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Author: rshunter2 Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 892  
Subject: OT: What are they teaching kids these days? Date: 11/12/2002 6:50 PM
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(This is an amputation, originally begun as a response to Ladyandy's #281. I caught myself going off the deeo end this time.)


Right you are, RSH... thank you for the correction. That's what I get for typing off the top of my head. :)

Don't feel too bad about the boo boo, first of all, PABA is related to UV, too, just as one of the UV filtering agents, not as a photosensitizer. It took me a while staring at it to connect with "hey, wait a minute, she must mean psoralen".

I'm disappointed that nothing much new seems to be going on with psoriasis and excema; of course I'm not on every board in TMF dealing with medicine, I ought to add more than I have, and maybe a lot's gone on. But that's one reason I buy the PDR every year and read up on every new drug, first, and then go through it from Abbott to Zeneca. It's something I've done pretty much since maybe junior high school. And I read my stepfather's pharmacology textbook, the classic one, Goodman & Gillman or whatever, till it fell apart practically (they got divorced in time, fortunate for both the book, and my mother).

I really shudder to think what they are teaching med students and nurses and pre-meds these days, and what kind of a background they come out of it in chemistry, organic chemistry, biochemistry, pharmacology, clinical pharmacy, toxicology, and physiology / pharmacokinetics.

Well, I shudder to think it's gotten worse, but it seems, for example in the 20 years between when my mother became an RN and I began tutoring Nursing students (which later inspired the teaching software I co-authored with an MD at UIMC, and unreasonably, the publishing credits list my name first; ironically, Tim wrote the driver software, and I rewrote and selected and entered new content), chem and pharmacology went way down from the level my mother was put through.
This isn't judging from the students; early on I said something subtle like "Gimme ALL your textbooks, I wanna see what's going on here".

I was very disappointed. Either the University of Pennsylvania School of Nursing in the '50's was far more stringent than Rutgers/Cooper (this was before UMDNJ/RWJ was created out of unbelievable grants from the RWJ Foundation; now they have to have a subtitle "The Medical School of Rutgers University", or something like that) was in 1976, or the bar was lowered generally.

Granted, medicine has changed and better always be changing, hopefully for the better. But I remember somebody laughing at me about antistatic / explosion precautions for the OR, oh I remember, it was an anaesthesiologist friend, "Oh we don't use any of that stuff anymore, you old fossil" (coming from someone older than I by 10-15 years, I took it as a joke); rather a bit of a pompous ass, actually.

And, also, wrong. There was an ER episode (yeah, be patient) where a wound area was being anaesthetized with ethyl chloride while somebody who knew no better turned on a cautery unit (well apparently neither knew better) and there was a bit of fire and explosion going on. The last few times I've been in ER's, I've noticed the lack of "NO FLAMMABLE ANAESTEHICS PERMITTED" signs; there was another episode, on the edge of totally bizarre and unbelievable, where pharmacy techs were making methamphetamine in the hospital pharmacy/formulary, as a hobby, I guess, and used IV bags to store one of the intermediates, or the reagents, and horribly, one of those got loose and was about to be used for irrigation, but the patient put out his cigarette [after the nurse screamed at him] in the kidney pan where some of the stuff had dripped into at about the moment the nurse exclaimed "what IS this stuff? there's something wrong with this bag". (Ah, drama.)

Tremendous explosion. I presume irrigation had not yet commenced. But the fire was made more furious by broken O2 lines blasting pure oxygen into the zone. Now, really, doesn't everyone know where the shutoffs are for what used to be O2, vacuum, N2O? Or at least for O2 (some panels didn't shut off everything.) Part A of the story was incredible enough without Part B. I even knew where they all were in every hospital I've been in, well not ALL, but the areas I was in. Part B2 is, any decent fire/disaster protection system for a hospital setting ought to cut off O2 and N20 in the area where fire sensors tripped. If that isn't an NFPA requirement by now, I'd be shocked.

Perhaps it's part of my defense / disaster mentality, but I do worry about something unthinkable happening that destroys the infrastructure and technical people (that lumps whatever I am along with medical and other sciences) are thrown back a century or more in terms of resources.

I'd also love a question thrown into the exams like "If a major catastrophe occurred, and you had the opportunity to loot a pharmacy to support people you were caring for, what would you take, and in what priority and by what reasoning?"

I still think it important that, say, bromides were used as sedatives and as the first antiepileptics, be known. And the roots of the various therapeutics be known, from aspirin to chloral hydrate to foxglove leaves to nightshade, chinchona bark, and the like.

Even in more normal settings, if the perfect drug isn't obtainable, the 2nd, 3rd, and 4th best choices ought to be immediately known.

RSH.
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