A Theory of Justice

Pulmonary block was fascinating and still manageable, a good combination. It really eased us back in after break. Most of the concepts having to do with the lung are somewhat intuitive, and though equations can get a little intimidating, as a whole, it's a pretty simple organ. I did learn a good deal from the block though. I feel a little more confident reading chest X-rays; though I still have some sort of veil of ignorance regarding most of radiology, I think I'm making progress in deciphering scans.

One of the interesting aspects of pulmonary medicine is occupational and environmental exposures. I hadn't really put that much thought into these diseases. For example, one can get hypersensitivity pneumonitis from the strangest things: avian proteins ("Bird Breeder's Lung"), mold ("Farmer's Lung"), aspergillus ("Malt Worker's Lung"), mycobacterium ("Hot Tub Lung"). It's strange how many different everyday exposures could cause lung damage in those that are susceptible to the antigen. Everyone knows about asbestos, but who would have thought beryllium could cause a disease looking like sarcoidosis?

We also had several physiology labs and a patient simulator lab. The physiology labs were pretty easy; we looked at the volumes of normal breathing, the gases in expired air, and the effect of breathing in lots of CO2 or little O2. And while a lot of people dislike the patient simulator (since it takes a while to get to San Francisco General Hospital), I enjoyed it. I like applying what I know to a (somewhat) real patient.

We also touched a little upon tuberculosis, an international health problem. I was shocked to find out nearly 1/3 of the world's population is infected with TB. Nearly all only have latent TB, but 10% of those with latent TB will progress to active TB, with greatly increasing rates in the immunocompromised. I just think that learning about international diseases is extremely important since the "ecology" of diseases outside the U.S. differs so much from that of the U.S.

In any case, we just finished the pulmonary section of Organs block. Renal is next. As a side note, the title of this blog and the "veil of ignorance" (first paragraph) refer to American philosopher John Rawls. Rales (which can be pronounced "rawls") are lung crackles that you hear on auscultation if there is fluid in the alveoli. I apologize for the pun.