Adenovirus.

It's high flu season. And I've gotten some foreboding reports.

First of all, I caught a wicked good flu last weekend. And not just a rhinovirus, a real honest-to-God hates-your-guts influenza. Rocked me right in the face. For folks who don't know, most people who say they have the flu don't actually have the flu. They've got a rhino, a corona, or some other virus that makes you feel crappy, and you might go home or you might soldier through work after all. The flu ain't like that. Influenza gives you body aches and intense malaise - you just can't do anything. You sit around hurting for at least a couple days with a brain that feels like marshmallow fluff. You'll probably get pretty dehydrated, what with the fevers. Lord knows I did. My girlfriend said my lips were the color of my even-paler-than-normal face. And then she went and got me a pile of Gatorade and made me some soup - she's pretty awesome like that.

But it was also good on her account because (surprise!) she came down with the exact same thing while I was convalescing. We chowed down on some good wonton soup and lo mein that night (surprisingly good sick food...)

Long story short: you remember the flu. It does not play around.

Now, even though we got knocked flat on our butts with the flu, it wasn't anywhere close to killing us. But there are some people whom it does kill, chiefly the very young, the elderly, and people with weak immune systems - 36,000 a year in America alone. To make the obligatory bizarre comparison: HIV kills around 20,000 people every year in the USA (according to the CDC.) Eh?

Perhaps the plural of "anecdote" isn't "evidence"... but everyone I know seems to have gotten laid out by the flu. And now I hear that my girlfriend's old alma mater is closing up for a little while because too many students and faculty have gotten too sick. Keep in mind that the flu shot didn't work this year*, another nasty thing about adenovirus - sometimes it moves too fast genetically for our vaccines to keep up.

Maybe my concern also has something to do with having watched "Children of Men" recently, a premise of which is that the world went to hell after the flu pandemic of 2008.

Wash your hands and cough into your elbows. The fertility of the human race is depending on you.



*Makes me feel like less of a dumbass for being the asthmatic on steroids who "just didn't get" a flu shot. Only a little less.

It's virus season

[Written sometime in the fall, remembered just the other day.]

As third-year medical students, we spend our fall and spring semesters rotating through various medical specialties - surgery, medicine, pediatrics, OB/GYN, psychiatry, family medicine, etc. - so we can have some small clue as to what we want to practice. Currently, I'm on pediatrics, and I love it for the most part. I was small-talking with the NP I'm working with this week, and we got to wondering why Thanksgiving is so close to Christmas. I'm beginning to think it's because of this little booger:

I hate viruses and rhinovirus tops my list. It's rhino and RSV season here, and if Thanksgiving and Christmas were farther apart it would be depressing. I picked up a little somethin' somethin' from the kiddies last week and it's really rocking my world. That's the joy of pediatrics - getting innoculated with the latest respiratory viruses. Then, you're immune for the rest of the year. I guess that's one of the joys of pediatrics. Long story short, I've been pretty miserable. It started Sunday night, and has only gathered speed since then. Maybe the fact that I got up at 0400 Monday morning to come back to my rotation didn't help, but that wasn't entirely my fault what with the first slush/snow hitting us on Sunday night and 70-something miles of highway separating my home apartment and the hospital where I'm rotating. Monday was bad, but not so bad until the evening when the fever started. I slept ten hours into Tuesday and felt worse, and only made it through the morning thanks to a fellow med student's gift of cough medicine - and even still, I just couldn't focus. Brain was all fuzzy. In the afternoon I slugged some cough syrup to no avail. My NP looked at me and said "Go home - we won't tattle on you."

Any other med school, and I don't think that simple reassurance would have meant so much. But at my institution (which shall remain unnamed) it means something. If my course directors got word of my skipping out this afternoon, I'd have associate deans leaping down my throat in a heartbeat. It's just not the sort of thing that is tolerated, even if I'm febrile and have my hands full just not infecting my patients with whatever lovely bug I've contracted.

Mind you, this is the same institution that sent not one, not two, but four emails in two weeks to the students - CC'd to the course directors - explaining that the day after Thanksgiving is not a holiday. And scheduled lectures for that Friday afternoon. And, scheduled them at 1400 so that we could return to our clerkship site the day after Thanksgiving, work the morning, then drive back to our home institution for those aforementioned lectures. Thankfully, my clerkship site told us that we have no clinical responsibilities for the day after Thanksgiving and put it in writing. I just have the misfortune of having lectures that Friday. But for my unluckier classmates, it means they're stuck here for that day, and if the folks aren't close by, they don't get to see their families until Christmas. Better figure out how to make a turkey on your own.

I know that I'm a fortunate son with a silver spoon in my mouth, and I'm extremely fortunate to be in med school at all. But in all reality, physicians get sick, physicians visit their families on Thanksgiving, and physicians are able to plan this all in advance. And, while I'm not a physician yet, I'm paying out the nose for all this. I graduated from college with a degree in biomedical engineering, and gave up the promise of a career in that field to enter medical school. Here's a comparison of my financial status now to what it could have been:

For $50,000 into the red every year, I'd like a little more input into my holiday schedule. What's more: while physicians are handsomely paid, the average doctor's salary isn't enough to compensate for the lost investment time in which they're A. accruing a towering pile of debt, or B. paying off their loans. If you go to college, get a good job once you get out, and manage your money well, you actually do better than the average doctor in the long run. Don't even get me started on plumbers. You could say that people who go into medicine just for the money either don't understand finance, or are brilliant and will do interventional radio or plastics and will be millionaires some day. Neither of which is me. So why shouldn't I be an engineer? The money's better, the hours are great.

Or hell, why not be a Marine? Boot camp only lasts three months, and you certainly don't pay for it. I've taken to wondering what that would be like, since so much of med school seems like mental retraining.

The second stage of boot camp includes an exercise called "the crucible."

The crucible is the culmination of everything a basic rifleman Marine should know. It is three days of constant strenuous testing, humping, hardship, punishment, and starvation. The recruit is given two field stripped MRE's (Meaning all thats left is the main meal and side meals, taking away any candy, condiments, and such), and this is meant to supply them for the next three days. Worthy of note, is that while some recruits have food to spare at the end of this ordeal, others consume their rations quickly, and when they become hungry, other recruits aid their fellows, some even giving their last bit of food to another. This is one of the goals of the crucible: to train marines to look out for one another. This also distinguishes leaders among the recruits, something the Drill Instructors look for in their platoons. The crucible consists of certain challenges for the recruits, broken into platoons, to accomplish as a whole, or failed as a whole. One single recruit completing an obstacle means almost nothing. If anyone fails, it means that those that completed it failed to aid their fellow recruit in the accomplishment of their given mission.
source

Maybe we don't have MRE's, but we do have acetaminophen and guiafenesin.