opportunity for face-to-face contact and clarification from the instructors speaks to the notion of option. 

The Driver, in addition to studying and working, spent the first two weeks in the throes of moving.  He rented out his house for the next year or more, to live in the apartment provided by our Department.  I plan to bivouac in the flat as necessary, making strategic raids on the house in Ballard for domestic and marital reinforcement.  Two other paramedic students will co-habitate with us.

The assignment for week three included obtuse chapters on muscular physiology and the endocrine system. After investing two days in sarcomeres, I found the endocrine material particularly baffling. I was not alone.  During this difficult academic week, the Driver informed me that he had been squandering his days off solving a septic drain field problem at his rental.  In typical fashion, he shrugged it off with a resigned and ambivalent, "Whatever." 

I characterize the endocrine system as similar to the nervous system, but with carrier pigeons, spam email, propaganda, and pixie dust. Run by Kim Jong Il and host of crazy minions.  Of course, I attended the classroom session, but I needed to revisit the taped lecture more than once, annotating my notes in different colors each time.  I took the test Friday, confident that I had most of the arcana and minutia under, at least temporary, control.  Twenty-three questions, and almost nothing on the bulk of my concentrated efforts. 

We are entering a cave, perhaps a long and winding tunnel.  We eighteen are only a few steps into the cavern, and the air is warm, the floor and walls dry.  Ahead, in the murk, I hear dripping water, sloshing sounds, and the occasional scream echoing off the rough stone.  For the next year, it is going to consume our every waking hour, just to get to the end of the tunnel.  Behind me, I can hear birdsong.  The heady fragrances of blossoms and mown grass still swirl in the air, and the bright summer sunlight filters into the gloom.  The backwards pull of security and ease is still palpable.

I have worked towards this once-in-a-lifetime opportunity for years.  I expect to see, learn, and do amazing things.  I have heard tales of suffering and humiliation.  I am excited, but I worry about the unknown.  I have seventeen comrades in this adventure, and A & P is only the first challenge.

Paramedichron #2

If your talk to a dietitian for any length of time about the American Diet, eventually the subject of nutrient density will come up.  The idea is that certain foods are nutrient-poor and that certain other foods are packed with vitamins and minerals.  Your goal, as a health-conscious American human, should be to maximize the nutrition of the foods you eat.  Sounds obvious.

Unfortunately, many of the toothsome items that we expect to be part of our day-to-day diet are packed with nothing but calories.  Evidently, you can apply the "yummy test" to any foodstuff, and if you really, really like it, it should probably be hidden on the top shelf, out of reach, out of view, or - better yet - left on the shelf at the grocery store.

Take, for instance, a cookie...  A delightful little nugget, consisting of sugar, simple carbohydrates, and fat, it offers little in the way of nutrition - even if packed with oatmeal, raisins, and nuts. It's a calorie bomb, specifically designed to tickle discreet receptors in our mouth and brain that respond to easy energy, a remnant of our hunter-gatherer origins. 

Once upon a time, buying groceries was extremely hard work.  Someone, probably the womenfolk, would have to traipse across the savanna, poking at the landscape, scratching in the soil, rattling the bushes, to fill the larder.  The menfolk, meanwhile, took part in ritual hunts that occasionally resulted in meat over a fire, but provided ample grist for tales of the One-That-Got-Away. 

Survival was hard, but evolution was kind, in time, to the early peoples who developed a taste for the sparse sugar or fat-laden "cookies" of the day.  Perhaps fruits, avocados, or rich fatty meats constituted the fortuitous treats to be had.  Regardless, our bodies evolved a mechanism that rewards calorie-dense consumption with a tiny chemical neurologic prize. Eat something sweet or rich, and you feel inexplicably good, even happy

I bring all this dubious anthropology up because I am suddenly immersed in studying Anatomy and Physiology.  The foundation of pending weeks of scholarship will be my understanding of basic biochemistry and microbiology.  I studied geology and chemistry in college, but I only have a sixth-grade biology education, which I dredge up from decades-old synaptic memories.  I am amazed that I remember anything, and, more amazing, is that what I remember is still relevant. 

The text I am reading, highlighting, and transcribing as notes, is nutrient-dense.  The information packed in its pages is the culmination of hundreds of years of scientific inquiry, and absolutely up-to-date. It is broccoli printed, bound, and delivered to my hands, and ultimately my brain. There is so much information on any given page that I frequently read it several times, before selecting the key facts that I will endeavor to commit to memory. I duplicate important diagrams and images, in the hope that recreating it will burn it into the fabric of my cerebellum. 

I am chewing, chewing, chewing, digesting the information with my note-taking hand, but the information is so mind-boggling, so arresting in its awesomeness, that I can't help but feel a tiny little tickle in my cortex, an electrochemical reward for understanding even a thin slice of our biological mechanics.  If I were a religious person, I would classify the feeling I get as reverent. As it is, the more I understand about the minutia of cellular biochemistry, the more dumbfounded I am. 

Life is amazing; learning is hard.