clinic pt. 3; of mice and of men

A subarachnoid hemorrhage patient came in today, the first I've ever encountered actually. Subarachnoid hemorrhages are bleeds occuring under the second layer, the arachnoid mater, covering the brain. It's funny because you often think that right below your skull is just your brain, shining and glistening, but that's not true, it's protected by three layers:



Skull
-----
Dura mater (tough, leathery)
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Arachnoid mater (thin, webby)
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Pia mater (v. thin, attached to brain)

Subarachnoid hemorrhages are interesting in that when bleeding occurs under this layer, it tends to bleed in a way that covers the whole brain rather than to bleeding just into one area and creating a pool of blood. Postmortem patients that had subarachnoid bleeds have brains that are all red because the layer allows the blood to spread diffusely through the cerebrospinal fluid. Patient had a CT which allows for confirmation of the bleed (CT scans allow blood to show up very clearly as being whiter - a subarachnoid bleed makes the whole brain look blurry), and then came to our unit for an angio just to confirm the source of the bleed. It was an aneurysm, much like this case:



We also had something I haven't seen before, which was a T9 facet joint injection. Basically this means that you stick a needle with a mixture of two medications (Marcaine - an anesthetic that acts on short term, Depo-medrol - a steroid that promotes healing in the long term) into the spaces between injured spinal area. I found it strange that the patient is lying there with a needle sticking out of his back as if he had just been stabbed.



After work, I got to go over to Dr. Kar's lab and shadow one of the research students. Little did I know that this was what I got to witness:



There were a bunch of mice in this cage looking really cute, which is saying a lot because I hate mice or rats or any rodent, really. I go, "Cute!" and she says, "No, don't get attached." She then picks up a mouse and puts it in this jar of anesthetic that promptly knocks it out. Then she pulls it out and stretches it out on its back like in the picture, and pours anesthetic down its throat, just in case. Using a pair of scissors, she slices open the stomach, and its entrails come pouring out. She carefully removes the ovaries, then, quite surgically, snips off the mouse's head.

I was fascinated because dissections are really neat, but at the same time, if it was me holding those scissors, I'm not really even sure I could do it. And even if I did, is that a part of me, morally, that is dying? Even though the mouse is completely anesthetized and probably feels no pain, it still begs the question that there is no real humane way to kill anything. Killing is killing, and I'm not sure where I stand on the issue. Hopefully I won't have to do any mice dissections?

Anyways, she then took the ovaries, put them in a dish, and then carefully opened them up with a scalpel. She removed the tiny mice growing in the ovaries, cut their heads off, then transferred them to another dish. She then cut their heads open to reveal their brains, then took them over to the microscope so she could dissect out the hippocampus in order to do neuronal cell cultures.

What a day.

***

In other news, the sleeper movie of this year, watch it:



Kate Beckinsale, Matt Dillon, David Schwimmer, Angela Bassett in a courtroom thriller about a reporter who has revealed a CIA agent. She opposes the federal court when they ask her to reveal the name of her source, and she refuses, which is essentially treason. As a result, she is jailed.

The movie is slow, but amazing on many levels. There's a speech delivered about 4/5ths through the movie by her attorney that is one of the best speeches I've heard in a movie, ever. There's also the mother of all twist endings that is guaranteed to floor. If you're heading to the rental place and are looking for something, better to watch this, it definitely beats Twilight. I'm so surprised movies like this go straight-to-DVD when they deserve to be on the podium.

Enjoy your long weekend.