The story of Yue Yue has outraged China and the world. In a prosperous city in Southern China, two-year old Yue Yue was crossing the street when she was hit by a van. The driver stopped, realized he had hit a child, and then drove on, running her body over a second time with his rear wheels. Over the next six minutes, a full 18 passersby notice her writhing on the ground but do nothing. A second truck runs over her legs. She becomes increasingly motionless, until eventually an older garbage collector woman comes along and calls for help. Yue Yue died at the hospital.

The incident has sparked a huge national debate about the condition of the Chinese moral spirit. While I have my own opinions about that, I don’t want to point specifically to Chinese morality. I remember the first time I heard about Kitty Genovese in AP Psych class, and how a dozen witnesses heard her cries for help as she was stabbed and raped to death.

The lack of compassion for others was what drove me into medicine, and in particular, the study of infectious disease. In my freshman year of college, I could barely keep my heart from pouring out my body as I watched the ostracization of HIV+ children in China as documented in “The blood of Yingzhou district”.  People affected by infectious diseases suffer a double-edged sword of physical and social consequences; no one wants to associate with a sick person who either committed a supposedly immoral act or can transmit the disease to others. I wanted to become a doctor who could provide those affected by a stigmatized illness the compassion and care they needed.

As it was the social impacts of disease that first attracted me to medicine, so too do I increasingly realize that the solution must lie in the social, not medical realm. Medicine can treat or cure, but only a shift in mindset can address the root causes. People need a new moral mindset that does not disparage these individuals in the first place. Thinking these thoughts as I study detailed and obscure anatomy only serves to depress me.

I want to share an excerpt from the foreword to one of Lu Xun’s books, A Call to Arms. Lu Xun is one of the most (if not the most) celebrated writer of modern Chinese literature, who rejected traditional Chinese culture as morally corrupt, and wrote in order to “awaken” the Chinese people. In fact, he was originally a medical student but discarded that profession in favor of literature. He writes…

 

These inklings took me to a provincial medical college in Japan. I dreamed a beautiful dream that on my return to China I would cure patients like my father, who had been wrongly treated, while if war broke out I would serve as an army doctor, at the same time strengthening my countrymen’s faith in reformation.

I do not know what advanced methods are now used to reach microbiology, but at that time lantern slides were used to show the microbes; and if the lecture ended early, the instructor might show slides of natural scenery or news to fill up the time. This was during the Russo-Japanese War, so there were many war films, and I had to join in the clapping and cheering in the lecture hall along with the other students. It was a long time since I had seen any compatriots, but one day I saw a film showing some Chinese, one of whom was bound, while many others stood around him. They were all strong fellows but appeared completely apathetic. According to the commentary, the one with his hands bound was a spy working for the Russians, who was to have his head cut off by the Japanese military as a warning to others, while the Chinese beside him had come to enjoy the spectacle.

Before the term was over I had left for Tokyo, because after this film I felt that medical science was not so important after all. The people of a weak and backward country, however strong and healthy they may be, can only serve to be made examples of, or to witness such futile spectacles; and it doesn’t really matter how many of them die of illness. The most important thing, therefore, was to change their spirit, and since at that time I felt that literature was the best means to this end, I determined to promote a literary movement.

Lu Xun, I need your genius mind, bold spirit, and big courage. The full foreword can be found here.

I used up my one allotted dumb question in med school today.

A family of patients with myotonia came to speak to us today. They have a problem with muscle relaxation and occasionally freeze up after using their muscles. The son described playing ultimate frisbee and being unable to let go of the disc. The baby girl cries with her eyes closed because she can’t relax the muscles in her eyelids. The mother is afraid to drive because her foot could get stuck and unable to brake. We watched as the squeezed their hands in a fist around a bar and struggled to let go. Interestingly, the condition worsens in the cold but improves with muscle use.

The disorder is inherited in an autosomal dominant fashion. Autosomal simply means not sex-inherited, that is, the gene does not lie on the X chromosome. Dominant means that one copy of the gene (we have two copies of every gene) is enough to cause the disease symptoms.

The family tree looked something like this:

You can see that there is someone with myotonia in every generation. Now, I was confused and asked why were there some children who did not have the disease even though their parents did. 

So, pretty much any high school or even middle school student with basic biology course can tell you the answer: Each diseased person has one disease gene and one normal gene. Thus, 50% of their children will receive the disease gene and 50% will not.

And here I am, with my biology undergraduate major and medical education asking a stupid question like that. We took our genetics final only two weeks ago and I passed with a 94%. I’m embarrassed to even go to class. I deserve to be kicked out of med school.

So yeah. No more stupid questions from me.

5/4/2

Now that I’ve finished my first round of exams, I can finally post the answers to the slides!

 

Collagen fibrils (thick blurry pink lines), elastic fibers (darker thin lines), fribroblast cells (nucleus visible only)

 

 

 

skeletal muscle

Cross section of ureter. Inner lumen can expand to accomodate urine. 

Mast cell (part of the immune system). The black circles are vesicles containing cytokines for immune and allergy response, such as histamine and heparin.

Tight junctions neatly arranged in hexagonal shape. Each “petal” of the flower is a connexon. Six connexons make a “flower” or tight junction.

Another view of the tight junctions. 

Fat cells. The intercellular space is stained and the inside is white because it is full of fat. 

Chondrocytes, the cells that make cartilage. Kinda looks like the Turkish Eye that protects your from evil.

This one reminds me of a time lapse of the highway, but it is actually bone.

Connective tissue with collagen (thick orange) and elastin (dark thin lines)

Loose woven bone (that is, immature bone. Your body makes this kind of bone when you fracture it, and then later makes stronger bone over it.)

This is part of a growing bone where the cartilaginous growth plate meets the bone. This process is called “endochondral ossification”, or the laying of bone over a cartilage template. This process continues until you stop growing at puberty.

Osteocytes in lacuna. Osteocytes are the cells that make bone, and they carve out specific spots, or lacunae, within the bone material, or matrix. The vertical lines coming out of each osteocyte are canaliculi, which connect osteocytes to each other via gap junctions and allow them to transport materials and signal to one another.

More bone tissue, this time showing a cross section. The circles are called “osteons”, which are a unit of bone matrix laid down circumferentially around an artery, vein, or nerve fiber. Again, you can see the osteocytes.

So anyone get them right?

P.S. I am not a doctor.. yet. Anything I say here should not be used as an authoritative reference and should most definitely not be used as medical advice.

My first exams are coming up in two days. Looking through histology slides at 1AM in the morning ultimately means that I end up thinking less about the science and more about the “oooh… how pretty..”

I definitely want these as a poster print on my wall or even as the print on my dress. Ten points if you can guess what these are (I’ll reveal the answers in two days while either celebrating the end of exams or moping about how poorly I did).

This one reminds me of a area time-lapse photo of a highway…