Rainy days here again…

Apparently, to have an interesting blog you must never talk about the weather. I remember reading this somewhere and thinking that it would never come up. However, the weather here has been frightful and deserves mention. The winter rains have come with gale force and the West coast has been hammered for the past two weeks with storms. These have been severe enough to cause significant damage as well as compromise our drinking water. For the past ten days we have had to boil our water before drinking it. This is something I have rarely had to do in the past and something which is generally uncommon in this part of the world. It’s so uncommon that I think I, along with most around, were taken by surprise when the boil water advisory was broadcast.

It’s interesting to note the reaction people had to the boil water advisory. In some cases it was like blind panic. People rushed the stores for bottle water and bought as much as they could. Safeway and other grocery stores actually rationed how much bottled water people could buy. For myself, I was more affected by the fact that I couldn’t get a decent cup of coffee in the city for a number of days (In my caffeine saturated state it was dangerous to be cut off so suddenly). The storms will pass shortly and the boil water advisory will no doubt lift, but I think if nothing else the whole experience has been a wake up call. Our complacency has been shaken with how quickly our precious supply of water was compromised.

The next best thing …

I know I should be studying anatomy right now. In fact I’m pretty sure that anything other than surfing the net for the next fad would be considered productive…but the thought remains (and with it the justification) what if I’m right?

I’m predicting, prognosticating and soothsaying that the next big thing is Caloric Restriction Diets.

So what, you’re thinking (did I tell you I can read minds as well?) don’t all diets call for some kind of caloric restriction? Yes, well…perhaps, but the difference is that this diet will lengthen your life. That’s right – not only will you shed those unsightly pounds and inches but also you will double your lifespan! Incredible, no? All you have to do is eat barely enough to survive! Sounds easy doesn’t it… You can see now why I’m so enthralled with finding out more about this next best thing.

For only $10.17 and the cost of shipping Amazon will send you “The Longevity Diet: Discover Calorie Restriction–the Only Proven Way to Slow the Aging Process and Maintain Peak Vitality” in 4 to 6 weeks. If you want to start counting those calories just search for a “calorie calculator” online. Still not convinced? Well perhaps we can look at the evidence.

Let’s start small – let’s start at the simple but noble Saccharomyces cerevisiae, otherwise known as Brewer’s Yeast. If we look at the literature there does seem to be some evidence that the lifespan of yeast can be extended past what one would expect (how long does brewer’s yeast live for?). In fact there seems to be some evidence that the average lifespan of nematodes, fruit flies, mice and now even monkeys can be expanded by simply reducing their daily caloric intake…interesting. Now there are those humans who want to jump on that longevity train and give up all the evil unnecessary calories that are dragging them to an untimely demise. Will it work?

The inner skeptic says no. The truth of it is that aging as a whole isn’t well understood. If you think about it in purely evolutionary terms there really isn’t a need for individuals past their peak reproductive period. In fact there are theories that propose that once we’re past a certain point, those genes that are expressed to help us propagate and spread our genetic material further begin to take on a more detrimental role. Take testosterone for example. Early in life high levels of testosterone are beneficial, but as men age the same hormones can predispose individuals to cancers as well as other diseases. This is a simplification but so is the overall concept of the “longevity” calorie restriction diet. Simply reducing the amount of calories consumed won’t be enough to increase ones lifespan. If you really look hard there are doubters out there (also here), in fact there are papers which suggest that the connection between calories and longevity are more complex than we realize (without a doubt!). So maybe, just maybe, it’s not as well thought out as it appears at first sight. The Longevity Diet (or Caloric Restriction Diet) will be an interesting fad to watch – will it take off in this world where there are now more obese than starving? Hard to say, but I think you know which way I’m leaning.

My second prediction is that mustaches are on the come back as well, but I’ll leave that for another post.

 

 

Student Debt

Here is an older article from the Vancouver Sun detailing student debt and choice of specialty. I have tried to make the same argument myself when debating with friends but have found it to be a weak stance to take. If you think about it, the fastest way to earn a decent salary after med school is not to specialize but rather take the fastest track to earning an income again. That track, in Canada at least, is Family medicine which has a two year residency as opposed to most specialties which have a 4 or 5 year residency. In fact in research done in the states (see article here) it was found that there was no association between the level of debt that the student left school with and the type of choice they made for their residency.

For myself student debt is a definite stress but I know that medicine as a profession pays well regardless of the specialty and with a little prudence it shouldn’t be problematic. Residency is more of a concern. The number of students has increased and the number of residence spots has stayed somewhat static. The competition for the lifestyle tracts (opthalmology, dermatology, etc) is greatly increased and you can see those students even at this point (year 2) kissing some major arse for something that they won’t have to serious think about for another year and a half. The problem for me is that I really don’t know what I want to specialize in yet so I don’t know quite where to focus my time and energy…but back to the point at hand about student debt – It’ll be huge when I leave school but I doubt it’ll actually influence what I eventually specialize in.

William Utermohlen 2000

William Utermohlen 1998

William Utermohlen 1967

Alzheimer’s and William Utermohlen

I have always held a certain fascination with the human mind. I find myself continually surprised at how integral the mind-body connection is and how little I know of brain and behaviour. I enjoy the philosophical side of the field, though I’ll leave those discussions and arguments for those that are far more eloquent than me. I am amazed at the physiological senses that mold our perception of being and most of all at the altered states of realty that result from mental illness. Mechanistically, matching the physical breakdown of cerebral processes with the deterioration of behaviour is hard for me to understand at this level of my education and I find myself immersed in stories related to the fields of Neurology and Psychiatry. I think this is why when I came across the story of William Utermohlen in the New York Times, I was completely engrossed.

The story, as reported in the NYT, is that William Utermohlen was an artist who in 1995 was diagnosed with Alzheimer’s. Alzheimer’s is a progressively degenerative neurological disorder which eventually leads to dementia through the gradual loss of neurons in the cerebral cortex. In essence, the area of the brain responsible for memory dies, and with it there is also a loss of learned skills as well as spatial and temporal disorientation. The disease eventually leads to a host of behavioural changes and motor abnormalities, including complete incontinence.

 

The NYT article states that “when William learned that he had Alzheimer’s disease he began to try and understand it by painting himself.” The paintings which were originally quite detailed and realistic show change to a more abstract form as the disease progressed year to year. The art portrays how William’s sense of space and his ability to translate his world to the canvass gradually begins to slip. It’s hard as an observer not to project a certain sadness on the paintings as one begins to realize how much of the artist’s ability has changed forever and how diminished his world has become. Rarely does one get such a glimpse into the patient’s perspective such as this and it is only through William’s artistic ability that outsiders can experience this sense of loss first hand.

[The original article, "Self-Portraits Chronicle a Descent Into Alzheimer’s",was published in the New York Times on 2006/10/24 by DENISE GRADY]